Is It Time to Pull the Plug on Poor Scheduling Practices in the U.S. Hospitals? Healthcare Support Workers, Scheduling Challenges & Intent to Leave

                                                                   Background and Purpose

Economic trends reveal a decline in secure, well-paying jobs and a steady rise in service-related jobs. U.S. Department of Labor reports that occupations in which job growth is predicted are in low-wage, service-related occupations. Most low-wage jobs require nonstandard work hours, offer only part-time employment, and provide workers limited paid time off.  Research on low-wage jobs indicates that predictable and stable work schedules that allow for some flexibility to manage work-family issues are scarce among this population of workers, making it difficult for working poor families to thrive.

Much of the research on scheduling challenges among low-wage workers has been done within the retail industry, with a few exceptions. Our paper extends this research by examining the prevalence of scheduling challenges among hospital housekeepers and food services workers and assessing the relationship of these scheduling challenges to workers’ intent to leave their job – an action that has negative implications for patient satisfaction, training costs and overall employee morale. Improving the quality of low-wage work requires multiple strategies; developing evidence that poor job quality is linked to operational costs, may serve to persuade employers to rethink standard business practices.

Objectives

Our study: (1) identifies the scheduling challenges experienced by hospital housekeeping and dietary workers; (2) determines whether scheduling challenges were significantly different between worker groups, and (3)  determines the relationship between occupational group, scheduling challenges and workers’ intent to leave.

Methods

This cross-sectional study used survey methodology to collect data from 278 low-wage earning housekeeping and dietary service workers at two U. S. hospitals.  Three types of scheduling challenges were assessed: schedule unpredictability (advance notice, day/time unpredictability and hours predictability), schedule instability (fluctuation in the number of hours, supervisor adjustment to schedule without consent and last minute schedule challenges) and schedule rigidity (control over work hours, planned and unplanned scheduled modification). Intent to turnover assesses the extent to which the respondent believes that s/he will leave current job within the next year, and this was assessed with a single item measure.  Race (white, non-white) and age were included as control variables.  Univariate and bivariate analyses were used to determine the nature and frequency of scheduling challenges.  Binary logistic regression was used to identify predictors of turnover.

Results

All workers experienced minimal schedule unpredictability with no difference between types of scheduling unpredictability experienced by the two groups.  Dietary workers reported more instability than did housekeepers and both worker groups reported significantly different amounts of rigidity.  Schedule unpredictability, in the form of unpredictable days and times, and rigidity, in the form of no employee input in scheduling, were found to be significant predictors of intent to leave among the total sample.  Worker group was not a significant moderator in any model.

Implications

Scheduling challenges are prevalent among hospital support staff; however, the types of challenges faced by this worker group are different from those experienced by retail workers. Future research would benefit from using objective measures of employee turnover and refining measures of schedule challenging reflective of non-retail work settings.