An assessment of organisational culture in Australian hospitals using employee online reviews

Abstract

Background Online reviews on job sites have been used as a source of information about organisational culture in industries such as hospitality and technology. An extension of this approach by applying thematic analysis to online reviews posted by healthcare employees could potentially identify areas for organisational improvement in relation to enhancing employees’ wellbeing and experience. The aim of this study was to analyse the content of online reviews posted by hospital employees on job websites for themes of organisational culture. Methods 103 anonymous online reviews across three job websites, posted by hospital employees of four hospitals within an Australian health network were extracted. Reviews had been posted across a period of six years, from 2014 to early 2020. Sentiment rating based on user-allotted ratings on the selected websites was calculated. The sentiment score was validated against the textual content of the review to confirm employee recommendation and sentiment. Sentiment was coded as neutral, positive, or negative. Significant keywords, associations, and usage within the context of identified sentiment were coded and clustered manually against eight pre-determined safety culture themes. These themes were derived from the most used assessment tools for self-reported measures of occupational health and safety, and safety culture in healthcare. Results Workers across clinical roles (n=49) and non-clinical roles (n=50) were evenly represented in the dataset. 35.9% of commenters (n=37) reported their length of employment in the hospitals that they reviewed. Most online employee reviews addressed broad themes related to perceptions of management (n=98), safety climate (n=97), teamwork climate (n=91) and working conditions (n=98). A significant set of reviews addressed themes related to job satisfaction (n=49) and learning, training, and development (n=41). 72.8% of online reviews (n=75) expressed positive sentiment towards their employer. Reviews expressing negative sentiment were largely posted by former employees and indicated areas of discontent that reflected organisational and systemic factors. Conclusions Online employee reviews posted by hospital workers on job sites provide valuable insights into healthcare organisational culture. Therefore, employee online reviews could be used as a supplementary, free source of data to inform organisational employee engagement initiatives.