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Tertiary Hospital’s Employee Behavior by Maslow Case Study


Nowadays, considerable attention is paid to the development of human resource management models according to which employees have to work, meet their needs and expectations, and improve the results of work that should be done (Bharnagar & Stivastava, 2012). Human resource management is the field within the frames of which organizational development, as well as human resource development, should be promoted and explained to managers and employees. Tertiary hospitals are the types of non-profit organizations that require appropriate and management to complete their main function and be a successful public charity representative (Tschirhart & Bielefeld, 2012).

The evaluation of organizational culture, behavior, and satisfaction is a crucial step that cannot be neglected because culture identifies the norms and values that should be used by employees, behavior demonstrates the way of how the requirements should be met, and satisfaction clarifies the results that should be achieved during the managing process (Tsai 2011). In this paper, the role of pharmacists’ service delivery in a hospital environment and its impact on employee performance, behavior, and satisfaction will be investigated through such management categories as communication, supervision, leadership styles, orders, workload, and staff cooperation.

The analysis of different management categories in terms of Maslow’s hierarchy of needs theory should help to understand how tertiary hospitals can develop the relations with pharmacists’ delivery services and overcome the performance, behavioral, and satisfaction challenges hospital employees face with.

Working Environment in a Tertiary Hospital in an Ambulatory Setting

Tertiary hospitals are the organizations that offer patients various types of tertiary care that may take place after a certain portion of primary and secondary care has been given. Kayden, Anderson, Freitas, and Platz (2014) explain a tertiary hospital as “a hybrid of intensive care and trauma units” (p. 319). In such organizations, employees aim at providing inpatients with cancer management, cardiac and plastic surgeries, etc. It is not enough to know how to provide care and learn its main peculiarities. It is important for the employees of tertiary hospitals to understand why people address such organizations and what aspects of caregiving should be covered. Tertiary hospital workers should complete several functions and get prepared for different events that can take place in their working environment.

During the last several years, the researchers have admitted a considerable shift in tertiary care that has touched the pharmacy practice model (Lorimer, Lalli, & Spina, 2013), patient care (Kumar, Venkateswarlu, Sasikala, & Kumar 2010), and staff morale (Chipeta, 2014). Tertiary hospitals aim at establishing appropriate clinical pharmacy services that help to cover different methods in intense care, internal medicine, and other surgical and pediatric issues (Fathelrahman, Ibrahim, & Wertheimer, 2016).

Employees have to understand that there are many areas they should take responsibility for, and their leaders need to realize that successful completion of employees’ duties depends on the way of how employees are organized and satisfied. Tertiary hospitals, as well as many other non-profit organizations, should have their culture, behavioral norms, and leaders that could gain control over various details (Tsai, 2011).

The organizational culture is the product of shared values and attitudes that can be observed during the process of care delivery (Jafree, Zakar, Zakar, & Fischer, 2016). Hospital leaders should understand that clinical pharmacist services help to establish team-based care and enhance the satisfaction of patients, pharmacists, nurses, and other hospital employees, who need appropriate pharmacist services in an ambulatory setting (Mysak, Rodrigue, & Xu, 2010).

In this paper, the case study on “Creating a successful oncology co-management relationship” (2015) will be taken as the basis to explain how the employees from different hospitals tend to face obstacles in managing their work and cooperation with other departments and organizations and want to find the solutions on communication, leadership, and staff cooperation level and improve their performance, behavior, and satisfaction. Some many theories and models can be applied to the offered case, and it is important to make the choice that helps to solve the challenges that occur in the tertiary hospital environment.

Maslow’s Hierarchy of Human Needs

In current case study research, the task is not only to identify the reasons why leaders and employees should develop appropriate relations with the representatives of the pharmacists’ delivery services department and explain how the improvement of such relations can influence employee performance, behavior, and satisfaction. The task is also to introduce the theoretical framework with the help of which hospital management can become successful and effective. As Rich, Singleton, and Wadhwa (2013) say, “sustainability is not unique to health, but is a unique vehicle for promoting healthy values” (p.i).

Therefore, healthcare, nursing, and other spheres should have sustainable management based on a clear theory or a principle. In the current case, it is offered to consider a theory of human motivation developed by Maslow in the middle of the 1900s. The hierarchy of needs theory is introduced as a pyramid with five levels on it: the physiological needs (such as the access to water, food, sleep, etc.), the safety needs (such as the provision of security, health, resources, etc.), the belonging needs (such as the possibility to develop friendship relations), the esteem needs (such as the promotion of confidence, respect, etc.), and the self-actualization needs (such as a chance for an employee to comprehend their full potential) (Maccoby, Norman, Norman, & Margolies, 2013).

Each need in this theory is the combination of factors that influence the work of a team. In case one employee fails to meet some physiological or self-actualization needs, the results and outcomes of the work may be not similar to those that are expected. Job satisfaction has been investigated by many researchers in different fields, supervisors, employees, managers, etc. to improve it and help people work better under the established norms and conditions.

Healthcare services, as well as the level of readiness of medical workers, may vary, and every healthcare organization should meet the main goal that is to choose the services that correspond with a “given environment of social, material, financial, and human resources” (Bharnagar & Stivastava, 2012, p. 75). Therefore, the theory offered by Maslow may have a strong impact on how medical employees and patients complete their duties and adapt to the situations they can find themselves (Morrison-Valfre, 2013).

Maslow (2012) admits that if there is one need that is satisfied, there will be another new need that should also be satisfied. Even if people believe that they do not have needs and are satisfied with everything they have, it is wrong to believe that any kind of need is absent. Maslow (2012) identifies several physiological needs that cannot be ignored. Besides, in hospitals, people should understand the worth of such needs as health and security of health.

On the one hand, the satisfaction of the lower-order needs like basic safety and human survival should matter (Almgren, 2012). On the other hand, it is not enough for medical employees to meet these types of needs to present high-quality work. They should also be provided with a portion of respect, understanding, and even the possibilities to gain self-actualization in the sphere of work they choose and meet the same need of their patients and other stakeholders (Babic, Kordic, & Babic, 2014).

Obstacles that Affect Employee Performance, Behavior, and Satisfaction

Many different obstacles may affect such factors as employee performance, behavior, and satisfaction in tertiary hospitals in an ambulatory setting. Pharmacy personnel should offer pharmacists’ delivery services and include several skilled people and clinical pharmacists, who are aware of various technological, informational, and even trainee aspects (Fathelrahman, Ibrahim, & Wertheimer, 2016).

These services may be provided to inpatients, as well as to outpatients, and the service quality standards are set to ensure the appropriate use of agreements and procedures. In the case study under consideration, the task is to understand how co-management agreements may improve the quality of work and the achievement of certain financial benefits. Employees should know what they do, and when they should make decisions. Therefore, one of the possible obstacles that may influence their performance is a poor or inappropriate level of education and background knowledge. Employees have to comprehend each step they take and each outcome they may get.

It may also happen that in a tertiary hospital, several departments should cooperate to promote the successful delivery of pharmacists’ services. Unfortunately, not all hospital workers are ready to work in teams. They prefer to work independently and take responsibility for the care and services they provide (“Creating a successful oncology co-management relationship”, 2015). In many European countries, hospitals are focused on promoting close cooperation of health care services to offer ill or disabled patients high-quality assistance (Acton, 2013). It means that the cooperation of staff is a crucial point for consideration in the majority of situations when it is expected to improve employee performance, understand human behavior, or promote satisfaction.

Finally, there may be a cultural or a kind of social obstacle that may be connected with the diversity of employees. Any work-related environment is the cooperation of people with their interests, needs, and demands. If there is no successful leader, or there is a leader with poorly developed abilities, employees face an obstacle of poor communication, misunderstandings of each other’s intentions, or inabilities to come to the same conclusions. Such social obstacles that can be based on Maslow’s hierarchy of needs also predetermine the quality of work.

Employees in a Tertiary Hospital

All employees in a tertiary hospital should know how to cooperate with the delivery services’ representatives. In the majority of hospitals, there is the department that takes responsibility for the provision of clinical pharmacy services and care that can help to improve patient outcomes in an ambulatory setting (Mysak, Rodrigue, & Xu, 2010). However, in some cases, the delivery of pharmacists’ services remains to be sporadic because more attention is usually paid to the profiles of patients, people’s dependence on drugs, and the necessity to resolve various clinical issues (Mysak, Rodrigue, & Xu, 2010).

Some hospitals are not ready for considerable changes and improvements that can be followed the implementation of special hospital information systems that aim at integrating various administrative, financial, and clinical aspects of the work in a hospital (Khalifa & Alswailem, 2015). Therefore, it is useless to discuss the changes in such levels for ordinary tertiary hospitals. LeBras and Dalen (2015) offer to decentralize pharmacists’ services as a chance to unite clinical and distribution services. Such an idea is characterized by several advantages such as the increase of patient safety, improved efficiency of patient care, and even job satisfaction of pharmacists and other representatives of a health care team (LeBras & Dalen, 2015).

People have to follow the orders and rules identified by society and the chosen organization. It is expected that health care providers start communicating better and more frequently to complete their functions and develop pharmacist interventions. Besides, interpersonal communication and mutual discussion of obstacles and possible problems can be an effective tool in human resource management. The pharmacists, as well as other employees of a tertiary hospital, should participate in several procedures and prescription processes that start with access to a database and end with the necessity to deliver a particular service (Reis, Scopel, Correr, & Andrzejevski, 2013).

In the case study chosen as an example, there is a need to incentivize the right behavior among medical workers (“Creating a successful oncology co-management relationship”, 2015). The attention to such decentralized services and the necessity to restructure the work of people should help to promote several effective changes that influence different aspects of the hospital’s work. For example, people start talking about the changes and the functions they have to complete in a new system.

As a rule, if many employees face the same task or change, and some groups of people demonstrate their abilities to cope with the challenges, other groups of people try to follow the same example and invent new ideas of how to meet the requirements. Though such an approach results in the neglect of several needs (identified by Maslow), the outcomes of such work may be rather beneficial.

Pharmacists’ Service Delivery and Satisfaction in a Hospital Environment

Taking into consideration the review of the literature and the attention to a particular case study, it is possible to create a story within the frames of which such management categories as communication, supervision, attention to orders, leadership, workload, and staff cooperation will be discussed in terms of a particular hospital environment to improve pharmacists’ service delivery and satisfaction of employees and patients.

There is a tertiary hospital that aims at promoting cancer management for people, who have already taken primary and secondary care. Now, they need intensive care that can help to decrease the level of possible oncologic complications and get prepared for the surgeries. Employees should demonstrate high performance, good behavior, and satisfaction with every step taken. It is not an easy task, and the attention to the aspects of Maslow’s theory of needs is required.

Communication between employees is important. It may be improved using regular meetings organized during a working day so that none of them interrupts the crucial work of the staff (“Creating a successful oncology co-management relationship”, 2015). It is enough to organize a meeting once per week so that employees can discuss the latest news, share their opinions, and offer their ideas that can be implemented in their work.

Supervision is another aspect of work that should be improved. For example, it is possible to consider the needs of employees during meetings, analyze them according to the hierarchy offered by Maslow (2012), and make the necessary implementations in a required period. Supervision should not be microscopic to promote self-actualization and the development of personal skills and abilities to solve problems, take care of patients, and deliver pharmacists’ services according to the standards and schedules established. At the same time, complete neglect of supervision is not appreciated because hospital employees and even patients should know that there is a group of experts, who can help and support them in cases of emergency.

To be satisfied in their workplaces, employees should also understand the worth of orders and the division of workload. Even if some employees are eager and able to complete more work, they should understand that there is a certain order, and all people in a hospital should consider the roles of each other in a team. There are cases when order or workload may be changed or broken, still, all these cases should be discussed with supervisors and other leaders, who take responsibility for the work performed in a hospital.

Therefore, it is important to consider the leadership styles chosen in the organization. In the current case, it is offered to follow the principles of transformational leadership within the frames of which leaders should underline the role of each worker and explain the importance of employees’ mission that is the promotion of health and care. The transformational theory helps to focus on such categories as communication with employees, the creation of a collective purpose, and motivation (Al-Sawai, 2013).

Finally, if all the above-mentioned factors and recommendations are taken into consideration, the idea of staff cooperation should be an evident solution that cannot be neglected. Transformational leadership, communication, and motivation can help to improve the quality of staff cooperation and explain that the more people try to solve their problems and challenges together, the better results can be observed. There is no need to impose someone’s opinion or neglect the ideas of other people. It is just enough to promote staff cooperation and make sure the hospital has its mission and complete it properly.


In general, healthcare management is a crucial topic for consideration in any medical organization. In this paper, employee performance, behavior, and satisfaction in the tertiary hospital in an ambulatory setting are the issues that may be considerably improved using good communication between the employees, understanding of the purposes each employee should complete, and following the orders that are established. Still, all these requirements should be met not at the expense of personal needs that are defined in the Maslow’s theory of needs because only all needs are met, employees may be satisfied and complete their work on a high level.


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