The Emerging Importance of the Frontline Supervisor for Improving Low-Wage Work: Hospital Support Workers, Supervisor Support & Turnover

                                                                                 Background

The changing environment of the health care industry provides an important context for understanding the consequences of poor working conditions on housekeepers and food workers. Limited research has explored the job quality of this workforce and its relationship to intent to leave. This is a critical oversight because hospital support staff plays a key role in patient care, both through the proper cleaning of the facility and through food preparation. Job quality for these workers is limited, as pay hovers close to minimum wage, benefits are limited and the workload is heavy.

 Compounding this issue, supervisors of hospital support staff are confronted with a complex set of supervisory challenges. They must act as gatekeepers to formal organizational policies and to informal practices, while also responding to patient and hospital needs.  Frequently front-line supervisors receive no personnel management training and as a result their behaviors could be contributing to the high turnover rate among front-line healthcare support workers.

 As a first step to understanding whether training front-line supervisors could be used as a lever to improve the quality of low-wage work, this study identifies:  (1) the level of supervisor support experienced by housekeeping and dietary service workers;  (2) the relationship between supervisor support and workers’ intent to leave, and (3)  the mechanism through which supervisor support relates to turnover.

Method

This observational, cross-sectional study used survey methodology to collect data from 278 low-wage earning housekeeping and dietary service workers at two U. S. hospitals.  We use a 3-item supervisor support scale to measures workers’ perceptions of emotional and task support as well as perception of fair practices (alpha =  .84).  Affective commitment (the mechanism through which we propose supervisor support will be related to turnover) is measured using a 5-item scale (alpha= .79). Intent to turnover measures the likelihood that an employee will leave his/her job within the next year, and 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 perceptions of supervisor support and assesses differences between the two groups.  Binary logistic regression was used to identify predictors of turnover.

Results

Approximately 30% of workers reported that their supervisor is not concerned with their welfare, 17% reported their supervisor was not helpful in getting work done and 14% reported that they were not treated fairly by their supervisor.  Preliminary results indicate that supervisor support is significantly and negatively correlated with intent to turnover (r = -.34, p < .001); affective commitment is positively correlated with supervisor support (r= .57, p < .001) and inversely correlated with turnover (r = -.51, p < .001). Additional analysis will be conducted to further explore the relationship between supervisor support and turnover. 

Implications

Preliminary analysis indicate that higher levels of perceived supervisor support reduce employees’ intent to leave their job, suggesting that training supervisors to increase their use of positive job performance behaviors could reduce the high turnover common among front-line hospital support workers.