Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2019

Open Access 01-12-2019 | Research article

The role of organizational attractiveness in an internal market-oriented culture (IMOC): a study of hospital frontline employees

Authors: Terje Slåtten, Gudbrand Lien, Peer Jacob Svenkerud

Published in: BMC Health Services Research | Issue 1/2019

Login to get access

Abstract

Background

Hospitals need to understand how to reduce their frontline employees’ turnover rate as well as how to positively engage them and improve their service. Central to these issues, we find, is the employees’ perception of their organization’s attractiveness. This objective of this paper is to clarify how the role of organizational attractiveness relates to frontline employees’ perception of their internal market-oriented culture as well as their turnover rate, engagement, and service quality. To our knowledge, no previous research has explored the role of organizational attractiveness from a frontline employee perspective in health-service organizations.

Methods

The conceptual framework we developed was tested in a quantitative study. We sent a questionnaire to nurses in several public hospitals in Norway. We then analyzed the data with confirmatory factor analysis and structural equation modeling in Stata. Further, we performed multi-group comparisons to test heterogeneity in personal characteristics. The indirect effects were tested by mediator analyses.

Results

We made three main findings. First, organizational attractiveness has a significant positive effect on frontline employees’ engagement (β = 0.833) as well as on the service quality they provide to hospital patients (β = 0.472). Additionally, it significantly lowers their turnover rate (β = − 0.729). Second, the ‘internal market-oriented culture’ (IMOC) has a significantly positive effect on organizational attractiveness (β = 0.587) and explains a total of 35% of the variance in organizational attractiveness. Third, organizational attractiveness fully mediates the relationship between “internal market-oriented culture” (IMOC) and frontline employees’ engagement and the service quality they provide to patients, and it partially mediates the relationship with the turnover rate.

Conclusions

This study proves that organizational attractiveness is vital for hospital managers to focus on, as it affects employees’ perception of whether the organizations is a great place to work. It reveals the need for those same managers to develop an internal market-oriented culture (IMOC) directed toward hospital frontline employees, as it has both a direct effect on organizational attractiveness and an indirect effect on employees’ engagement, turnover intention, and service quality.
Appendix
Available only for authorised users
Literature
1.
Ind N. Living the brand. How to transform every member of your organization into a brand champion. London: Kogan Page Limited, 2010.X
2.
Landry MD, Hastie R, Onate K, Gamble B, Deber RB, Verrier MC. Attractiveness of employment sectors for physical therapists in Ontario, Canada (1999-2007): implication for the long term care sector. BMC Health Serv Res. 2012;12:133.PubMedPubMedCentralCrossRef
3.
4.
Trybou J, Gemmel P, Vaerenbergh YV, Annemans L. Hospital-physician relations: the relative importance of economic, relational and professional attributes to organizational attractiveness. BMC Health Serv Res. 2014;14:232.PubMedPubMedCentralCrossRef
5.
Currie EJ, Hill RAC. What are the reasons for high turnover in nursing? A discussion of presumed causal factors and remedies. Int J Nur Stu. 2012;49:1180–9.CrossRef
6.
McHugh MD, Kutney-Lee A, Cimiotti JP, Sloane DM, Aiken LH. Nurses’ widespread job dissatisfaction, burnout, and frustration with health benefits signal problems for patient care. Health Aff. 2011;30:202–10.CrossRef
7.
8.
Castle NG, Engberg J, Anderson R, Men A. Job satisfaction of nurse aides in nursing homes: intent to leave and turnover. Gerontologist. 2007;47(2):193–204.PubMedCrossRef
9.
Slåtten T, Svensson G, Sværi S. Service quality and turnover intention as perceived by employees– antecedents and consequences. P Review. 2011;40(2):205–21.
10.
Berthon P, Ewing M, Hah L. Captivating company: dimensions of attractiveness in employer branding. Int J Advertising. 24(2):151–72.CrossRef
11.
Carpentier M, Hoye GV, Stockman S, Schollaert E, Theemsche BV, Jacobs G. Recruiting nurses through social media: effects on employer brand and attractiveness. J Adv Nurs. 2017;00:1–13.
12.
Hoye GV. Nursing recruitment: relationship between perceived employer image and nursing employees’ recommendations. J Adv Nurs. 63(4):366–75.
13.
Mehrabian A, Russel JA. An approach to environmental psychology. Cambridge: MIT Press; 1974.
14.
Sivertzen AM, Nilsen ER, Olafsen AH. Employer branding: employer attractiveness and the use of social media. J Prod & B Manage. 2013;22:473–83.
15.
Berthon P, Ewing M, Hah LL. Captivating company: dimensions of attractiveness in employer branding. Int J Adv. 2005;24(2):151–72.CrossRef
16.
Pingle S, Sharma A. External employer attractiveness: a study of management in India. J of Contemporary Manag Res. 2013;7(1):78–95.
17.
Ambler T, Barrow S. The employer brand. J Brand Manag. 1996;4(3):185–206.CrossRef
18.
Lievens F, Highhouse S. The relation of instrumental and symbolic attributes to a company’s attractiveness as an employer. Personnel Psy. 2003;56(1):75–102.CrossRef
19.
Aiman-Smith L, Bauer T, Cable D. Are you attracted? Do you intend to pursue? A recruiting policy-capturing study. J of Bus and Psy. 2001;16:219–37.CrossRef
20.
Bagozzi RP. Principles of marketing management. Chicago: Science Research Associates; 1986.
21.
Gregory DM, Way CY, LeFort S, Barrett BJ, Parfrey PS. Predictors of registered nurses’ organizational commitment and intent to stay. Health Care Manag Rev. 2007;32(2):119–27.CrossRef
22.
Kraut AI. Predicting turnover employees from measured job attitudes. Org Beh and H Perf. 1975;13:233–43.CrossRef
23.
Park JS, Kim TH. Do types of organizational culture matter in nurse job satisfaction and turnover intention? Leadership Health Serv. 2009;22(1):20–38.CrossRef
24.
Theurer CP, Tumasjan A, Welpe IM, Lievens F. Employer branding: a brand equity-based literature review and research agenda. Int J Manag Rev. 00:1–25.
25.
Schaufeli WB, Salanova M, Gonzalez-Roma V, Bakker AB. The measurement of engagement and burnout: a two-sample confirmatory factor-analytic approach. J of Happiness Studies. 2002;3:71–92.CrossRef
26.
Yan YH, Kung CM. Hospital image and compensation/benefit system on organizational attractiveness. Public Health. 2017;2(1):33–41.
27.
Slåtten T, Lien G. Consequences of employees’ collective engagement in knowledge-based service firms. J Serv Science Res. 2016;8:95–129.CrossRef
28.
Slåtten T, Mehmetoglu M. Antecedents and effects of engaged frontline employees – a study from the hospitality industry. Manag Serv Qual. 2011;21(1):88–107.CrossRef
29.
Kaye B, Jordan-Evans S. Engaging talent. Exec Excell. 2003;20(8):11.
30.
Chen SY, Wu WC, Chang CS, Lin CT, Kung JY, Weng HC, Lin YT, Lee SI. Organizational justice, trust, and identification and their effects on organizational commitment in hospital nursing staff. BMC Health Serv Res. 2015;15:1–17.CrossRef
31.
Yalabik ZY, Rossenberg YV, Kinnie N, Swart J. Engaged and committed? The relationship between work engagement and commitment in professional service firms. The Int J of Human Res Manag. 2015;26(12):1602–21.CrossRef
32.
Kashive N, Khanna VT. Building employee brand equity to influence organization attractiveness and firm performance. Int J of Bus and Manage. 2017;12(2):207–19.CrossRef
33.
Barney JB. Organizational culture: can it be a source of sustained competitive advantage. A Manag Rev. 1986;11(3):656–65.
34.
Schein E. Organizational culture and leadership. 1st ed. San Francisco: Jossey-Bass; 1985.
35.
Lings IN, Greenley GE. Measuring internal market orientation. J Serv Res. 2005;7(3):290–305.CrossRef
36.
Lings IN. Internal market orientation – constructs and consequences. J Bus Res. 2004;54:405–13.CrossRef
37.
Hogan SJ, Coote LV. Organizational culture, innovation, and performance: a test of Schein’s model. J Bus Res. 2013:1–13.
38.
Zachariadou T, Zannetos S, Pavlakis A. Organizational culture in the primary healthcare setting of Cyprus. Health Serv Res. 2013;13:1–8.CrossRef
39.
Yafang T. Relationship between organizational culture, leadership behavior and job satisfaction. BMC Health Serv Res. 2011;11:1–9.CrossRef
40.
O’Reilly CA, Chatman JA. Culture as social control: corporations, cults and commitment. In: Cummings L, Staw B, editors. Research in organizational behavior. Greenwich, CT: JAI Press; 1996. p. 18–166.
41.
Leekha CN, Sharma S. Employer branding: strategy for improving employer attractiveness. Int J Org Analysis. 2014;22(1):48–60.CrossRef
42.
43.
Lupina E, Gravingen KA. Intern markedsorientering i offentlig sektor – en studie av somatiske sykehus. Masteroppgave 2015. Høgskolen i Lillehammer.
44.
Gounaris SP. Internal-market orientation and its measurement. J Bus Res. 2006;59:432–48.CrossRef
45.
Boshoff C, Allen J. The influence of selected antecedents on frontline staff’s perceptions of service recovery performance. Int J of Serv Industry Manage. 2000;11(1):63–90.CrossRef
46.
Slåtten T. The effect of managerial practice on employee-perceived service quality: the role of emotional satisfaction. Manag Serv Qual. 19(4):431–55.
47.
Anaza NA, Rutherford BN. Developing our understanding of patronizing frontline employees. Manag Serv Qual. 22(4):340–58.CrossRef
48.
Mehmetoglu M, Jakobsen TG. Applied statistics using Stata – a guide for the social sciences. London, UK: Sage; 2017.
49.
Raykov T. Estimation of composite reliability for congeneric measures. Appl Psychol Meas. 1997;21:173–84.CrossRef
50.
Acock AC: Discovering structural equation modelling using Stata, 2013. College Station, Texas: Stata Press.
51.
Mehmetoglu M. Medsem: a Stata package for statistical mediation analysis. Int J Computational Economics and Econometrics. 2018;8(1):63–77.CrossRef
52.
Zhao X, Lynch JGJ, Chen Q. Reconsidering baron and Kenny: myths and truths about mediation analysis. J Consum Res. 2010;37:197–206.CrossRef
53.
Yanfang T. Learning organizations, internal marketing, and organizational commitment in hospitals. BMC Health Serv Res. 2014;14:152.CrossRef
54.
Liedtka JM, Haskins ME, Rosenblum JW and Weber J: The generative cycle: linking knowledge and relationships. Sloan Manag Rev 1997, Fall: 47–58.
55.
Zeithaml VA, Bitner MJ, Gremler DD. Service marketing – integrating customer focus across the firm. New York: McGraw-Hill; 2008.
56.
Wernerfelt B. A resource-based view of the firm. Strategy Manag J. 1984;5(2):171–80.CrossRef
57.
Carver L, Candela L. Attaining organizational commitment across different generations of nurses. J Nurs Manag. 2008;16:984–91.PubMedCrossRef
58.
Tsai Y, Wu SW. Using internal marketing to improve organizational commitment and service quality. J Adv Nurs. 2011;67(12):2593–604.PubMedCrossRef
59.
Heskett JL, Jonas TO, Loveman GW, Sasser EW, Schlesinger LA. Putting the servcie-profit chain to work. Harvard Bus Rev. 72(2):164–74.
60.
Homburg C, Pflesser C. A multiple-layer model of market-oriented organizational culture. Measurement issues and performance outcomes. J Mark Res, XXXVII:449–62.
61.
Nakrem S. Understanding organizational and cultural premises for quality of care in nursing homes: an ethnographic study. BMC Health Serv Res. 2015;15:508.PubMedPubMedCentralCrossRef
62.
Banaszak-Holl J, Castle NG, Lin MK, Shrivastwa N, Spreitzer G. The role of organizational culture in retaining nursing workforce. The Gerontologist. 2015;(3):462–71.PubMedPubMedCentralCrossRef
63.
Kucherov D, Zavyalova E. HRD practices and talent management in the companies with the employer brand. European Journal of training and Development. 36(1):86–104.CrossRef
64.
Iliopoulos E, Priporas C-V. The effect of internal marketing on job satisfaction in health services: a pilot study in public hospitals in northern Greece. BMC Health Serv Res. 2011;11:1–8.CrossRef
65.
Von Treuer K, Karantzas G, McCabe M, Mellor D, Konis A, Davison TE, O’Connor D. Organizational factors associated with readiness for change in residential aged care settings. BMC Health Serv Res. 2018;18:1–6.
66.
Quinn RE, Rohrbaugh J. A spatial model of effectiveness criteria: towards a competing values approach to organizational analysis. Manag Sci. 1983;29:363–77.CrossRef
67.
Hofstede GH. Culture’s consequences: comparing values, behaviors, institutions, and organizations across nations. Thousand Oaks, CA: Sage; 2001 (2nd ed).
Metadata
Title
The role of organizational attractiveness in an internal market-oriented culture (IMOC): a study of hospital frontline employees
Authors
Terje Slåtten
Gudbrand Lien
Peer Jacob Svenkerud
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2019
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-019-4144-8

Other articles of this Issue 1/2019

BMC Health Services Research 1/2019 Go to the issue

Research article

An evaluation of oncofertility decision support resources among breast cancer patients and health care providers

Research article

Planning, implementation and operation of a personalized patient management system for subjects with first suspect of cancer (OnkoNetwork): system description based on a qualitative study

Research article

Adult mental health provision in England: a national survey of acute day units

Research article

Implementing a best-practice model of gestational diabetes mellitus care in dietetics: a qualitative study

Research article

Dementia assessment and management in primary care settings: a survey of current provider practices in the United States

Research article

A systematic review of the effects of advance care planning facilitators training programs