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

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. Electronic supplementary material The online version of this article (10.1186/s12913-019-4144-8) contains supplementary material, which is available to authorized users.

Nurses’ appraisal of organizational attractiveness and the role of management support, interdepartmental collaboration climate, and service quality of care

“…Third, we explore the role of a number of factors in promoting OA, examining how and in what way three different types of hospital nurses' perceptions, namely performance, management, and climate, are linked to OA. In this way, the study responds directly to the call for more research: "future research might examine whether supportive and cooperative leadership style promotes OA [organizational attractiveness] as well as a supportive, cooperative climate in the organization in general" ( [7], p. 13). No previous study within or outside the domain of healthcare research has examined these associations.…”

“…Although little research has been undertaken on the concept of OA in a healthcare context, the few relevant studies indicate that OA is associated with important outcomes such as a positive increase in employee work engagement and service quality to patients, and a decrease in turnover intentions [7].…”

“…The latter would very likely be detrimental for the organization in both the short and the long term. Nevertheless, to our knowledge, only two studies have discussed and explicitly defined OA from an internal and current employee perspective, namely Trybou et al [4] and Slåtten et al [7]; these two studies have inspired the development of the definition of OA used in this study. According to these authors, OA can be described theoretically and defined as an attitudinal construct; it is about "people's attitude toward the organization for which they work" ( [7], p. 8).…”

“…One consequence of this one-sided focus on recruitment or prospective applicants is that a focus on OA from an internal and current employee perspective has been generally neglected. Within the healthcare domain, only three studies have been undertaken with a focus on the concept of OA from a current employee perspective, namely Trybou et al [4], Yan and Kung [1], and a recent study by Slåtten et al [7]. Clearly, there is a need for more research that considers OA from a current employee perspective within the domain of healthcare.…”

“…Second, among these three studies, only Slåtten et al [7] consider how current hospital nurses perceive the attractiveness of their hospital organization. This is surprising for a number of reasons.…”