the quality of work life study - research brief

Research completed in partnership with the University of Maryland, Baltimore

On the Frontlines of Sodexos Healthcare Division The Quality of Work-Life Study Research Brief Dr. Jennifer Swanberg, Professor, University of Maryland School of Social Work

Helen Nichols, MSW, Research Associate, University of Maryland School of Social Work


In May and August 2014, academic researchers surveyed 270 Environmental

Service (ES) and Food Service (FS) workers at two U.S. hospitals in Sodexos

Healthcare Division. The goal of this study was to gather information about workers

perceived job quality for use in designing a future study aimed at reducing turnover,

absenteeism, and work-related injuries at both sites.

For Sodexo, this study provides an opportunity to improve the Quality of Life of

these workers, as well as the Quality of Life of the patients they serve. In turn,

hospitals can benefit from greater efficiency, reduced costs, improved safety and

increased performance.

Setting the Stage for the Quality of Work-Life StudyEnvironmental and food service workers play a

critical role in hospital success. Frontline hospital

support jobs include the ES and FS workers

responsible for preventing the spread of infection

within the hospital; these workers also ensure the

health, safety and satisfaction of patients, both

through the proper cleaning of the facility and

through food preparation.1,2,3

In fact, the physical environment of the hospital,

which includes cleanliness, is the third most

important factor in the overall Hospital Consumer

Assessment of Healthcare Providers and Systems

(HCAHPS) Survey patient rating. Patients often

assess a hospitals attention to detail and the risk

of infection by the level of cleanliness.4 The quality

of dietary services provided within hospitals also

affects how patients perceive their overall hospital

experience.5

Furthermore, ES and FS workers interact with

patients on a frequent basis, and this direct patient

contact is largely responsible for the impression

patients will develop regarding their stay.6 In

fact, more than 80% of the time a patient spends

in the hospital is not related to direct care, and

patients who report any problem with their room

or hospital staff rate their overall experience 39%

lower than patients with no problems.

Despite their important role, frontline healthcare

jobs are characterized by low wages and limited

advancement opportunities.7In 2012, it was

estimated that 44.8% of healthcare support

workers earned an income at or below the poverty

level,8 and most will continue to earn low wages

for the remainder of their careers.9 These jobs

typically require heavy workloads, are fast-paced,

and may provide workers low control over job

tasks.10,3 They also may require workers to manage

inconsistent weekly schedules.11 Furthermore,

supervisors and hospital support staff may

struggle to communicate effectively, and workers

may perceive a low level of supervisor support.10

Healthcare executives are increasingly concerned

with high turnover rates among their frontline

workers. When turnover among frontline

workers is high, there is a negative impact on

the quality of patient care, which eventually

hurts the overall financial performance of the

organization.12 Industry studies report turnover

rates among frontline hospital support workers

as high as 100%.13 Hospitals with high rates of

turnover experience decreased patient satisfaction

and customer service quality, as well as lower

profitability and higher discharge costs.14,15 It is

clear, therefore, that job quality for these workers

is critical, as decreased job quality among

frontline healthcare workers is reflected in greater

turnover.16

2 TheQualityofWork-LifeStudyStudyBrief Proprietary and Confidential


The Quality of Work-Life Study DescriptionAs stated previously, academic researchers

surveyed 270 ES and FS workers at two U.S.

hospitals in Sodexos Healthcare Division. Sites

were specifically selected by the corporate

executive team for this purpose.

The survey included 57 questions covering worker

attitudes, opinions and expectations, ability to

balance work and family, and whether or not they

were likely to look for a new job during the next

year.

Supervisors told workers about the survey at least

two weeks in advance and provided reminders

when researchers arrived on site. Workers were

able to take the 30-minute survey during their

regular work shift in a private room at each site.

Surveys were available in English and Spanish,

and a bilingual member of the research team was

available to explain the survey and to answer

questions for Spanish-speaking workers. Those

who completed the survey were given a $20 gift

card for their participation.

The research team included Dr. Jennifer Swanberg

and graduate students from the School of Social

Work at the University of Maryland, Baltimore;

Dr. Maureen Perry-Jenkins from the University of

Massachusetts, Amherst; and Dr. Rachel Permuth

and research staff from Sodexo. The entire team

was on site at each hospital for two consecutive

days, during all three shifts (day, evening and night).

Who Participated in the Study? Surveys were completed by 147 ES workers and

123 FS workers. They ranged in age from 18 to

69 years, although the largest segment (35%) of

workers was between 18 and 29 years of age.

The average worker was 40 years old, 73% of

workers were women, 39% had completed at

least some college and 57% were not married. ES

workers were more likely to identify as non-White

(79%) in comparison to FS workers (52%) and 13%

of all workers identified themselves as Hispanic.

Almost 25% of workers were primary caregivers

for an ill, elderly and/or disabled family member,

and 47% had at least one child under the age of 18

living with them.

How Did Workers Describe Job Quality?A variety of factors related to job quality were

measured; a few key survey results are described

below.

Compensation: Most workers were employed by Sodexo on a full-time basis (81%) and only

12% reported working standard hours, defined

as daytime hours from Monday through Friday.

ES workers earned $9.94/hour, significantly

less than FS workers, who earned $11.14/hour.

Scheduling: The most common scheduling problem was a lack of schedule control.

For example, 29% of respondents reported

difficulty anticipating the days and times they

were scheduled to work each week and 34%

experienced frequent last-minute schedule.

SupervisorSupport: Higher levels of supervisor support were related to: (1) decreased levels

of work stress; (2) decreased turnover intent;

(3) increased job satisfaction; (4) increased

decision-making authority and control, as

reported by workers.

WorkStrainandStress: Across both groups of workers, 61% reported that their job required a

hard level of physical effort and 67% reported

that their work is stressful.

Work-LifeBalance: Both ES and FS workers reported difficulty attaining work-life balance:

23% reported that the demands of their family

or personal life interfere with their work,

and 26% reported that the demands of work

interfere with their family life.

Proprietary and Confidential TheQualityofWork-LifeStudyStudyBrief 3


OccupationalHealthandWellness: More than half of all workers (55%) came to work sick at

least once in the 30 days preceding this survey.

A significant number of workers reported

missing work due to a work-related illness and/

or injury 52% missed at least one day and 24%

missed three or more days in the preceding 12

months.

What Job Quality Factors Make Some Workers More Likely to Quit?Almost half (44%) of all workers stated that they

were likely to look for a job with a new employer in

the next 12 months. The inability to easily predict

the days and times of scheduled work from

week to week and frequent last-minute schedule

changes were both found to predict higher

turnover intent. Lower levels of supervisor support

were related to higher turnover intentions. Higher

levels of interference between work demands and

family/personal demands were also related to

increased intent to turn over.

Suggestions for SupervisorsBased upon the results of the survey, the

researchers developed a list of suggestions and

strategies for frontline supervisors.

TrainFrontlineSupervisors. Frontline supervisors are vital to ensuring the goals of

upper management are being accomplished by

the frontline workers who carry out everyday

tasks.17 They may have primary responsibility

for implementing human resource policies,

which can impact employee behaviors.18,19

Leadership training, however, is often provided

on an infrequent and irregular basis to these

supervisors. Furthermore, business experts

recommend that new frontline supervisors

receive even more training and support as they

learn their new roles.17

Providein-persontraining. Frontline

supervisors should have regular in-person

training. In this training, interpersonal

communication skills can be practiced

via role playing, such as how to mediate

workplace conflict or how to creatively

resolve issues of work-life conflict.

Providetrainingthroughmentors. Match

new frontline supervisors with a more

experienced frontline supervisor who can

serve as a mentor. Consider cross-site

mentoring especially when sites have few

supervisors and other Sodexo contracted

facilities are nearby.

AllowWorkerstoMakeMoreDecisions.Different employees enjoy different tasks

capitalize on this. Increased decision-making

authority decreases work stress.20

Allowchoicesinwhentasksaredone

andwhodoesthem. FS workers on the

night shift may need to prep food for the

oncoming day shift, but this can be done at

any time during the night. Allow workers to

choose the specific time during the night

to complete food prep. Allow workers to

decide among themselves who will do food

prep and who will do other tasks.

ImproveSchedulingPractices. This strategy is mutually beneficial improved scheduling can

reduce turnover for Sodexo.21

Giveemployeesavoiceinschedule

creationandschedulechange.Ask for and

include worker preferences in scheduling

decisions, and ensure that there is a simple

way for workers to request time off that will

not jeopardize the total number of hours

they are scheduled to work.

Createstabilitywhileprovidingoptions.

Provide workers with their schedules at



least two weeks in advance. Give workers

the opportunity to cover or swap shifts

with one another.

ProvideSupervisorSupport.Supervisor support is essential for frontline workers,

as they often do not have the resources or

influence to deal with the stress of work

demands.22

Providedirectsupport. Supervisors should

be attentive and sincerely listen to what

workers have to say, and they should work

with them to find solutions to workplace

issues.

Createotheravenuesofsupport.

Supervisors can encourage coworker

support; for example, by facilitating the

swapping of shifts between coworkers. This

might include posting shifts that workers

want to switch in a central area in the break

room and minimizing shift swap paperwork.

PracticeGoodCommunication.Create buy-in and increase worker engagement by including

them in the decision-making process.23

Askquestions. Workers most likely have

great ideas about what might work better

ask them.

Provideinformation. Explain why certain

goals are important to Sodexo and the

hospital.

Setclearexpectations.Ensure workers

know what job responsibilities are expected

of them, how these goals are measured and

over what time period mastery should be

attained.

Sharesuccess. Reward success (i.e.,

improved HCAHPS) and highlight worker

contributions.

Next StepsBased on the findings from the Quality of Work-

Life Study, researchers will develop a training

module that addresses some of the issues faced

by frontline Sodexo healthcare workers. The

module will be geared toward supervisors and

designed to reduce employee turnover, enhance

productivity and improve overall quality of work-

life. Once developed, the training module will

be included in the next research proposal, and

implemented and evaluated if the study is funded.

For more information about this study, please

contact Dr. Jennifer Swanberg (jswanberg@ssw.

umaryland.edu) or Dr. Rachel Permuth (Rachel.

[email protected]).

Dr. Jennifer Swanberg, Professor,

University of Maryland School of

Social Work

Helen Nichols, MSW, Research

Associate, University of Maryland

School of Social Work



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