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Role of Motivation Factors in Increasing The Individual Productivity of The Workers : A Case Study of Indo us Super Specialty Hospital, Hyderabad, India

University : University of Chester
Module Title: Management Research Project
Module Code: BU7001

Title of project: To study the motivation factors that increase productivity per person working in the heart care institute at Indo US super specialty hospital, Hyderabad India

Brief description of project :

Overall aim of research: 

  1. To identify how human asset will increase the value of organization. 
  2. What factors drive them to contribute better for their organization?
  3. Identify gaps between performers and non performers with in specific departments and highlight areas of improvement.


Proposed research method(s):      

Indo Us Super specialty hospital vision is to treat high-end cardiac   procedures and surgeries utilizing the latest technology medical equipment’s at an affordable price to patient.

Medical Specialties in INDO US Hospital Ameerpet Hyderabad India are primarily Cardiology, Cardio Thoracic surgery, Gastroenterology, General and family medicine, Interventional Radiology, Laparoscopic surgery, Nephrology, Orthopedics and Pulmonology. 


A detailed questionnaire will be sent to the respective mail ids of nearly 100 staff working in various departments with in Indo Us hospital excluding (doctors, visiting consultants, middle and top management executives).  

Indo Us hospitals is well connected with computer system at every department and staff have access to these systems and institution have assignment individual with official mail Id. 

Management have approved this project and there will not be any issues in collecting required data from individual. Supervisor`s of respective departments like Out patient services, Front office, security services, ambulance services, in patients service department, food & canteen services, biomedical department, quality services, pharmacy services & paramedics will be connected thru voice calls for further evaluation on proposed project with relevant questionnaire pertaining to our research aim.  


Based on responses received from individuals on checklist will apply analysis both qualitative and quantitative and highlight out come of this research.


Introduction: 

Telangana is state in southern part of India which is 29th stated of India(Deepti, 2017) officially declared on 2nd  June 2014 with population of about 35million considered as medical tourism hub. Good network of hospitals, professional doctors and paramedics are availability 24x7 and Government is encouraging with convenient facility for international patients for smooth pre and post discharge formalities. (Melly, 2017).


Indo US Hospital established in the year 2012 which is 100 bedded hospital by famous cardiothoracic surgeon Dr Dasari Prasad Rao who was first person in state to perform Coronary Artery Bye Pass grafting in the year 1985 at Nizams institute of medical sciences and Dr K Sarat Chandra eminent interventional cardiologist promoter of this prestigious institution. Dr Prasad Rao trained many students to perform Open heart surgeries, Radial Artery grafting in coronary bypass, beating heart surgery, left ventricular assist devices, heart transplantations.  Government of India under the ministry of home affairs designated Dr Dasari Prasad Rao with Padma shri award (2001), which is civilian ward for distinguished services in the field of medicine and service to general public. Indian government will give these awards once in a year on the even of Republic day(Padma awards, 2017). 


Indo Us Super specialty hospital vision is to treat high-end cardiac   procedures and surgeries utilizing the latest technology medical equipment’s at an affordable price to patient.

Medical Specialties in INDO US Hospital Ameerpet Hyderabad India are primarily Cardiology, Cardio Thoracic surgery, Gastroenterology, General and family medicine, Interventional Radiology, Laparoscopic surgery, Nephrology, Orthopedics and Pulmonology. 


Sharp/critical Literature review:


Major functional areas inside the hospital who support the proper functions and uninterrupted patient care services are mainly Nursing services, allied health services, Pathlab services, Diagnostics services like non – invasive labs, clinical support services (like pharmacy, out patient services, Administrative services, Non Medical staff who run hospital on day- day works of infrastructure facilities, house keeping services, Finance department (which act as brain behind smooth functions of hospital for timely payments and collection from credit departments),Medical record sections, Human resources Department (the main link among all functional areas).  A well-defined coordination among all departments with in hospitals at every stage results better care and positive outcome (Junwen, Jing, Kathy &Kay. 2016). 


This study objective is to identify few individuals working in their respective departments who out perform their job responsibilities, the driving force behind their dedication towards organization vision and mission, Job satisfaction among medical and non medical staff. Identify the gaps between performers and non-performers to suggest Human resources department on action plan for better productivity.


Employees working on permanent pay rolls of this institute are focused on motivation factors in their respective roles and responsibilities (Marlene. Page6 2012) and reasons for selecting this institution is 

  1. It is in vicinity 4 leading super specialty 500-bedded hospitals.
  2. Total number of percutaneous coronary interventions and Coronary artery bypass graft surgeries are on par with other hospitals. 
  3. Indo Us staff members are less than other institutions in this region.


Participants in this study are close to 100 working staff in medical and non medical excluding professional doctors. 

To study the motivation factors among individuals, to understand their behavior, determination to accomplish corporate mission, analyze their competent levels. Researchers pointed out that motivated employees contribute better that leads to better productivity (Pratyay & Debalina. Page 59, 2013).

As mentioned (Raymond.1995) economists believes that productivity is directly proportionate to the stand of individuals or organizations, by understanding the issues thoroughly and implementing course corrections with in job related functions results will be higher out put for organization. There are many un answered questions when it’s related to issues at healthcare.

The main role of hospital is linking the human asset with the process in organization by providing key roles and responsibilities attached with reward system. HRM should encourage and invest in continuous training that ensures upgrading skills levels resulting higher returns for organization. (Muhammad &Majid. 2017)

Courtesy @ Boxall and Purcell(2003) they have formulated very interesting theory i.e. AMO formula that explains that the contribution of employee is sum of their Ability added with Motivation and Opportunity(chance to perform better). This formulae accelerates the employee interest for their job responsibilities, elevates interest levels, enhance better performance in addition to motivation.

This study is identify the hidden factors that drives the motivation what we see in a motivated team or staff is just tip of ice berg(Muzio, 2010) and impact of factors associated with it.(Dan. 2013)


Methodology and Methods

  1. Framework: This study is prospective & cross sectional study(John, hafiz, Roberts & David. 2007) and involving a mixed method research (Saunders, Lewis & Thornhill.2017) both quantitative and qualitative study covering several department personnel with in organization to identify visible as well as hidden factor motivation and job satisfaction.  This study design is mostly descriptive and end result will be combination both primary as well as secondary collection. Inclusion criteria are all 100 permanent working medical and non- medical staff with in organization and excluding criteria will be professional doctors, contract workers from third party (temporary workers) and employees who are not interested to be part of this study.
  2. Data collection will be in different modes.
    1.  As a first step details of all employees will be collected from HRD department as this study got approval from management.Detailed questionnaires will be sent to their respective official mail ID along with a draft of subject. A follow up call or mail to confirm the receipt of this mail will be conducted. Will request management to circulate internally through interoffice memo to all department heads for cooperation towards this objective. 
    2. Lead time for their responses will be about 3 weeks for the initial questionnaire’s i.e based on factors affecting jon satisfaction and on core competencies of individuals
    3. A detailed interview will be as second step to understand and collect more information and choice of their rating rather than summary.

           While preparing final draft for interviews it is recommended to do proper checklist of questions which are relevant to research topic.(Judith 2005)  and a choice of rating should be provided on a scale of 1 to 10. 1 being disagreement and 10 is outstanding or excellent.


  1. Data analysis : This mixed utilizes quantitative and qualitative research methods combined in a single arm. As elaborated well (Tasahakkori & Cresswell. 2007) where in the acquired data will be sorted according to the predetermined questions and conclusion based on final results utilizing both qualitative and quantitative research types. Single study in which two methods will give enough information on the study objectives as commented (David & Kofi. 2015).


  1. Methodology of data analysis
    1. Collected datawill be in form of numerical and words will be summarized  all numeric will be analyzed using Microsoft EXCEL in different chat format for ease of understanding that include column, line bar, area, scatter and doughnut so as to understand and interpret the out comes easily.
    2. A summary of data obtained by conducted interview will be summarized utilizing both qualitative and quantitative data.
  2. Ethical committee approval: Researchers should obtain ethical committee approval before the begging of project. No force or pressure should be directed on the participant for required information it should be a voluntary by participant (Neuman. 2014). Informed consent form if required can be even in regional languages for effective collection required data. 
  3. Risks associated in this.
    1. If top performer drops out of this study the end result will be statically not significant
    2. Subjects may give different answers for same question that leads to inappropriate impression
    1. It may be difficult to collect data from all 100 participants as there will drop outs due to (Leave from duties, out of station activities)

Answer

Abstract

Employee motivation in relation to optimizing organizational profit has been subjected to argument among several researchers. In the sector of healthcare service, it has been seen that the organizational structure differs from developed countries to developing countries. However, the profession of providing medical care demands dedication and the health workers are subjected to long working hours and toilsome working schedule. This study attempts to explore the role of motivation in the higher productivity of the healthcare services. According to several scientists motivation is the prior need of the workers of health care sector. This study is hence, designed to evaluate the relation between motivation factors and the individual productivity of the human capital of an organization, if there is any relation. The issue of the research that is Role of motivation factors in increasing the individual productivity of the workers has been scrutinized through the origin and evolution of related studies. Along with that the issue has been researched prior to a case study of indo us super speciality hospital, Hyderabad, India. 

The results and discussion of the study is based upon the responses that have been collected through a survey conducted with a sample size of 100 workers excluding the doctors and the external medical support of the hospital. The study attempts to provide necessary information regarding the impact of motivation on the higher productivity prior to the identification of the motivational factors. 


Acknowledgement

Conducting this research was not been possible without the help and support of my educational guides especially my professors who guided me through the study. I am obligated to my fellow classmates for helping me to complete my study successfully. In the like manner I appreciate the toil and support that my educational director has provided me that worked as the major driving for successful commencement of the study. I acknowledge and appreciate the behaviour of the worker of INDO US SUPER SPECIALITY HOSPITAL for supporting me and helping me in obtaining the necessary information for commencing the study. Lastly, I would like to acknowledge the constant effort and support of my family and friends in the course of the study. 


Chapter 1: Introduction

The introductory chapter of this dissertation sheds light on the moot perspectives that are to be evaluated in the course of the work. The rationale of the study is framed upon the background study conducted prior to the selection of the topic. Based on the issue of the research and the study on the issue the aims and objectives of the research are established in this introductory chapter. Research questions are formed in this chapter in order to conduct necessary research in answering them in the course of the dissertation. Considering the research questions along with the aims and objectives of the research hypothesis of the study has been built in this chapter. The chapter also sheds light on the importance of the study and helps in understanding the relevance of the study at contemporary times. Providing the methodological overview of the research in a nutshell, this chapter also presents the framework of the complete structure of the dissertation.


Background of the study

In the past few decades, scientists and behavioural sciences experts have been intrigued by the impact of human motivation in influencing the individual productivity of the workers. The experts have applied several motivational theories that are developed in the last century in order to understand the link between motivation and job satisfaction and the productivity of the employees. Motivation and leadership styles based on the personal characteristics are some of the factors that are believed to have impact over the individual productivity of the subordinates in a particular organization. The established belief that natural tendency of man is to be lazy regarding the work and mostly men are forced or imposed through several circumstances to work, has created development process of the society because it results in low productivity. Low productivity is one of the moot concerns of developing countries like India ( www.thehansindia.com, 2017). Human capital has the credibility to influence the productivity of an organization and human capital is the chief factor that has the capability to use other available resources in the society for production of specific services for satisfying individual needs. Achieving the organizational goals depends highly on the human resources and evidence suggests that motivating the health workers is one of the primary determinants in retaining the health worker performance. Poor working conditions, personal safety concerns and lack of required medical equipments can not be replaced by motivation but these factors play a key role in productivity of the work force for health care sector in developing countries. The study has been conducted in Telengana, which is a state in the southern part of India,and it is the 29th state of India that is consisted of approximately 35 million people. This state is considered as the medical tourism hub of the country. This place takes pride in 24X7 availability of medical aid through effective network of hospitals, medical experts and paramedics. The state Government continuously encourages and supports convenient medical facility for the international patients along with post discharge formalities and specialities. Indo US Hospital is one of the renowned medical centres of this state ( www.thehansindia.com , 2017). The study is based on the evidences collected from this particular health care service providing organization and the health workers of the organizations. The problems that the workers generally face in their workplace regarding lack of medical equipments and working conditions are used as the variables that are to be evaluated in accordance with their motivational needs in order to increase the productivity of the stated workforce. 


Overview of the organization

The health centre under study namely, Indo US Hospital was established in the year 2012 and it is a new health venture of the state that is growing fast and has achieved popularity among the international patients in a short period. This hospital a 100 bedded hospital that is run by famous cardiothoracic surgeon Dr.Dasari Prasad Rao who is famous for performing the first Coronary Artery Bypass grafting in the year 1985 at Nizams Institute of Medical Sciences and Dr. K Sarat Chandra. Dr. Chandra is an eminent interventional cardiologist promoter of this institution. Dr. Rao encourages and trains several students to perform Open Heart Surgeries, Radical Artery grafting coronary bypass and other critical surgeries. The ministry of home affairs the Padma Shri award in the year 2001 had designated him. 

Vision and mission of the hospital: The organization aims at conducting high-end cardiac procedures and surgeries effectively. The organization visions to treat critical heart surgeries with the aid of latest technologies and medical equipments at the same time their mission is to provide their services at an affordable price to the patients.

Services:The medical specialities that Indo US Hospital offers are Cardiology, Cardio Thoracic surgery, Gastroenterology, general and family medicine, Interventional Radiology, Laparoscopic surgery, Nephrology, Orthopaedics and Pulmonology. 

Rationale of the study

Rationale of the study helps in understanding the relevance of the selected issue by evaluating the potency of the issue.

What is the issue of the research?

The key issue in the regard of this study is to identify the role of motivation in enhancing the individual productivity of the healthcare workers.

Why is it an issue?

This is important to identify the role of motivation in enhancing the productivity and the value of the organization in health care sector as several recent studies have shown that the healthcare sectors in the developing countries are failing to reach its goal due to ineffective workforce. Ineffective workforce has been considered as one of the chief reasons that affect organizational success. The health indicators of India have illustrated a steady improvement and have been subjected to a substantial progress in the recent years and the service is getting nearer to that of the developed countries. Therefore, the need of improving the workforce of in the healthcare industry is strongly felt.

Why is it an issue now?

WHO in the recent years has identified that the poor human resource management is one of the most significant health system challenges of the developing countries like India. Herein, it is relevant to explore the true picture of human resource management of the healthcare services of these countries in order to understand the role that motivation can play in improving the human capital of the healthcare organizations. 

What can this research shed light on? 

This research attempts to shed light on the importance of different motivational factors that have the credential in effectively improving the work engagement of the human capital in the health care organizations. Several motivational factors have also been identified that can improve the current standard of the workforce and can effectively improve individual productivity. 

Aims and objectives of the research

The primary aims and objectives of the research are:

  • To identify the link between human asset and the productivity of an organization
  • To identify the role of human resource or human capital in increasing the value of the organization
  • To identify the factors that works as the major driving force in encouraging them to contribute better for the organization
  • To identify the underlying gaps between the performers and the non performers within particular departments 
  • To highlight the areas that require improvement

Research questions 

Both primary and secondary questions are been outlined in order to understand the path how the aim of the research is to be achieved.

Primary question

What is the role of the motivation factors in increasing the individual productivity of the workers working in the Heart Care institute at Indo US super-speciality Hospital?

Secondary questions

Along with the primary question of the research few related questions are also framed in ordr to evaluated the motivational variables.

  • What are the motivational factors that help in enhancing the individual productivity of the employees of the mentioned healthcare centre?
  • What are the sources of motivation?
  • Can motivation help employees in working in challenging working conditions?
  • Can motivation at all affect the individual productivity of the healthcare workers?


Research hypothesis 

H0: Motivational factors do not have any effect over the individual productivity of the workforce in the chosen healthcare organization.

H1: Motivation is the most important variable in increasing individual productivity

H2: Motivation is one of the factors that can influence the productivity and value of a healthcare organization.

Significance of the study

Over the years, the experts have argued regarding the role of motivation in increasing the individual productivity of any organization that ultimately adds in the value of the organization. In healthcare sector, motivating the employees often provided positive results in increasing the overall positive production power of the organization. The significance of the research is it identifies the motivational factors that are effective especially the healthcare workers along with that it also attempts to evaluate the influence of motivation in increasing the productivity of the healthcare workers. 

Structure of the dissertation


Figure 1: Structure of the dissertation

 (Source: self- generated)


Summary 

This chapter has successfully identified the issue of research and prior to that has set a path for successful commencement of the study. The introductory chapter has identifies the purpose of the study. Firstly, different variables have been identified and the correlation with the background of the organization has been established. The questions that are to be answered in the course of the study have been set and aims and objectives for conducting the study have been framed. In the end of the chapter the significance of the study has been enlighten. 


Chapter 2: Literature review 

Introduction

This chapter of the dissertation attempts to establish an argument prior to further study and analysis of the primary data. In order to understand the role of motivation in the healthcare industry of India it is important to evaluate different Motivational Theories and models. An critical insight into the prevalent literature is also significant in order to understand the established belief regarding the role of motivation in increasing individual productivity of the employees. Through this chapter the concerned theories and models have been evaluated as oer the aspiration of relating the important variables of this study with them. As there have been relevant researches regarding this issue, the relevant literature associated with this topic has been evaluated in order to understand the areas that require to be highlighted in the current study. The scope of future research has also been depicted at the end of this chapter. 

Motivational theories and models 

Motivation and motivation theory is a part of the broad rubric in the studies of organizational sciences. In the arena of organizational behaviour it is one of the most widely studied areas. There is no specific theory of motivation (Maslow, 2015). Several critics have proposed different theories of motivation. The complexity of the issue is generated due to the lack of a unified theory of motivation. The inception of motivation theory was majorly dependent upon the instincts and psychologists like Sigmund Freud believed that most powerful determinants of individual behaviour were those of which the individuals are not consciously aware. Relevantly this idea has been developed in the behavioural motivational theories of early Twentieth century. 

Several researchers have focussed on the individual motivation and some focussed on the internal drives as a potent explanation for differences in individual motivation. Based on the difference of approaches motivational theories can be classified into two distinct groups and they are popularly known as the content theories of motivation and the process theories of motivation. 


Figure 2: Theories of Motivation

(Source: Maslow, 2015)

Content theories of motivation

Content theories or the need theories of motivation is focussed on the internal factors of the individuals. Generally motivation is treated by the theories as the product of internal drives that compel an individual to act or move in a particular manner toward the satisfaction of individual needs (Maslow, 2015). Major content theories are Maslow’s hierarchy of needs, Alderfer’s ERG theory, Herzberg’s motivator-hygiene theory and McClelland’s learned needs or three-need theory (Maslow, 2015)


Figure 3: Theories of Motivation

(Source: Pinder, 2014)

  • Maslow’s hierarchy of needs: Maslow segregated the individual’s needs in his hierarchy of needs. The theory suggests that the individual needs exist in a hierarchy that is consisted of physiological needs, security needs, needs related to belongingness, esteem needs and self-actualization needs (Pinder, 2014). The theory identifies the physiological needs to be the basic needs of individuals including necessary factors for survival. Security needs are concerned with the need of safety in the physical environment of a person. Unsatisfied needs are responsible for motivating behaviour; therefore, lower level needs like physiological and security needs must be met before the upper level needs. 

Application of the hierarchy of needs to the management of the healthcare sector is obvious (Pinder, 2014). The needs that exist at the lower level such as safe working conditions and adequate pay need to be met first.


Figure 4: Maslow’s Hierarchy of needs

(Source: Lepper & Greene, 2015)

  • Alderfer’s ERG Theory: Alderfer’s ERG theory has been extensively discussed as a simplified extension of the hierarchy of needs proposed by Abraham Maslow. According to the apprehensions of ERG theory, the notion of motivation prior to any employee is framed upon three elementary criteria whose acronyms coined the title of the theory. Above everything, the employees expect several fundamental means to retain the existence that is what E stands for (Pinder, 2014). These fundamental means ranges from safety to physiological health and several other means, which is one of the primary requisites for the employees to stay motivated. R stands for Relatedness, which take the urge of any employee to proliferate their interpersonal relationships into consideration while heeding on several other aspects such as social esteem and acknowledgement. G stands for Growth and considered as one of the pivotal criterion to sustain the desired level of motivation within an employee (Pinder, 2014). If the organization that the employee is serving is sensible enough to endow the employee with opportunities of individual development, it enhances the dedication of the employee towards the assigned task while catering the motivational impulses of the employee.
  • Herzberg’s motivator-hygiene Theory: It is also known as Two-factory theory since Herzberg intends to designate two crucial factors that actively cater the motivational impulses of the employees. Furthermore, Herzberg seem to heed on the aspects that can entertain job dissatisfaction in an employee and causing lack of motivation to perform the job in a dedicated manner. In this regard, Herzberg seem to categorize the pivotal factors of job satisfaction into two major classes such as Hygiene Factors and Motivational factors with the self-proclamation that the hygiene factors is unable to be designated as potential motivators (Lepper & Greene, 2015). Some of the major motivational factors seem to resonate with the factors prior to ERG Theory and that is why sometimes it has been considered as an simplified extension of the ERG theory. Herzberg seem to segregate the motivational factor in a chronological fashion where Recognition ranks the top while resonating with the R in ERG Theory (Lepper & Greene, 2015). In this regard, apart from social status, the employees have been found to crave for acknowledgement from their immediate authority prior to their accomplishment. The next factor is named as Sense of achievement that intends to tap the ability of the employee to apprehend a tangible outcome out of their performances. The notion of growth and promotional opportunities resembles with what have been mention as G in the ERG model. The sense of accountability is also one of the prime concerns that this head take into consideration (Lepper & Greene, 2015). Moreover, this framework have also found that motivation is a predominant function of the meaningfulness of the assigned task that most of the employee crave for in order remain dedicated towards the organization.  
  • McClelland’s three-need Theory:The apprehension that has been proposed here against the motivational impulse of an employee seems to be framed upon the three rudimentary needs that employees typically covet. The seed of this framework has been sprouted in the phenomenal book written in 1961 named as The Achieving Society by David McClelland. The characteristics, which have been characterized here, seem to embark on three factors of employee motivation that can be categorized as Achievement, Affiliation and Power (Dweck, 2017). In terms of achievement, employees have been observed to be in need of a comprehensive metric of challenging tasks that they are conditioned to accomplish. In this regard, they are prone to obtain an awareness about the vulnerable risks which they are typically instructed to keep a calculate record of. It has been also under this domain that employees crave to avail regular feedback on their tasks since it is an inherent nature embedded within them, which nudges the respective employees to analyze them. They usually seek organizational aid to accomplish their desired goal as well. On the other hand, in terms of affiliation, the framework seems to tap the craving of the employees to socialize. Every employee desires to be in a strong attachment with a social group while expecting acknowledgement from their fellow colleagues and the inmates of the group. It has been also discovered in this regard that most of the employees prefers collaboration to competition and volatility (Dweck, 2017). The category power speaks for itself as every employee intends to wield in order to influence other considerably. In this specific segment, they intend to participate in verbal competition and ensure triumph on their favour. This has been coupled with the urge to relish recognition and status.   

Figure 5: Comparison of Content Theories of Motivation

(Source: Dweck, 2017)

Process theories of motivation

These theories, unlike indicating the content that serves the motivational impulses prevalent in the employees, seem to reflect on the process of motivation prior to an individual employee. In this regard, these theories seem to consider the inevitable cognitive distinction prevalent in exclusive employees in order to illustrate the conditions and rudimentary needs of satisfaction of a respective employee (Rasskazova,Ivanova  & Sheldon, 2016).  These theories attempt to explain the likelihood of specific choice prior to the sense of satisfaction of a respective employee. In this regard, Expectancy Theory, Goal-setting theory and Equity Theory has been described.


Figure 5: Process Theories of motivation

(Source: Rasskazova,Ivanova  & Sheldon, 2016)

  • Expectancy Theory: It has been lauded as one of the most rational explanation of the motivation and Victor Vroom has proposed it in 1964. This framework is also called as VIE which is Valence, Instrumentalityand Expectancyrespectively. It suggests that the choice of the employees regarding a particular course of action has been governed by their perception regarding their i) own capabilities, ii) expectation of acknowledgement and rewards and iii) perception regarding the moot value of these rewards. It is diametrically opposite from the content theories since the pursuit of this theory is principally aimed at the consideration of a particular individual to choose a particular demeanour over another (Pinder, 2014). This choice process has been illustrated in this framework as an exclusive cognitive aptitude and the subsequent analysis of the factors that caters the evaluation of the appraisals can be categorized as Expectancy, Instrumentality and Valence respectively. The notion of expectancy seem to suggest the inquiry that desires to evaluate the capability of a respective individual to perform a certain task. Furthermore, the notion of instrumentality seems to cater the enquiry regarding a corporeal outcome prior to the performance. The notion of Valence seems to cater the inquiry regarding the pitch and value of the outcome. Vroom seems to express the notion of expectancy and instrumentality in a probabilistic way while considering the vulnerability of the conditions prior to satisfaction and dissatisfaction (Dweck, 2017). On the other hand, while expressing the notion of valence Vroom seems to adopt a subjective approach since the individual is exclusively involved in the evaluation of value out of corporeal outcome, though the force that has advocated this impulse will be considered as a prospective function of these key factors. Thus, it can be stated that the cumulative effect of Valence, expectancy and Instrumentality has been evaluated to determine the notion of motivation (Rasskazova,  Ivanova& Sheldon, 2016). Furthermore, this cumulative effect has been considered as the mathematical product of these and if the value of any element becomes equal to zero the entire value of motivation become zero. In the organizational premises, it has been lauded as one of the most significant findings to retain the impulse of motivation of the employees of the respective organization. The major critique that has proposed over here is the introduction of the notion of instrumentality seems to induce excessive intricacy in the cognitive process prior to an exclusive employee.
  • Goal-setting theory: This theory is proposed by Edwin Locke and his associates in 1960 and eventually it has obtained sophistication throughout the years of persuasive research. This theory seems to emphasize on the aspects of purpose and intent that might drive an employee to obtain desired objectives (Rasskazova,  Ivanova& Sheldon, 2016). In this regard, the framework happens to characterize the objectives of an employee through incentives, self-perception and the sequence in which the objectives has been formulated. These traits coupled with the attitude of arranging objectives urge for an exclusive behavioural strategy in order to evaluate the performance keeping the abilities and constraints in mind. Furthermore, the awareness of the outcomes prior to the adopted demeanours has been considered valuable for subsequent amendments of behavioural strategies. In the framework Locke seem to propose some conclusion after conducting an introspective study prior to the influence of behaviour strategies on the notion of motivation. The initial corollaries of these conclusions seem to suggest that difficult goals usually cater higher performance as compared to easy goals depending upon the attempt of the person to accomplish them. Through this statement, this framework appears to suggest that employees typically direct their behavioural strategies towards accomplishment of goals. Furthermore, challenging goals coupled with a considerable specificity appear to cater higher performance as compared to the general goals since specific and challenging goals own the ability to guide the performer to adopt a precise intention prior to the specification. In this regard, the behaviour of the employees appears to be directed towards the procurement of considerable precision. Furthermore, the awareness regarding the feedback of every task ensures higher performance prior to the difficult and precise goals that are required to be accomplished. In this regard, it is evident that Locke seems to suggest that feedbacks typically come with an embedded ability to motivate employees. Moreover, the beneficial outcomes of goal setting partially (but a considerable moiety) depend on the commitment of a personnel towards their desired goal. In summary, the framework seems to suggest that performance level of every exclusive employee can be enhanced simply by setting complex and specific goals. Furthermore, it has also addressed the ability of feedback to stimulate motivation.

Figure 6: Overview of the Goal-setting Theory

(Source: Pinder, 2014)

  • Equity Theory: This theory is framed upon the common proclivity of comparative analysis prior to every individual. Employees, following no exception, seem to compare their job inputs and outputs with their fellow colleagues. Moreover, the perception seem to seek a ratio of corporeal job outcomes upon the input that the employee has been imparted (Pinder, 2014). The state of equity has been accomplished if the ratio of input and output seem to resemble with the ratio of the fellow colleague that the employee seem compare with. In this regard, the current framework seem to suggest four comparison criteria in order to evaluate the proportion of comparison and those can be categorized as Self-inside, Self-Outside,  Other-inside and Other-outside respectively. Moreover, the framework also suggests that the choice of the referent seem to be influenced against the data about the referents and their ability to allure the person against him. In this regard, this framework seem to suggest several variables that influences the choice such as Length of tenure, Amount of education and the Salary level of the employee (Pinder, 2014). Through anticipating the common proclivities of an exclusive employee to change the choices seem to categorize the immediate act within six choices. In an empirical tone, it can be stated that people are not only concerned aware their rewards that they are destined to get prior to the performance they have been able to execute. The employees seem to conduct a comparative analysis with an entity equivalent to the position and this, as this framework suggests, is one of the governing criteria that characterize the motivational impulse. The conclusion of this framework that apart from absolute rewards, relative rewards can also assist to determine motivational impulses prior to an exclusive employee. 


Figure 7: Comparison of Content and Process Theory

(Source: Pinder, 2014)



Role of motivation in healthcare organizations 

It is a well acknowledged fact that health worker motivation is the chief determinant of retention of the health workers in the healthcare sector. It has been proven from the existing studies of the domain that motivated workforce apply more knowledge in their work other than the non-performers. In the developing countries several challenges including poor working conditions, personal safety needs of the employees and inadequate equipments, motivation is significant in retaining the productivity of human resources. 

In the recent years employees’ motivation has become one of the determining factors that defines organizational success. However, it is true that it is important to understand the motivating the individuals through initiative, rewards and effective leadership. Motivated workforce is more likely to increase the overall productivity of the organization. Successful motivation indicates that the workforce understands the organizational goals and objectives and they are more concerned about the organizational benefits. In the healthcare sector the major mission lies in providing necessary medical services to the patients in need. As the chosen hospital provides challenging and complex medical support to the patients, it is important for the employees to understand that work engagement is a moot necessity in this field. All of the health care organizations including this hospital functions with the proposed actions in order to accomplish the organizational goals with best use of the hospital’s workforce. Motivation is the process that indicates at initiating human activities which is directed towards attainment of specific goals. 

Figure 8: Correlation between motivation and individual productivity

(Source: Daneshkohanet al. 2014)

Previous literature 

There are several experts who have worked in this arena in order to identify the role of motivation in increasing individual productivity of the healthcare employees. However, it is important to understand different perspectives in order to identify significant factors of motivation that are influential in increasing per person productivity of the healthcare workers. In evaluating the previous literature, several articles that focus on the motivational needs in the medical sector of developing countries have been considered to be relevant. For better understanding, the chosen articles have been evaluated in a chronological order. 

Article 1

One of the most important works in this area has been done by (Daneshkohanet al. 2014). This article evaluates the working condition of the medical sector in Iran and significantly locates the problems that the employees chiefly face that affects their productivity. In order to identify the motivational needs of the healthcare workers the authors have successively chosen a particular health care organization for the research. As the results of the research suggested there are several motivational factors that helps in enhancing the individual productivity of the employees. However, the authors have also pointed out that the capability of these factors in motivating and encouraging the employees in order to accomplish the organizational goal is not at the same level. The employees of SBUMS have been seen to be majorly influenced by the following motivational factors.

  • Good management
  • Support of the higher authority
  • Good working relationship with the colleagues 

The researchers identified that in the chosen setting 47.2% of the employees were not satisfied with the existing schemes and their potency in improving the performance of the employees. The major demotivating factors that affected the productive outcome of the employees have been identified to be unfair treatment among the subordinates, lack of appreciation and management errands. 

This article is important as it potently points out the motivational needs of the healthcare employees and the factors that have the credential to influence individual productivity of th employees. 

Article 2

The paper by S.K. Srivastava and Kailash Chandra Barmola on the Role of Motivation in Higher Productivity is a significant one as provides a psychological overview regarding an individual’s necessity of motivation in increasing their individual productivity. The paper explores different prevalent definitions of motivation in order to compare and illustrate the moot aspects that are associated with motivation. Along with that the article has also explored different motivational theories which has been effective in understanding the appropriate motivational framework for healthcare industry. The authors in the paper have successfully established a correlation between motivation and productivity that also supports the H1 of this study. The importance of this paper lies in the fact that it also evaluates several strategies associated with motivation that can enhance the productivity of the human capital of a particular organization. The importance of motivation and the difference of its function in motivating an individual and a group is another potent outcome of the study. 

Article 3

The report by MarjoleinDieleman and Jan Willem Harnmeijer attempts to locate the factors that have the credential of improving the performance of the health workers. The report identifies several reasons of poor performance of the healthcare employees. This article does not reflect much upon the role of motivation as it primarily focuses at identifying the factors behind the poor performance of the healthcare employees. However, it also locates the chief elements that influence productivity, competence and responsiveness of the employees. It potently relates motivation to the job satisfaction of the employees which is one of the major influential factors of high productivity. The study establishes that job satisfaction is related to motivation and it is affected by several external factors like working condition, organizational structure and working culture of a particular organization. 

Other relevant literature

Most of the sources that have been studied in the course of the research reflects upon the fact that human resource is the most vital part in healthcare system and the workforce of the healthcare sector requires to be motivated in order to perform in a highly productive manners. The articles that are associated with the motivational needs of the healthcare employees in particularly developing countries emphasize on the fact that poor working condition demotivates the employees. Therefore, to maintain their individual performance it is important to motivate the employees in order to perform in an effective manner. 

The function of the healthcare workers are often tiresome and exhausting. Therefore the need of motivation is dominant in this industry. Several critics have argued that the motivational needs vary from one person to another and a tangible scale can not be utilized in order to measure the motivational needs of the healthcare workers. However, the working condition and organizational policies of a particular healthcare system affect the behaviour of the employees and the management of the organization needs to focus on the factors that majorly hinder the workforce from performing in a productive manner. 

The recent research works have identified that for the developing countries the healthcare services have been improving in recent years and the reason behind such improvement has been identified to few organizational frameworks that associate employee motivation with employee retention. A productive workforce has been considered to be one of the primary criteria of successful healthcare service organizations (Dolea & Adams, 2005). The organizational goals of the subsequent health care organizations are aligned with the productivity of the workforce and it is correlated with the individual performance of the workers as well. The experts have agreed that satisfied and motivated employees are key to run the entire health system seamlessly. 

Figure 9: Factors behind Employee productivity

(Source: Dolea & Adams, 2005)

Current literature 

The study of the chosen organization has helped in identifying the employee needs of each department of the hospital. The job responsibilities of the employees and the problems that they majorly face have been located in the course of the research. Current literature attempts to provide a brief insight on the organizational structure and segregation of the departments and the classification of the employees based on their job roles.

Functional areas of the organization 

The segregation of the departments are based on the type of support that each of the department provides. It has been noticed that organization is run through departmental functioning (Dolea & Adams, 2005). The major functional areas within the hospital that aims at providing uninterrupted services can be classified as following:

  • Nursing services
  • Allied health services
  • Pathlab services
  • Diagnostic services like non-invasive labs
  • Clinical support services including pharmacy, outpatient services, Administrative services and non medical staff, housekeeping department and the finance department
  • Medical report sections 
  • Human resources department 

It is important to have coordination among the departments in order to provide better care and positive outcome. 


Employee satisfaction in the chosen hospital

The study has identified few individuals who are working in the respective departments who have portrayed dedication toward their work and outperformed their job responsibilities. The study has attempted to identify the driving force behind their performance. It has been noted that the major reason for their good performance is their dedication towards achieving the organizational vision, missions, goals and objectives. The rate of job satisfaction is high among these employees. A conclusive study has been conducted in order to identify the underlying gap between the performers and the non-performers. It has been noticed that the performers are more engaged towards their works while the non-performers have several organizational issues regarding their departments and job roles.

Job characteristic Model to motivate the employees of the chosen hospital

It has been already mentioned the work itself can be a fecund source of motivation if the work can be characterized with challenge and precision with the assurance of absolute and relative rewards. Several recent researches seem to suggest that proper job design with several exclusive ingredients has the ability to drive motivation and the consequent effort from the employee (Deepthi Reddy, 2017). Furthermore, several contemporary researches suggests that the Job Characteristic Model happens to be one of the most effective model to drive employee motivation in the hospitality and health care industries since the prospective exponents in this urges for the acknowledgement of the motivational spirits the most. Several contemporary fecund article on the motivational impulse of health care employee seem to adhere to this model guided by an expected effective and corporeal outcomes.

In an empirical tone, it is obvious that Job Characteristic Model seem to characterize any job into five core dimensions and this trend of characterization includes the respective model into the domain of process models prior to the motivational impulse of the employees (Dan Richards, 2013). 

The five core dimensions can be empirically categorized as;

  • Skill Variety: The employees seem to evaluate a job against the proportion of diverse activities prevalent in the job. This trend signifies the desire of every employee to apply diverse talents and expertise (Peters, Chakraborty,  Mahapatra & Steinhardt, 2010). This has earn prominence in the health care sector since this framework of skill variety enables the respective employees of a health care unit to earn acknowledgement for their embedded skills and talents for instance, to assess the specific psychological needs of a particular patient. 
  • Task Identity: The employees further judge a piece of work by the proportion of completion that the job demands for. This proportion of completion can be considered as the elements of challenge and specificity integrated with the job. The employees, especially the employees prior to health care sector seem very pedantic regarding the proportion of completion of a particular job since they wield this as the parameter of the degree of precision and competency required for the particular task. 
  • Task Significance: This head intends to tap the proportion and essence of a job to be valued (Dolea & Adams, 2005). The significance of a particular task has been evaluated by the vulnerable impact and influence of the job that denotes nothing but the value of performance. Task significance seems to be a governing regulator in the premises of health care since the essence of such classification of tasks ensures fruitful relative rewards.
  • Autonomy: This classification intends to tap the command of an individual choice prior to a task while evaluating the degree of discretion that the particular job allows for.
  • Feedback: As it was feebly mentioned in the previous discussion, in the approved discourse of motivation feedback has been considered as an analogue of relative reward (Murphy, Chuma, Mathews, Steyn & Levitt, 2015). Employees has been conditioned them to possess a staunch urge regarding the appreciation. 

Figure 10: Importance and individual Engagement

(Source: Daneshkohan et al, 2018)

This framework seems to suggest that the presence of the initial three dimensions encourage the employee to retain towards the assigned tasks through driving motivation. Furthermore, this factor also seems to enhance the level of performance and satisfaction. This framework earns prominence in the health care sectors since it enables the employees with the room of self-analysis while evaluating their performance characteristics through absolute and relative rewards. 

Summary

In this section, the crucial emphasis has been imparted on the identification of the parameters that are most likely to drive motivational impulse among the employees prior to the health care unit. Moreover, apart from the content theories, this section desires to heed on the process theories prior to motivation. Deduced simulations and corresponding apprehensions has been critically reflected against the score of a succinct secondary research backed by the pertinent literature on the same discipline. The essence of the apprehensions presented here is it is not only the demands whose fulfilment keep an employee motivated, they also crave for precise and challenging job profiles coupled with tangible significance and relative rewards.


Chapter 3: Methodology 

Introduction

This chapter aims at identifying the framework of the complete research work. The methods that have been used in conducting the entire study has been discussed along with the effectiveness of the chosen research plan. The data collection process and the specific techniques that are used in order to appropriately evaluate the gathered data have been elaborately illustrated in the chapter prior to the approach and philosophy that have been followed in executing the analysis of the collected data. The moot dimensions of the tools and technique that have proved to be effective in facilitating the process of the research have been highlighted in the chapter. 

Method outline

With the aspiration of conducting the study effectively in order to gain significant outcome, the entire design of the study is framed upon a significant approach. In regards to obtaining optimal result the research has been conducted with aid of positivism philosophy, deductive research approach, descriptive research design, survey research strategy for primary data collection and both quantitative and qualitative technique for the analysis of the obtained data. In order to commence an appropriate sampling technique, certain respondents of the population have been chosen through probable and non-probable method. 

Research onion

Research onion is considered one of the major tools of research methods that helps to illustrate a clear understanding of the entire strategy that has been applied in the course of the research. According to Saunders et al (2009), research onion is a layered approach that is comprised of six different layers. It illustrates the process of concluding the study through six different stages of the study and that are research philosophy, research approach, research design, research strategy. Data collection method, data analysis process and time horizon of the entire study. In order to gain aspired result layers or folds of research onion have been followed that indicate objective outcome of the complete study. 

Figure 11: Research Onion

(Source: Saunders et al. 2009)

Research paradigm

The proper guideline of the study is provided through selecting an appropriate research paradigm or research philosophy that suits the purpose of the research. Three most widely used, canonical as well as fundamental research philosophies are Interpretivism, Positivism and Realism. Other research philosophies that have contributed effectively in the paradigm of research are post positivism and pragmatism (Kothari, 2004). Reality of the substances can be well understood along with a scope of a subjective outcome with the help of interpretivism. Interpretivismin the course of this particular study can result in single truth hypotheses of the study (Kumar, 2014). Therefore, in order to have an objective result the study has been based upon positivism research philosophy. Positivism is helpful in predicting and evaluating the exploratory learning changes.

Justification for selecting positivism:

  Positivism has been selected as the appropriate philosophy for this particular study as it is helpful in analysing the dependent and independent variables of this particular study (Panneerselvam, 2014). For instance the role of motivation on the individual performance can be evaluated through the philosophy and the role of motivation in increasing organizational productivity as well. As the research work highlights a well acknowledged fact that motivation can positively impact or enhance the productivity of the health workers, positivism has been chosen as the philosophy. It has helped in broaden the scope of the study and has effectively contributed in the factual analysis of the data. Through the logical interpretation and evaluation it has helped in reaching a conclusive summary through the factual evidence.

Research approach

In the domain of academic and market research, the major two approaches that are widely followed by the researchers are deductive approach and inductive approach. These two approaches have contrasting features and they are polar by nature. Inductive approach indicates the considerable adjustment of the general setting of the initial research paradigm into considerably constrict frame. Inductive approach allows the researcher to generate a new theory in accordance with the obtained data (Silverman, 2016). Inductive approach narrows the scope of the research. Deductive approach is used in order to test a theory and begins with a hypotheses. For this study deductive approach has been chosen as the appropriate approach of the study.

Justification for selecting deductive research approach

For this particular study deductive approach has been chosen as the appropriate research approach as it suits the purpose of the research. This study aims at exploring the theories and models of motivation in order to locate the potency of motivation in increasing individual productivity of health workers. Deductive approach has helped in gathering relevant and necessary information for conducting the research successfully. Deductive approach has been chosen for its credibility regarding top to bottom approach that has been used in order to prepare the hypotheses of this study after having necessary knowledge of the motivation theories and models and this topic constraints the scope of developing a new theory therefore, deductive approach has been chosen as the appropriate one. 

Research design

Primarily there are three types of research designs that are followed by the researchers. The three major research designs are Exploratory, Explanatory and Descriptive research design. Exploratory design is chiefly used in order to evaluate the theoretical contemplations that are associated with the issue (Flick, 2015). Descriptive design on the other hand provides the researcher with the scope of depicting the participants of the researcher in an accurate manner. There are several scopes that descriptive designs permit the researcher like observational study of the participants and in depth study of the chosen population. In order to suit the needs of this study, descriptive design has been chosen.

Figure 12: Research Design

(Source: Panneerselvam, 2014)

Justification for choosing descriptive design:

Descriptive design has been chosen in order to evaluate the data collected from the respondents. As the primary research is based on the behaviour of the health workers in the chosen hospital, descriptive design permits the scope of evaluating the performance of the employees and associates their performance with their motivational needs.

Research strategy

It is important to structure the research accordingly with the help of a particular research strategy research strategy dictates the moot function through which the study has been conducted. Research strategy as mentioned by (Panneerselvam, 2014) can be Experiment, Survey, interview and case study. This study has selected the survey process in order to obtain necessary from the workers of the chosen hospital. Survey has been chosen in order to gather data from a large number of respondents in order to identify the trends that are present in the motivational needs of the employees. Survey is cost effective and it helps in gathering relevant data in a short span of time. 

Sample selection

Sampling technique: 

Sampling method consists two major sampling techniques that are known as the probability sampling and non probability sampling. As far as probability sampling is concerned individual members of the chosen, population has a known non-zero probability to participate in the study (Taylor, Bogdan&DeVault, 2015). Probability sampling methods are comprised of stratified sampling, systematic sampling and random sampling. The respondents in the course of this particular study have been selected on the basis of random sampling. Random sampling has been acquired as the appropriate sampling technique in order to limit the bias of the principles of probability sampling.

Population:

In the domain of research, population indicates to the people who have participated in the study. For this research the population indicates at the workers of the hospitals except the doctors from whom the respondents of the survey have been selected. 

Sample size:

In order to evaluate the necessary information it is impossible to select the entire population of the study. In order to operate the survey seamlessly, a particular number of respondents are chosen for the study and this is known as the sample size of the study, for this particular research 200 respondents who works in this Super Speciality Hospital. 

Data collection technique

It is important to select a proper data collection technique in order to examine the variables of the research effectively. It is possible to accumulate the data through various techniques. The chief data collections techniques are primary data collection technique and secondary data collection technique (Silverman, 2016). Primary data is collected directly by the researcher and it is considered as the new data that has not been used previously in any other research works. Secondary data indicates the data that has been gathered by someone else for other purposes. Secondary data is generated from the previous research works, books, journals and articles or other relevant sources. 

In the process of the study, primary data has been collected from the opinions of the employees and their response to the provided questionnaire. The information of the hospital and its departments as well as the system that they work with have been obtained through the observational study that has been conducted at the hospital. Secondary data has been used in order to build the objective and questions of this research. This data has been sourced from previous research works on the subject of employee motivation and their performance. The data obtained from the survey that has been conducted among the employees of the hospital is the primary data for this particular study.

Data analysis technique

In order to effectively accumulate the result of the study, it is important to select a particular data analysis technique that is suitable for the purpose of the study. The two major type of data analysis technique are the quantitative technique and the qualitative technique of data analysis. Quantitative data have been analysed through the statistical method of Excel. In the process of the statistical method the numeric value that has been obtained from the responses of the employees have been converted into percentage form for further analysis based on the research questions. Qualitative data have been analysed through developing transcripts of the interviews that have been conducted with the departmental heads. 

Ethical consideration

It is important for any research to be compliant with the ethical considerations of the research. This research has been compliant to the liberty of contribution on the part of the respondents, good behaviour towards the organization and organizational personnel, data protection and application of the data. The data that has been gathered in the course of the study has been protected under the Data Protection Act of 1999. Apart from that the respondents have not been forced in any circumstances to participate in the survey or the interview. In order to maintain the confidentiality the identity of the participants has not been disclosed in the course of the study. Along with that, organizational productivity has not been hampered in commencing the research. The data that have been used from secondary sources has been acknowledged and the obtained data has been solely used for the purpose of this study and not any other commercial purpose. The data that has been used in the study have not been manipulated or altered to suit the result of the study. 

Time table

Activities
1st  Week
2nd - 7th   Week
8th– 11th   Week
12th -15th   Week
16th – 19th  Week
20th – 23st  Week
24nd – 25rd  Week
26th week
Topic selection









Secondary data collection










Primary data collection










Literature review










Methodology identification









Analysis and interpretation of   primary data  











Findings of the study and comparing   them with literature










Conclusion










Draft formation









Submission of final work









Figure 13: Timeline of the Research

Source:

Summary

The chapter has illustrated the methodological tools and techniques that have been used in the research. Along with that, the discussion of the chapter has helped in providing critical insight in the process of obtaining the results and have shed light on the complete framework of the study. 


Chapter 4: Data analysis and Discussions 

Introduction

In this section, the researchers seek to derive primary information from live participants in order to percolate the trend of opinions across the secondary findings of literature review prior to the moot pursuit of the research. In this regard, the researcher desired to conduct both qualitative and quantitative data analysis technique in order to derive the requisite primary data as it was empirically mentioned in the research methodology section. Despite having a succinct overview of the primary research out of literature review, the researchers have arranged a semi-structured interview to enrich their archive of primary information. On the other hand, the researchers have also managed to conduct a survey wish 100 potential respondents which have been nominated across the hierarchy of management of the chosen hospital. In an elaborative tone, in order to participate in the semi-structured interview prior to the qualitative research, 5 potential respondents have been chosen across the representatives of Out-patient services, Front office services, In-patient services, Biomedical unit and the pharmaceutical and paramedical unit. On the other hand, the potential respondents of the survey have chosen across the employees and the representatives of the rest of the departments (Ambulance services, Food & Canteen services etc). The obtained data has been presented while abiding by the ethical considerations as mentioned in the research methodology section.

Qualitative questionnaire

  1. What motivational drivers do      your organization patrons to retain the dedication of the employees?
Out-patient   services representative
Front   office representative
In-patient   representative
Biomedical   services representative
Pharmaceutical   and paramedical services representative
We offer   considerable incentives if the employee has been able to retain their   performance in a consistent fashion. Moreover, we endow them with paid leaves   except times of high pressure.
Incentives   are there to compensate their excellence. Moreover, we offer relaxation to   each employee if they performed overtime consistently.
We   impart a sincere attention while fixing shift of responsibilities prior to   the performance of the respective employee. Moreover, since we have been able   to discern our ace employees, we interact to them regular in order to   encourage them to retain their consistencies.
I think   incentives are enough to retain the requisite motivational impulses expected   from an employee. Moreover, we ensure them that they will be endowed with   shift of the responsibilities ethically. 
We   ensure that they must not perform under the surveillance of choking   deadlines. Moreover, we ensure that the employee will remunerated properly   against their consistent performance. 


Trend Analysis: It is very evident from the cumulative inclination of the remarks that the leading exponents of the organization categorize the sense of motivation of the employees in terms of financial compensation and work relaxation. This flagrantly exhibits the lack of the sense of relative rewards as a significant driver of motivational impulse prevalent in the attribute of the prospective exponents of the organization. It is also evident that they rely on the traditionally perceived drivers of employee motivation.  

  1. How far do you think that the      training and development programs arranged by your organization are      fruitful for your employees prior to their individual development?
Out-patient   services representative
Front   office representative
In-patient   representative
Biomedical   services representative
Pharmaceutical   and paramedical services representative
That is   the moot essence of organizing a training and development program. Moreover,   as we are able to discern the ace employees of our organization along with   their embedded expertise, we attempt to cultivate those expertise through   these sort of programs.
It is   evident that fecund training and development programs is potent enough to   breed individual talent. Our organization is considerably aware about the   individual development of the employees. But since the employees are obliged   to perform under a tight schedule, the organization is inherently unable to   observe such programs frequently.
I think   the organization attempt its best to patron and cultivate individual talents   embedded in their employees. Though we are unable to observe those kind of   programs in a regular basis, we seek the participation of our employees when   we came across certain critical cases. I hope the employees take them as the   appreciation of their talent.
We breed   individual learning of our employees as we intend to prepare them for higher   excellence. Apart from observing training and development program, though in   a least regular basis, we encourage them to participate in several internship   program at our expenses.
I think   the organization is well aware about how to breed embedded expertise out of   their employees. We intend to enable them to get involved into cases that   inherently requires higher skills. We expect our employees to take them as an   integral part of their training and individual development.


Trend Analysis: Apparently, it appears from the cumulative inclination of the remarks that the organization are well aware about the embedded talents prevalent among their employees. Furthermore, it is an inherent constraint of the very profession which refrain the management to observe such sort of training programs prior to individual development since they are obliged to operate under a hectic schedule. However, it is evident from their approach that are not well aware about training programs being a intense driver of motivational impulses prior to the employees.

  1. What do you think that the      urgent deadlines can cater higher productivity with desired performance      characteristics out of your employees?
Out-patient   services representative
Front   office representative
In-patient   representative
Biomedical   services representative
Pharmaceutical   and paramedical services representative
Firstly,   the employees are expected to recognize it as a constraint of their   profession. Secondly, the organizations cordially attempt to offer compensation   if an employee has to perform under stringent deadlines in a consistent   fashion.
We   intend to reduce the degrees of urgent deadlines since we are aware that it   affects the performance of the employees. In cases, when we are bound, we   sincerely offer compensation against that.
I do not   think the employees have to perform under a strict deadline in a regular   fashion. Whatsoever, they must recognize the axioms of their profession. We   sincerely think of compensations if such cases occur regularly. 
The   employees are expected to respond to this as a constraint of their   profession. And, as far my awareness goes, they respond accordingly. 
Everyone   in every organization have to perform under strict deadlines. In return, the   organization is available to entertain their appeals prior to compensation.


Trend Analysis: It is very evident from the cumulative inclination of the remarks that they expect their employees to consider urgent deadlines as a part of their job. Moreover, the organization appear accessible to entertain relaxation as appealed by the employees. However, it is evident that frequent tasks of urgent deadlines hamper the notion of employee motivation which lacks acknowledgement from the statements of the respondents.  

  1. What measures do you think can      obtain desired performance from the so called non-performers?
Out-patient   services representative
Front   office representative
In-patient   representative
Biomedical   services representative
Pharmaceutical   and paramedical services representative
The   organization requires to present a lucid and transparent idea about their   requisite performance standards in a strict note.
They   will non-performers no matter what measures or steps the organization. It is   their inherent nature to perform that way.
The   organization can ensure a mandatory attendance of them prior to the   individual development programs.
The   organization need to be strict prior to the requisite performance level.   Moreover, they must listen to their version of the story such as what restricts   them to perform accordingly.
They   still can be encouraged to participate in the training programs prior to   individual development. Moreover, the instances of excellent performances   from their fellow colleagues can be presented in front of them coupled with a   strict instruction of the requisite performance standards.


Trend analysis: It is very evident from the cumulative inclinations of the opinions that the organization is well aware about the steps that might pave the so called non-performers towards excellent performance. Thus, it is a mystery regarding the agents that prevents the organization to work accordingly. Moreover, the introspection regarding the motivational needs that distinguishes a non-performer from a performer is vague and orthodox prior to the organization.

  1. What do you think is the      cardinal reasons behind the decline of performance characteristics of your      organization in the recent years?
Out-patient   services representative
Front   office representative
In-patient   representative
Biomedical   services representative
Pharmaceutical   and paramedical services representative
The   employee turnover rate reduces considerably in the last decade that has   affected the cumulative productivity.
The   employees are not responding to their tasks sincerely despite having a rich   presence of possible requisite apparatus.
There   are several sectors in the organization that urge for massive reorganization.   Interacting with the employees have reduced considerably as well.
There is   no iota of inadequate equipment to complain for. Probably, the employees have   started to take their responsibilities callously.
The   organization have attempted their best to respond to the emerging needs of   the employee. Interaction with them might have been reduced. That is   something which disables the organization to heed to their other demands.


Trend analysis: It is evident that there exist a huge diversity in the opinions prior to the reason of performance decline. The majority of the respondents have admitted the interaction with the employees have reduced considerably. This tendency disables the employees to address their emerging demand prior to the working environment of the organization. Moreover, a flagrant lack of a forum prior to the employees to address their terms and grievances has also been discovered.

Quantitative Questionnaire

  1. How far do you agree that PRP      influences the facets of motivation among employees?
Responses
% of responses

Number of Respondents
Total Number of Respondents
Agree
35%
40
100
Strongly Agree
55%
60
100
Disagree
5%
5
100
Strongly disagree
5%
0
100


Table 1: influence of PRP on employee motivation

(Source: self- generated)


Figure 14: influence of PRP on employee motivation

(Source: self- generated)



Trend analysis: It is very evident from the responses that the majority seeks to confront the payment mode prevalent in the organization. They seem to address that instead of setting the wage on the position of the employees, it needs to be founded upon the level of performance portrayed by the respective personnel. 



  1. Do you agree      that, motivation is important for the elevation of business processes in      an organisation?
Responses
% of responses

Number of Respondents
Total Number of Respondents
Yes
70%
70
100
No
20%
20
100
No Comments
10%
10
100

Table 2: Importance of Motivation in elevation of business processes

(Source: self- generated)


Figure 14: Importance of Motivation in elevation of business processes

(Source: self- generated)



Trend analysis: It is quite an expected response that the majority appear to address. An organization is obliged to heed on the motivational demands and impulses of the employees in order to thrive with their absolute objectives.



  1. How far do you      believe that, employee motivation is interrelated to maximisation of      profits?
Responses
% of responses

Number of Respondents
Total Number of Respondents
Agree
35%
35
100
Strongly Agree
30%
30
100
Disagree
15%
15
100
Strongly Disagree
20%
20
100

Table 3: Employee motivation and maximization of profit

(Source: self- generated)


Figure 15: Employee motivation and maximization of profit

(Source: self- generated)



Trend analysis: The majority seem to comply with the option which is highly expected. Massive participation of dedicated employees is mandatory to maximise the profit of an organization.



  1. How far do you      agree that dynamic apprehension is one of the requisite personality traits      to regulate the degree of motivation in health care sector?
Responses
% of responses

Number of Respondents
Total Number of Respondents
Agree
35%
35
100
Strongly Agree
55%
55
100
Disagree
5%
5
100
Strongly Disagree
5%
5
100

Table 4: dynamic apprehension and individual motivation

Source: Self generated

Figure 16: dynamic apprehension and individual motivation

Source: Self generated


Trend analysis: As it is evident from the cumulative inclination of the responses, dynamic apprehension is one of the prime factors that shape the frame of motivational needs prior to an employee. Dynamic apprehension can be considered as a major individual trait that reflects ambition as a crucial motivational need.



  1. How frequent you are prone to      take leaves?
Responses
% of responses

Number of Respondents
Total Number of Respondents
Frequently
32%
32
100
Twice a month
34%
34
100
Once a month
34%
34
100

Table 5: Number of leaves

Source: Self generated

Figure 17: Number of leaves

Source: Self generated


      Trend analysis: It is evident from the majority of responses that most of the time the employees of the chosen hospital have to work under urgent deadlines frequently.



  1. How far do you agree that      assigning challenging tasks is an analogue of relative rewards?
Responses
% of responses

Number of Respondents
Total Number of Respondents
Agree
34%
34
100
Strongly Agree
21%
21
100
Disagree
15%
15
100
Strongly Disagree
30%
30
100

Table 6: challenging tasks is an analogue of relative rewards

Source: Self-generated 

Figure 18: challenging tasks is an analogue of relative rewards

Source: Self-generated 


Trend analysis: The major inclination of the responses seems to suggest a reluctant remark. However, the inclination of their responses is positive.



  1. How far do you agree with the      fact that employee empowerment drives motivational impulses?
Responses
% of responses

Number of Respondents
Total Number of Respondents
Agree
36%
36
100
Strongly Agree
26%
26
100
Disagree
14%
14
100
Strongly Disagree
24%
24
100

Table 7: Employee empowerment as a driver of motivational impulses

Source: self generated

Figure 19: Employee empowerment as a driver of motivational impulses

Source: self generated


Trend analysis: The majority of the remarks exhibit a assertive remark.



  1. How far do you agree with the      fact that the organization is ethical in terms of responsibility shifting?
Responses
% of responses

Number of Respondents
Total Number of Respondents
Agree
35%
35
100
Strongly Agree
25%
25
100
Disagree
30%
30
100
Strongly Disagree
10%
10
100

Table 8: Ethical terms of the organization

Source: Self generated

Figure 20: Ethical terms of the organization

Source: Self generated


Trend analysis: The majority of the respondent exhibits an affirmative response.



  1. How far do you agree with the      fact that your goals are completely aligned with the absolute objective of      the company?
Responses
% of responses

Number of Respondents
Total Number of Respondents
Agree
30%
30
100
Strongly Agree
22%
22
100
Disagree
20%
20
100
Strongly Disagree
28%
28
100

Table 9: Individual goals and organizational goals

Source: Self generated

Figure 21: Individual goals and organizational goals

Source: Self generated


Trend analysis: The majority of the responses exhibit an affirmative remark



  1.  Please Rate the performance appraisal      system prevalent in your organization
Responses
% of responses

Number of Respondents
Total Number of Respondents
Good (1-4)
35
35%
100
Moderate (5-7)
35
35%
100
Poor (8-10)
30
30%
100

Table 10: Rating of the performance appraisal system

Source: Self generated

Figure 22: Rating of the performance appraisal system

Source: Self generated


Trend analysis: The majority of respondents exhibit an affirmative remark.



  1. How far do you agree with the      fact that the organization is interested to encourage individual      development of the employees through training and development?
Responses
% of responses

Number of Respondents
Total Number of Respondents
Agree
28
28%
100
Strongly Agree
22
22%
100
Disagree
20
20%
100
Strongly Disagree
30
30%
100

Table 11: Interest of the organization in encouraging individual development

Source: Self generated

Figure 23: Interest of the organization in encouraging individual development

Source: Self generated


Trend analysis: The majority of the responses exhibit a negative remark as they strongly disagree with the notion.



  1. Please rate your comprehensive      experience being a participant of one of those training programs
Responses
% of responses

Number of Respondents
Total Number of Respondents
Good (1-4)
28
28%
100
Moderate (5-7)
42
42%
100
Poor (8-10)
30
30%
100

Table 12: Rating of individual comprehensive experience

Source: Self generated

Figure 24: Rating of individual comprehensive experience

Source: Self generated


Trend analysis: Majority of the responses seem to reflect a reluctant remark.



  1. How frequent do you have to      perform under the surveillance of urgent deadlines?
Responses
% of responses

Number of Respondents
Total Number of Respondents
Frequently
55
55%
100
Twice a month
35
35%
100
Once a month
10
10%
100

Table 13: frequency of performing under urgent deadlines

Source: Self generated

Figure 25: frequency of performing under urgent deadlines

Source: Self generated


Trend analysis: It evidently shows that the employees have to perform under strict deadline frequently.



  1. How far do you agree with the      fact that the workplace ambience can be characterized with collaborative      instincts and mutual help?
Responses
% of responses

Number of Respondents
Total Number of Respondents
Agree
21
21%
100
Strongly Agree
22
22%
100
Disagree
20
20%
100
Strongly Disagree
37
37%
100

Table 14: Workplace ambience in respect to collaborative instinct

Source: Self generated

Figure 26: Workplace ambience in respect to collaborative instinct

Source: Self generated


Trend analysis: The majority of the responses seem to exhibit a negative remark.



  1. Please rate the conflict      mitigation ability of your organization
Responses
% of responses

Number of Respondents
Total Number of Respondents
Good (1-4)
30%
30
100
Moderate (5-7)
29%
29
100
Poor (8-10)
41%
41
100

Table 15: Rating of the conflict mitigation ability of the organization

Source: Self generated

Figure 27: Rating of the conflict mitigation ability of the organization

Source: Self generated


Trend analysis: Majority of the opinion suggest that it is not up to the mark. 



  1. How far do you agree with the      fact that the workplace ambience allows you to incorporate individual      ideas in your job?
Responses
% of responses

Number of Respondents
Total Number of Respondents
Agree
21%
21
100
Strongly Agree
11%
11
100
Disagree
30%
30
100
Strongly Disagree
38%
38
100

Table 16: Workplace ambience and individual ideas

Source: Self generated

Figure 28: Workplace ambience and individual ideas

Source: Self generated


Trend analysis:  Majority of the opinions exhibit a negative remark that the ambience is not collaborative



  1. Please rate the wage management      system of your organization
Responses
% of responses

Number of Respondents
Total Number of Respondents
Good (1-4)
55%
55
100
Moderate (5-7)
25%
25
100
Poor (8-10)
20%
20
100

Table 17: Rating of the management system

Source: Self generated

Figure 29: Rating of the management system

Source: Self generated


Trend analysis: Majority of the opinion exhibit an affirmative remark that the wage management system is up to the mark.




  1. How far do you agree with the      fact that you are obliged to perform in comparatively meagre salary as      compared to your position in your organization?
Responses
% of responses

Number of Respondents
Total Number of Respondents
Agree
11%
11
100
Strongly Agree
9%
9
100
Disagree
45%
45
100
Strongly Disagree
35%
35
100

Table 18: Employee position and salary

Source: Self generated

Figure 30: Employee position and salary

Source: Self generated


Trend analysis: The majority of the opinions disagreed with the essence of inquiry.



  1. How far do you agree with the      fact that your workplace is in favour of you in terms of job security?
Responses
% of responses

Number of Respondents
Total Number of Respondents
Agree
49%
49
100
Strongly Agree
21%
21
100
Disagree
20%
20
100
Strongly Disagree
10%
10
100

Table 19: Workplace in terms of job security

Source: Self generated

Figure 31: Workplace in terms of job security

Source: Self generated


Trend analysis: Majority of the opinions seem to exhibit an affirmative remark while agreeing with the essence of inquiry. 



  1. How far do you agree with the      fact that your work rate is flexible as compared to your position in the      organization?
Responses
% of responses

Number of Respondents
Total Number of Respondents
Agree
35%
35
100
Strongly Agree
20%
20
100
Disagree
34%
34
100
Strongly Disagree
11%
11
100

Table 20: Flexibility of work rate

Source: Self generated

Figure 32: Flexibility of work rate

Source: Self generated


Trend analysis: There exists a considerable dimension of reluctance in two prior remarks. Cumulative inclination is deceiving and vague. 

Conclusion

In the light of the above section, the researcher came across that there exist several issues that can be exhibited as the chief reasons of the lack of motivational impulses prevalent in the chosen organization. Furthermore, it is evident and can be presented as the datum of the cumulative inclination of the opinions that the majority of the management refuses to consider relative rewards as a potent tool to feed motivational impulses. 



Chapter 5: Conclusions and recommendations

Introduction

As the moot objective of conducting this study is to discern the parameters that differentiates the performers from the non-performers prevalent in Indo-US Super speciality hospital while heeding on the factors that drives the motivational impulses of the performers, it is almost inevitable for the researchers to adopt a holistic approach towards the aforementioned pursuits. Since a pertinent archive of apprehensions regarding the drivers of employee motivation is already prevalent, the researchers seek to percolate those apprehensions against the emerging issues of the chosen hospital while adapting positivism as the research philosophy. Furthermore, the researchers attempt to critically investigate almost the entire oeuvre of literature in order to delve deep to the problem while procuring the fundamental aspects of employee motivation. The corporeal outcomes of this investigation aids to shape the qualitative as well as quantitative questionnaire prior to the research question. In case of data analysis, the lauded technique of trend analysis has been wielded here to process and interpret the cumulative responses of the participants of the survey. Furthermore, the interpreted data has been attempted to quantify via graphs which is also founded upon the previously conducted trend analysis.

Linking with Objectives

Linking with objective 1

It is imperative to mention in the beginning the objectives hereby are evidently influenced by the principles of the research philosophy. Having a glimpse on the recent history of poor performance that the chosen hospital has been able to exhibit, it is obvious that the management have been unable to direct their massive human asset towards improved performance coupled with high productivity. It is also evident that management relies on the traditional authoritarian method of accomplishing tangible productivity with urgent deadline which, while ensuring massive participation of the human asset, is unable to retain the desired performance characteristics. The interpretation of acquired data also justifies the prevalent statement. In this regard, an obvious void between the cumulative demand of the employees and the absolute objective of the hospital is flagrant.


Linking with objective 2

It is an exaggeration to mention that the human capital plays the crucial role towards the enhancement of value of the respective organization. It is evident from the prevalent performance history of the chosen organization that, despite having a rich and massive presence of human capital, the organization has been unable to extract the desired performance out of them. Apart from the authoritarian attitude that every corporate organization is prone to impart on their employees, this trend of performance exhibits a sheer lack of motivational impulse within the employees which justifies certain results.

Linking with Objective 3

It has been feebly mentioned in the previous segment that the organization is evidently devoid of the drivers that consolidates motivational impulse and subsequently breeds higher performance characteristics. Apart from a flagrant misalignment prevalent among the cumulative will of the employees and the organization itself, it is also flagrant that the organization is inadequate enough to coach their employees against the tasks of higher merit. Employees seek to be involved in the tasks of higher expertise in order to accomplish relative rewards coupled with the fecund scope of individual development. 

Linking with Objective 4

It is the inherent distinction in motivational needs that function as the distinguishing factors of designating employees as performer or non-performer. It apparently exhibits the biased attitude of the organization towards their employees while portraying the lack of proper training programs that poses a hindrance before the employees to become a prospective performer. In this regard, the organization can be recommended to prepare the scope for the talented performers to exhibit their expertise in certain domain while observing effective training programs and other means to fulfil the motivational urges of the non-performers. 

Linking with Objective 5

The domains that require massive improvement are already been subtly highlighted in the data interpretation section coupled with the cumulative recommendations provided in several previous discussions. Apparently, it has been discovered that there exists a huge void that withers the alignment of the cumulative goals of the employees with the absolute will of the organization. Furthermore, the apparent absence of rich training programs inherently resists the so called non-performers to perform accordingly. Apart from that, the absence of the spirit among the employees being involved in challenging tasks of higher merit, apart from eliminating the opportunities of individual improvement, resist them to obtain the requisite motivational impulse. 

Recommendations

The domains which are prevalent in the organization and require cordial and sincere heeding of the management have already been discerned in the previous segments. In an elaborative tone, it has been identified that there exists a unfathomable void between the absolute objective of the organization and the cumulative will of the employees. This void is catering the hindrance that inherently resists the so-called non-performers to perform accordingly. This, apart from hampering the absolute productivity of the organization, cause the exponential decline of the performance characteristics of the chosen hospital. Furthermore, the upbringing of the performers is founded the craving of challenging jobs with higher precision. In this regard, the chosen hospital can be recommended to arrange fecund training programs that might enable them to cultivate their embedded talents and expertise. This, apart from satisfying the motivational cravings of the performers, can cater an effective enhancement of the risk mitigation capability prior to the chosen hospital. The organization should observe open consortiums comprising of the representatives of the non-performers domain and the representatives of the board of directors to listen to the motivational needs of the non-performers and several other appeals and can act accordingly to ensure higher productivity coupled with improved performance characteristics.

Conclusion

It is very evident and appreciated by several scholars prior to the psyche of motivation that work itself is a potential driver of motivational impulse. Most of the employees covet to avail a job of higher excellence with precision since that quenches their thirst for relative rewards. Moreover, most of the employees crave for feedback against their every task since it enables them to pursue an insightful self-analysis in order to stay motivated with the requisite level of dedication towards their work. In this regard, every organization can be recommended to observe training programs with sheer possibilities in order to nourish the craving of individual enhancement prior to the employees. Furthermore, the executives of an organization must attend the appeals of every employee while providing them regular feedback of their performance since it, apart from retaining the motivational impulse of the employees, presents a precise sense of performance criteria before the employees and indulge them to function accordingly.




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