Research in Social and Administrative Pharmacy
Volume 7, Issue 1 , Pages 51-63, March 2011

Key determinants of hospital pharmacy staff's job satisfaction

  • Cicely S. Liu, B.Pharm.(Hons.)
    • ,
  • Lesley White, Ph.D.

      Affiliations

    • Corresponding Author InformationCorresponding author. N519, Pharmacy Building (A15), University of Sydney, Sydney, NSW 2006, Australia. Tel.: +61 2 9351 4447; fax: +61 2 9036 7689.

Faculty of Pharmacy, University of Sydney, Sydney, NSW 2006, Australia

published online 30 June 2010.

Article Outline

Abstract 

Background

The level of job satisfaction among pharmacy personnel is of importance because it may affect performance and retention.

Objectives

The objectives of this study were to (1) examine the level of job satisfaction among pharmacists and pharmacy support personnel practicing in Australian hospitals, (2) compare the level of job satisfaction with career satisfaction, (3) investigate the key factors determining hospital pharmacy staff's job satisfaction and their relative importance, and (4) identify the influential factors on their perceptions related to the ideal job.

Methods

A cross-sectional survey was sent to 350 pharmacy staff in Australia. Participants had the option of returning the completed survey by means of mail or online. Previously validated 5-point scales measured each of the study variables. Data analyses included descriptive statistics, analysis of variance, factor analysis, and multiple linear regression.

Results

Responses were received from 188 subjects (53.7%). Job satisfaction was 3.62±0.77, which was significantly higher than career satisfaction 3.38±0.85. Different job satisfaction mean scores were seen among age groups (F=2.718, P<.05). Percentage of time spent in dispensing was negatively correlated to job satisfaction (β=−0.202, P<.01). Sex, job positions, education levels, size and location of the hospitals, and work experience were not significant factors in determining job satisfaction. Job-related predictors of job satisfaction were ability utilization and recognition. Ability utilization was the most important factor in their perception of the ideal job.

Conclusion

The primary determinants of job satisfaction were intrinsic aspects of the job; that is, what makes people satisfied is the work that they do or the way they are used. Hospital pharmacy staff need to feel certain about their future, so managers should strive to secure the pharmacist's role in the provision of health care. It is suggested that pharmacy managers focus on altering the job to provide greater use of skills and abilities and to provide increased challenge in the work. Further research should focus on other predictors of job satisfaction and possible ways to enhance satisfaction level.

Keywords: Job satisfaction, Hospital pharmacy, Pharmacy staff, Workforce issues

 

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Introduction 

The extent and determinants of job satisfaction in hospital pharmacy have been the topics of considerable interest to the profession over the last 3 decades. Investigators concur that increased job satisfaction enhances job performance,1, 2, 3, 4 and in addition, a decreased level of job satisfaction may result in difficulties in attracting and retaining experienced staff in the hospital pharmacy labor force.5, 6 Hospital settings are particularly susceptible to these issues because a pattern of lower satisfaction was found to exist among hospital pharmacists than in the community sector.7 In Australia, the demand for hospital pharmacists has been driven by turnover of existing staff rather than an overall growth in the number of positions.8, 9 Pharmacist job turnover rates in the United States ranged from 7.5% to 17% during 1998 to 2005,6 which cost health care institutions an estimated 5% of the total annual pharmacy operating budget,10 and in Australia, most of the young pharmacists only remain in the hospital sector for 1-2 years before moving into the more highly paid retail sector.11 Training is not cost-effective if employees become dissatisfied and seek other opportunities outside hospital pharmacy before they have a chance to contribute productively12; therefore, it is important to understand the key factors that contribute to job satisfaction in hospital pharmacy in order that strategies may be put in place to improve job satisfaction levels.

Job satisfaction has been defined as “the match between an individual's expectations and the perceived reality of the job as a whole.”13 The most influential theory to explain job satisfaction is the two-factor theory of job satisfaction, which states that job satisfaction comprises 2 components: intrinsic job factors (characteristics of the worker personally) that include desire for achievement, recognition, responsibility, and advancement and extrinsic job factors (characteristics of the organization) that are related to features of the job, such as supervision, salary, company policy and administration, and working conditions.2, 14, 15

Previous research has studied the effects on job satisfaction of demographic factors and various work-related factors, such as work activities, hours worked, income, and job positions. Although demographic factors, such as age, sex, and education levels, have been found to be statistically significant determinants of job satisfaction, results from various studies were somewhat contradictory.2 Both Salameh and Hamdan16 and Hassell, Seston and Shann17 found female pharmacists hold high levels of job satisfaction compared with their male counterparts. Job position was consistently found to be the significant predictor of job satisfaction. A study of 354 hospital pharmacists in 1 state in the United States18 found that clinical pharmacists reported the highest mean satisfaction scores, but whether manager pharmacists were more satisfied with their job than staff pharmacists was still controversial.19 A 2002 survey of 96 pharmacists and pharmacy technicians revealed that pharmacy technicians were less satisfied with their job than pharmacists because of inadequate pay, few opportunities for job advancement, limited skills used, routine and laborious tasks, and staffing shortages.20 Clinical involvement was shown to have a positive association with job satisfaction in Cox and Fitzpatrick's19 study of 161 randomized pharmacy in Arizona. Studies have found the direct influence of supervisor and coworkers' support on job satisfaction,21, 22, 23, 24 and a 2003 study of 85 pharmacists demonstrated that quality of work and opportunity for self actualization were of primary importance to hospital pharmacists.25 It has also been well established that job stress and excessive workload negatively affect job satisfaction.1, 6, 19, 20, 21, 22, 23, 24, 26 Mott's21 study in 541 randomized pharmacists in 4 American states found that between 1983 and 1997, the number of pharmacists citing stress as an important reason for leaving a position increased, whereas those citing salary as a reason for leaving decreased. In interpreting the job satisfaction findings for pharmacists, few studies have made a clear distinction between whether they are measuring satisfaction with the current job or with pharmacy as a career. Murawski et al's27 study with 108 community pharmacists has found that job satisfaction predicts career satisfaction. The results from these studies have been useful in identifying the pharmacy staff who are likely to have a high level of job dissatisfaction.

However, most of the studies included only a few hypothesized predictors or they included only members of a specific organization. As a result, it is difficult to reach a definite conclusion on the relative importance of various factors to job satisfaction from the existing literature. One study investigated the influence of various characteristics on job satisfaction and intention to leave and found that more enriched jobs in terms of factors such as task variety, identity, significance, and autonomy resulted in greater job satisfaction and a lower interest to leave.28 However, this study was conducted in Taiwan, and given the differences across health systems in various countries, it was considered valuable to investigate the issue in Australia.

Therefore, the overall objectives of this study were to (1) examine the level of job satisfaction among pharmacists and pharmacy support personnel practicing in Australian hospitals, (2) compare the level of job satisfaction with career satisfaction, (3) investigate the key factors determining hospital pharmacy staff's job satisfaction and their relative importance, and (4) identify the influential factors on perceptions related to the ideal job.

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Method 

Data collection 

Data were collected using a cross-sectional survey. A minimum required sample size of 100 pharmacy staff was determined to be necessary based on 80% power, 95% level of confidence, and an effect size of 0.15. The assumption of a 33% response rate dictated an approximate sample size of 300. A list of Australian hospitals was obtained from the Australian Institute of Health and Welfare, and it was estimated that there are, on average, 10 to 15 pharmacy staff in each hospital of more than 100 beds; therefore, 26 hospitals were selected by convenience sampling. Five (19%) of these were regional hospitals. A phone call was made to the Director of Pharmacy of each hospital asking for their participation. If they agreed to participate, participant information statements and surveys were then mailed out, and respondents had the option of returning the survey by reply-paid envelope or submitting it electronically by means of a survey Web site. A follow-up call was made to each Director of Pharmacy approximately 2 weeks later. The total number of potential participants was calculated by summating the number of staff from all hospitals who agreed to participate from the information given by each Director of Pharmacy.

The study was approved by the Human Research Ethics Committee of the University of Sydney. All participating hospitals were requested to sign a hospital CEO approval and a Director of Pharmacy consent form. Participants were reassured that the questionnaire was anonymous and that nonparticipation would have no implications for their ongoing employment.

Measurements 

The survey consists of 4 sections: (1) job satisfaction and career satisfaction, (2) influence of various factors on perceptions of ideal job, (3) influence of various factors on current job satisfaction, and (4) demographic characteristics and work-related information.

The dependent variables, job satisfaction and career satisfaction, were measured by 10 items adapted from Barnett and Kimberlin's29 previously validated instrument. Using a 5-point scale (1=strongly agree, 5=strongly disagree), these items asked the individual to indicate their satisfaction with their career (items 1-6) and their current job (items 7-10) without referring to any particular aspect of the work.

Both positive and negative statements were used in measuring the dependent variables, and scoring was recoded for negatively worded items, so that a higher score indicated greater job or career satisfaction.

The influence of various factors on pharmacy staff's current job satisfaction was measured using a 5-point scale for 41 items from standardized instruments, including questions from the Short Form of the Minnesota Satisfaction Questionnaire and the Barnett and Kimberlin's instrument.29, 30 The selected items covered statements related to ability usage (5 items), salary and advancement (5 items), interpersonal relationships (12 items), workload and staffing (5 items), work schedule (3 items), company policies and management (8 items), and workplace environment (3 items). The influence of various factors on pharmacy staff's perception of their ideal job was measured using the same set of 41 items. Two open-ended questions about “the aspects of their work that you like the most and the least” were also included to investigate those aspects that may not have been predicted based on the literature.

Demographic characteristics (age, sex, highest education level) and work-related information (job position, employment status, number of years in hospital, long-term employment goals, location and size of the hospital, quantitative workload, and work activities) were collected in the final section of the questionnaire.

Pilot test and statistical methods 

A pilot test was performed in 1 hospital to evaluate the wording of the questions, and amendments were made for clarity. Data were coded, entered, and analyzed using SPSS 16.0 (© 2008 SPSS Inc., Chicago, Illinois) for Windows. In determining the levels of job satisfaction and career satisfaction, the internal consistency reliability of each subscale was assessed using a correlation matrix and Cronbach's alpha. Satisfaction level was computed by averaging the respondent's scores in each item. The mean scores for job satisfaction and career satisfaction were compared using a paired-samples t test.

Factor analysis was performed to define the underlying factors that summarize the essential information contained in the 41 items of the job satisfaction scale. Cronbach's alpha was calculated to ensure that all items were measuring the same construct and, finally, the relative importance of various factors on current job satisfaction was assessed using multiple regression.

The 41 items measuring the influential factors on pharmacy staff's perception of their ideal job was summarized to 8 underlying factors. The relative importance of these factors on perception of ideal job was compared by calculating the mean score of each factor. Open-ended questions were coded by one of the researchers and randomly checked by an experienced coder. Any discrepancies were discussed and where necessary adjusted.

Differences of job satisfaction by demographic factors and work-related characteristics were tested using analysis of variance and independent sample t tests.

Setting 

The primary role of hospital pharmacists in Australia is to promote the safe and effective use of medicines through supplying drugs and drug-related information to patients, preparing special treatments, educating other health care professionals (HCPs), and providing specialist advice using a team approach to ensure that medication therapy is wisely selected.31, 32 The role of the hospital pharmacy technician generally includes distribution, manufacturing services, and supporting clinical pharmacy services.33

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Results 

From the 26 hospitals approached, 14 hospitals participated in the study. Of these, 4 hospitals have more than 600 beds, 2 hospitals are in regional areas, 1 is a children's hospital, and 1 specializes in geriatric care. Of the 12 that were not included, 5 hospitals agreed to participate but did not obtain the hospital CEO's approval within the time frame, 3 hospitals refused because of being too busy or because the Director of Pharmacy was away, and 4 hospitals could not be reached because of no one answering the phone. A total of 350 pharmacy staff were employed in the 14 hospitals, and of these, 188 (53.7%) responded between August and October 2008. Among the responses, 142 (75.5%) were returned by mail and 46 (24.5%) were completed online.

Respondents' demographics 

Table 1 summarizes the demographics of respondents. There were 169 usable surveys for this section of the survey. Among the respondents, 81.7% were female, 41.1% were under the age of 30, 43.8% were pharmacists, 80.5% were full-time employees, 97.0% worked in metropolitan hospitals, and 94.7% worked in public hospitals. Sixty-three percent of the respondents stated that they planned to remain in hospital pharmacy in the long term. A significant amount of time at work was spent in processing prescription (28.6±24.1%), ward visiting (24.0±16.7%), and management and administration (20.3±22.4%).

Table 1. Demographic and work-related characteristics (N=169a)
CharacteristicsFrequencies (%)Mean (±SD)
Age
≤3041.7
31-4021.4
41-5020.2
>5016.7

Sex
Female81.7

Education
School certificate20.1
B.Pharm. (incl. Honors)55.6
Postgraduate24.3

Employment
Full time80.5

Position
Dispensing technicians20.7
Intern pharmacist5.9
Pharmacist43.8
Senior pharmacist24.3
Managementb5.3

Location of hospital
Metropolitan97.0
Rural3.0

Hospital sector
Public94.7
Private5.3

No. of beds in hospital
100-2005.9
201-40024.3
401-60026.0
>60032.0

Long-term employment goal
Remain in hospital pharmacy63.3
Move into community pharmacy3.6
Move to other pharmacy-related position12.4
Move away from the profession17.8

No. of years in hospital 10.05 (±9.52)

No. of years in current job 4.99 (±5.82)

How long it takes to work (min) 41.62 (±27.23)

Overtime hours per week 1.94 (±2.72)

No. of missing days per month 0.83 (±1.43)

Reasons for taking time off work (d)
Illness 0.51 (±0.40)
Education 0.24 (±0.19)
Don't feel like work 0.01 (±0.01)

% time spent in various duties (%)
Processing prescriptions 28.64 (±24.06)
Wards visiting 23.97 (±16.68)
Consulting other HCPs 7.68 (±6.91)
Training (as learner) 3.04 (±5.77)
Management and administration 20.28 (±22.40)

aMaximum sample size (specific numbers of respondents to each item varied because of nonresponses).

bIncluding director of the pharmacy, deputy director of pharmacy, and chief pharmacist.

Job satisfaction and career satisfaction reliability 

Reliability tests were performed on the 4-item job satisfaction subscale and 6-item career satisfaction subscale. Cronbach's alpha for the job satisfaction subscale was 0.76, indicating acceptable internal consistency reliability. One item of the career satisfaction subscale (“recommendations to others about whether to choose pharmacy as an occupation”) was removed based on the item total correlation (<0.30).34 The final Cronbach's alpha for the career satisfaction subscale was 0.78. Using a 5-point scale where 1 equals high satisfaction and 5 equals low satisfaction, the mean scores of job satisfaction and career satisfaction were 3.62 (standard deviation [SD]=0.77, n=188) and 3.38 (SD=0.85, n=188), respectively. The mean score of career satisfaction was significantly lower than that of job satisfaction (t=4.91, P<.01).

Effects of demographics characteristics on job satisfaction 

Table 2 describes the association between the respondent's demographic and work-related characteristics and job satisfaction. The levels of job satisfaction among pharmacists (mean=3.74±0.74) and pharmacy support personnel (mean=3.59±1.23) participating in the study were not significantly different. Younger respondents (<30 years) reported significantly lower mean job satisfaction than did other age groups (mean=3.53±0.76, F=2.718, P<.05). However, there was no consistent trend evident across age groups. There were no significant differences in the distribution of job satisfaction scores based on sex or highest academic degree held. The results did not indicate any significant differences in the distribution of job satisfaction scores between large or small, public or private, metropolitan or rural hospitals.

Table 2. Job satisfaction in relation to demographic and work-related characteristics (n=169)
CharacteristicsMean score (±SD) of job satisfactionaTest statisticsP value
Age 2.718b.046
≤303.53±0.76
31-403.92±1.19
41-503.66±0.87
>503.99±0.60

Sex 0.001c.972
Male3.56±0.79
Female3.75±0.89

Education 0.215b.807
School certificate3.62±1.20
B.Pharm. (incl. Honors)3.73±0.81
Postgraduate3.72±0.74

Position 1.670b.160
Dispensing technicians3.59±1.23
Intern pharmacist3.95±0.40
Pharmacist3.69±0.83
Senior pharmacist3.65±0.74
Management4.36±0.36

Hospital sector 0.638c.426
Public3.71±0.90
Private3.64±0.63

No. of beds in hospital 0.998b.396
100-2003.78±0.75
201-4003.93±0.65
401-6003.83±0.93
>6003.64±0.90

Long-term employment goal 7.758b.000
Remain in hospital pharmacy3.90±0.72
Move into community pharmacy4.29±0.29
Move to other pharmacy-related position3.44±0.85
Move away from the profession3.17±1.21

No. of years in hospital 0.073d.343

No. of years in current job 0.091d.242

How long it takes to work (min) −0.115d.142

Overtime hours per week 0.032d.686

No. of missing days per month −0.035d.655
Part-time no. of hours per week −0.398d.022

% time spent in various duties
Processing prescriptions −0.202e.009
Wards visiting 0.099e.202
Consulting other HCPs 0.071e.360
Training (as learner) 0.054e.485
Management and administration 0.080e.303

aMean job satisfaction scores with possible values ranging from 1.00 to 5.00. A higher value corresponds to greater job satisfaction (1. Very dissatisfied; 2. Dissatisfied; 3. Neither satisfied nor dissatisfied; 4. Satisfied; 5. Very satisfied).

bANOVA.

cIndependent sample t test.

dSpearman's rank-order correlation.

ePearson product-moment correlation.

Job satisfaction level had a significant influence on respondents' long-term employment goals (F=7.758, P<.00). Respondents who intend to move away from the profession completely (mean=3.17±1.21), reported significantly lower job satisfaction scores than those who plan to remain in hospital pharmacy (mean=3.90±0.72) or move into community pharmacy (mean=4.29±0.29).

The number of hours worked per week among part-time respondents was significantly negatively associated with their job satisfaction (ρ=−0.398, P<.05). Work experience, distance to work, and overtime schedule were not found to have a significant association with respondents' level of job satisfaction.

The amount of time respondents spent in different duties was not statistically associated with their job satisfaction except that the mean job satisfaction significantly decreased as the percentage of time spent in processing prescriptions increased (t(169)=−0.202, P<.01).

Predictors of current job satisfaction 

An initial correlation matrix was run on the 41-item instrument, and 1 item on each of job security and fringe benefits was removed because of low correlation (<0.30).34 Eight factors, as listed in Table 3, were extracted using principal components analysis. An additional 2 items from the working environment (“I have access to equipment” and “I have appropriate working conditions at my job, eg, lighting, work space, ventilation, noise level, etc”) and 1 item each from interpersonal relationship (“My colleagues get along with each other at my job.”) and workload (“Management ensures that every person does a fair day's work.”) were deleted because of low factor loadings (<0.40).35 The final factor loadings are shown in Table 3. Cronbach's alpha of the scales ranged from 0.701 to 0.884 except for “interprofessional relationship,” which had an alpha value of 0.65. The desirable level of Cronbach's alpha is at least 0.70.35 However, values as low as 0.64 have been considered acceptable in similar research.29 Despite its low reliability, “interprofessional relationship” was included in this study because of its theoretical appeal. Based on these findings, individual items were summed to form scales.

Table 3. Factor loading, reliabilities, and multiple regression results of various factors on current job satisfaction (n=176a)
VariablesFactor loadingbMean scorec (SD)Cronbach's alphadRegression coefficient (SD)Standardized regression coefficientet valueP value
Ability utilization 3.77 (0.71)0.8770.663 (0.077)0.6248.596.000
1. My job is challenging0.805
2. I can use my abilities0.834
3. Do different things0.728
4. Decision making0.503
5. Accomplishment0.705
6. Develop responsibility0.730
7. Access to information0.539

Recognition 3.09 (0.89)0.8210.187 (0.075)0.2052.482.014
1. Recognized for achievement0.673
2. Prestige in organization0.656
3. Praise0.592
4. Recognized by other HCPs0.476

Management 3.16 (0.77)0.884−0.122 (0.080)−0.126−1.519.131
1. Involve in decision making0.492
2. Supervisor's knowledge0.791
3. Supervisor is competent0.808
4. Sensitive to problems0.529
5. Hospital policies0.548
6. Respond to complaints0.739
7. Feedback0.671
8. Clarity on role0.547

Workload and duties 2.94 (0.85)0.7710.053 (0.062)0.0610.855.394
1. Patient consultation0.681
2. Dispensing duties0.691
3. Managerial duties0.778
4. Adequate staffing0.658

Interprofessional relationship 3.57 (0.76)0.6450.014 (0.063)0.0140.221.826
1. Nurses cooperation0.730
2. Doctor cooperation0.709

Patient-pharmacist relationship 3.77 (0.61)0.8810.023 (0.078)0.0190.301.764
1. Treat courteously0.813
2. Patients' appreciation0.796
3. Do things for others0.631

Working schedule 3.22 (0.90)0.701−0.004 (0.061)0.004−0.060.953
1. Holidays schedule0.753
2. Flexibility in schedules0.688
3. Even unpopular work0.488

Salary and advancement 2.69 (1.03)0.8250.001 (0.055)0.0020.027.979
1. Chance for advancement0.604
2. Overtime pay0.579
3. Promotion0.745
4. Prospects for income0.700

Constant (job satisfaction) 0.557 (0.209) 2.665.009

aUsable response in this section was 176.

bPrinciple components analysis, varimax rotation, values greater than 0.40 are considered adequate based on sample size.

cMean value of summated items for each scale. Mean satisfaction scores with possible values ranging from 1.00 to 5.00. A higher value corresponds to greater satisfaction.

dEstimate of the internal reliability of the scale; values greater than 0.70 are considered adequate.

er2=0.541.

When multiple regression was conducted using the 8 factors, 2 predictors were found to significantly affect the level of job satisfaction, which explained 53.4% of the variance in job satisfaction (F=21.79, P<.000). Ability utilization (β= 0.683) was the most important predictor of job satisfaction. The size of the standardized regression coefficient of ability utilization (0.624) was as much as 3 times higher than that of recognition (0.205). Other factors were found to be nonsignificant in predicting job satisfaction.

With respect to the respondents' current job, the aspects that were perceived to be most satisfactory among the 8 predictors (41 items) were ability utilization (mean=3.77±0.71) and patient-pharmacist relationship (mean=3.77±0.61), whereas salary and advancement (mean=2.69±1.03) and workload and duties (mean=2.94±0.85) were ranked as the least satisfied aspects.

Influence of job-related factors on perception of ideal job 

The most influential factor on the respondents' perception of their ideal job was ability utilization (4.19±0.70) as shown in Table 4. The mean scores of the remaining factors were tightly grouped. Workload was ranked as the least important factor influencing their perception of their ideal job.

Table 4. Influence of job-related factors on perception of ideal job (n=176)
RankFactorsMean scores (SD)
1Ability utilization4.19 (0.70)
2Working schedule and condition4.01 (0.69)
3Management3.99 (0.76)
4Salary & advancement3.95 (1.04)
5Recognition3.95 (0.66)
6Patient-pharmacist relationship3.93 (0.72)
7Interprofessional relationship3.91 (0.70)
8Workload3.89 (0.76)

The most and the least enjoyable aspects of hospital pharmacy 

More than 20% of the respondents mentioned being able to work with other HCPs, contributing to patients' health care, clinical involvement, and learning opportunities as the most enjoyable aspects of working in hospital pharmacy, as shown in Table 5. Nearly one-third of respondents stated that long-term staff shortages were the least enjoyable aspect at work. Not being recognized as important by other HCPs, low salary, poor management, and no chance for promotion were also frequently mentioned.

Table 5. The most and the least enjoyable aspects of hospital pharmacy (n=169)
Frequency
N%a
Most enjoyable aspects
Able to work with other HCPs4526.6
Contributing to patients' health care4023.7
Clinical involvement3621.3
Learning opportunity3621.3
Teamwork1911.2
Challenging1810.7
Variety of tasks1710.1
Interesting169.5
Fix working hours148.3
Patient contact148.3
Ability utilization116.5
No commercial pressure95.3
Job security63.6

Least enjoyable aspects
Staff shortage5230.8
Not recognized as important by other HCPs3118.3
Salary2816.6
Bad management2716.0
No chance for promotion2313.6
Politics and bureaucratic constraints1710.1
Interpersonal conflict1710.1
Not flexible in terms of annual leave137.7
Not enough funding137.7
Not challenging (technicians)105.9
Lack of care to patients95.3
Always be interrupted1—
Physical environment1—

aPercentage does not add to 100%.

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Discussion 

For hospital pharmacy to expand clinical pharmacy services, attracting and retaining adequate staff to deliver the safe and effective use of medicines is essential. The issue of staff shortages in hospital pharmacy has been, to some extent, attributed to an absence of job satisfaction.36 This study has provided a source of data on current hospital pharmacy staff's job satisfaction in the Australian context. The key factors in determining hospital pharmacy staff's job satisfaction as well as their perceptions of the factors that influence their ideal job most have also been identified. The results of this study provide a useful background for the development of strategies to improve job satisfaction in the hospital pharmacy labor force.

The average level of pharmacist job satisfaction in this study was 3.74±0.74, and the average for dispensing technicians was 3.59±1.23. Olson and Lawson's18 1996 study of 354 pharmacists in Florida using the same Barnett and Kimberlin scale reported a job satisfaction level of 3.43±0.90. A 2007 study of 1004 pharmacy technicians in the United States has reported a job satisfaction level of 3.47±0.70 but used a different 5-point scale questionnaire.22 Another 2003 study of 610 pharmacists in Thailand found the mean overall job satisfaction level was 29.9 out of a possible 40 points.37

The comparison of results is complicated when different scales are used, and very different national health political and economic environmental constraints exist.15 Cross-cultural research is recommended in the future to enable the evaluation of job satisfaction level internationally.

The results of this study showed hospital pharmacy staff (both pharmacists and technicians) were significantly more satisfied with their jobs than they were with hospital pharmacy as a career. This was not unexpected because Desselle and Holmes22 and Gaither and Mason38 observed similar results. However, it must be noted that the Desselle and Holmes study was conducted only with pharmacy technicians and Gaither and Mason study was conducted only with pharmacists. One possible explanation could be that pharmacists were not certain about the future of their profession; further qualitative research is recommended to elucidate this point.

Lower satisfaction scores were found for respondents who were younger than 30 years; however, there was no consistent trend with increasing age. A large-scale survey of 11,244 multidiscipline employees found age was positively correlated to job satisfaction.39 A 2005 Australian study of 266 hospital pharmacists showed recent registered pharmacists felt a lack of personal accomplishment and they are more likely to suffer from burnout.40 Pharmacy practice may not be what young pharmacy staff expected it would be, and disillusionment may result in relatively low levels of job satisfaction. At junior levels, there are relatively low salaries and often little empowerment. Young pharmacy staff may perceive that their opportunities for promotion and increasing salary are less than in community pharmacy.41 If younger pharmacists are not gaining satisfaction in their job and career, pharmacy, as a whole, may risk the consequences of long-term dissatisfaction.

Even though sex has previously been shown to be a determinant of job satisfaction, this study did not find that sex and job position affected job satisfaction. However, the lack of significance of these findings may be because of the relatively small sample size of males and rural hospital and private hospital respondents. According to the Australia National Labour Force 2001 study42, up to 1999, 78.1% of hospital pharmacists were female, 83.4% worked in metropolitan centre, 18.5% were in a managerial position, 20.3% were senior pharmacists, and 60.4% were pharmacists. Future research should stratify for these demographic factors.

Our results also suggested that for staff who work on a part-time basis, the more hours they worked each week, the less they were satisfied. However, caution is warranted in drawing any firm conclusions about this impact, given the small number of respondents who worked part time.

The study results supported a major theme from earlier studies that job satisfaction decreased as more time was spent processing prescriptions.18 This relationship may occur because pharmacists feel unchallenged by dispensing. As a group, nearly one-third of their time was spent dispensing. The continued growth in hospital admissions and limited hospital budget has left pharmacists little time for increasing clinical activities.11 On the other hand, the correlation between job satisfaction and clinical involvement, such as ward visiting and consulting medical practitioners, was not strong. However, an Australian study among 143 oncology pharmacists showed job satisfaction is closely associated with clinical involvement.43 This unexpected result from our study may possibly be because of an overlap of the classification of each activity; thus clarification is warranted in future studies.

Ability utilization was found to be a predominant factor in determining job satisfaction in hospital pharmacy. It was also ranked as the factor with the most influence in determining job satisfaction in their ideal job. This is consistent with previous research,1, 18, 19, 24, 44, 45, 46, 47 providing further evidence to support the two-factor theory of job satisfaction, which states the primary determinants of job satisfaction are intrinsic aspects of the job; in other words, what makes people satisfied is what they do or the way they are used by management.15

Recognition, another important intrinsic factor, also was observed as a predictor of job satisfaction. This result, taken together with the low career satisfaction existing among hospital pharmacy staff, further confirmed that they were not certain about their professional status. Several extrinsic factors (management, workload, and salary) were not found to be significant predictors of job satisfaction; however, both Murawski et al27 and Sansgiry and Ngo25 found extrinsic factors had a higher correlation with jobs and career satisfaction than intrinsic factors. Future research should, therefore, stratify for these extrinsic factors.

The effect of management or supervision relationship on job satisfaction may be an indirect one. Efficient management may provide employees with greater use of skills and abilities, and its direct effect was found to be insignificant in this study. The working schedule was not found to be a predictor of job satisfaction either, possibly because other aspects of the organizational environment, extrarole factors, and individual factors are more critical.

In this study, the cooperation of other HCPs scale had a Cronbach's alpha score lower than 0.70, even though the identical scale in a previous study was found to be more than 0.70.46 The low reliability may explain why it did not emerge as a significant predictor in this study.

Although workload and inadequate pay were ranked as the aspects of the respondents' current job with which they were least satisfied, we found they were not direct negative predictors of job satisfaction as has been well established in literature. It is possible that if a pharmacy staff member holds a strong commitment to the profession, it may mitigate the effect of overload. Again, qualitative research is recommended to elucidate this point. However, this does not mean inadequate staffing is not problematic. Work overload is an ongoing concern among pharmacists as evidenced by a 1982 survey in which 93% of respondents indicated that they “feel that it's time for the profession to mount a more aggressive assault on workload issues.”48 This is consistent with Gaither et al's6 more recent research, which found that more than 50% of pharmacists reported that their workload had significantly increased in the previous year and that it was one of the most common reasons for leaving. Increasing salaries may be useful in the short term but may not be the best strategy for long-term satisfaction. According to the two-factor theory of job satisfaction, this extrinsic factor may lead to dissatisfaction, which may be reduced by increasing salaries, but such actions will not make workers satisfied.15 The theory is supported in Drug Topics' latest survey of U.S. employee pharmacist salaries, which evidenced that increased salaries do not necessarily increase job satisfaction.49

Qualitative comments from the respondents provided additional possible predictors of job satisfaction. The most common determinants of job satisfaction mentioned were being able to work with other HCPs, contributing to patients' health care, clinical involvement, and learning opportunities. Responses did not coincide fully with those concerning job satisfaction, suggesting either that the respondents interpreted the questions differently or that the open format question encouraged a more considered response. Teamwork and interaction with patients remained a source of job satisfaction, whereas the role of job security and commercial pressure could be further investigated in a future study. Findings suggested that the strategies of increasing the hospital pharmacists' role in clinical activities, and establishing a professional identity for pharmacists within the health care sector, appear to have been welcomed by hospital pharmacists, many of whom now enjoy their role as a member of a multidisciplinary health care team.

The most common source of work dissatisfaction comes from insufficient staff, a factor that many respondents linked to problems such as overwork, stress, being tied to tedious tasks, a lack of variety in their jobs, being unable to complete tasks to their satisfaction, and interpersonal problems among staff. Bureaucratic restrictions and tight budgetary constraints were also on the list; indeed in Australia, the shortage of hospital pharmacists has coincided with considerable decreases in hospital budgets across the country.11

The problem in attracting and retaining experienced pharmacy staff in hospitals has been persistent and may be structural. Kahaleh and Gaither's50 2007 study found individuals who are empowered have better organizational commitment, which was a significant predictor of job turnover intention. A clear indicator of pharmacy staff's future intentions is apparent. Hospital pharmacy staff not satisfied with their job indicated plans to move away from hospital pharmacy or from the profession, altogether. Maintaining or improving job satisfaction among pharmacists is critical to the future strength of the profession.

The level and the determinants of job satisfaction in Australian hospital pharmacy staff have not been published previously, and, thus, this study offers a contribution to the literature. The findings suggest that hospital pharmacy staff need to feel certain about their future, so managers should strive to secure the pharmacist's role in the provision of health care. Managers cannot use one management style across all staff and expect success because the motivations underlying job satisfaction for different age groups are different. One place to start is with performance appraisal systems and rewards clearly linked to pharmacist performance and ideally including performance factors other than just prescription volume and punctuality and good grooming.2 The results of this study also suggest that pharmacy managers who notice signs of job dissatisfaction in employee pharmacists might focus on altering the job to provide greater use of skills and abilities and to provide increased challenges in the work, and, where possible, altering the staffing to eliminate any work overload. Although there are obviously significant difficulties because of budgetary constraints, ideally the salary level should be increased in order that it is commensurate with the amount of work undertaken and the level of responsibility.

Limitations 

This study was conducted with a limited number of participants in concentrated locations in 2 Australian states. Although a wide range of hospital types were included in the study, an additional limitation of this study was the use of convenience sampling, which meant the sample may not be representative of the population of hospital pharmacy staff in general and future research should stratify for demographic factors and analyze differences between respondents and nonrespondents. Because of time constraints, a relatively small sample size was used. Although this was greater than for many comparable studies, future research using a larger sample size would enhance the generalizability of the research. This may also address the fact that some of the reliabilities found in this study were lower than the desirable level. In addition, a cross-sectional survey could only examine how variables affect job satisfaction at a single point in time. Combining all of the various positions into 1 group of pharmacy staff makes comparisons with previous studies of pharmacists' job satisfaction difficult because many of those studies did not include other pharmacy staff in their analyses.

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Conclusion 

This study determined the influence of various demographic and job-related variables on hospital pharmacy staff's job satisfaction. The results from this study may provide useful strategies for hospital pharmacy administrators and identify strategies to improve job satisfaction among hospital pharmacy staff in Australian hospitals. Further research should focus on addressing the above limitations primarily by using a larger stratified nonconvenience sample. It should also include other predictors of job satisfaction and investigate strategies to enhance satisfaction level. This could assist in the retention of current employees and the recruitment of new ones and lessen the burden of any pharmacist shortage on the hospital system.

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PII: S1551-7411(10)00033-1

doi:10.1016/j.sapharm.2010.02.003

Research in Social and Administrative Pharmacy
Volume 7, Issue 1 , Pages 51-63, March 2011

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