Health Education and Health Promotion

Effect of Working from Home on the Performance of Healthcare Professionals in the Hamadan City, Iran

Document Type : Descriptive & Survey

Authors

R. Salehi 1
H. Gharaee 2
B. Yousefi 3

1 School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran

2 Department of Health Management and Economics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran

3 Department of Surgery, School of Medicine, Hamadan University of Medical Sciences, Iran

https://doi.org/10.58209/hehp.12.2.207
Abstract
Aims: In today’s world, numerous healthcare organizations are embracing new forms of work organization that offer their employees increased flexibility and independence, a particularly crucial aspect in the context of the COVID-19 pandemic. Working from home has become indispensable for healthcare organizations to maintain competitiveness in the global market. The objective of this study was to investigate the impact of Working from home perception on employees’ performance at Hamadan University of Medical Sciences during the COVID-19 pandemic.

Instrument & Methods: This cross-sectional study was carried out among the personnel of three medical training centers affiliated with the Hamadan University of Medical Sciences. The study population comprised employees working in administrative and support departments. Using Morgan’s table, a statistical sample of 140 employees was chosen to participate in the study by completing a questionnaire. The questionnaire was distributed online through systematic random sampling from December 2021 to June 2022. Data analysis was conducted using SPSS 22 and Smart PLS 3 software.

Findings: The majority of participants were women aged between 31 and 40 years with a bachelor’s degree. The results of the mean test indicated that both individual performance (3.25±0.48) and organizational performance (3.51±0.51) among employees were above average, reaching a favorable level. According to the t-statistic, the average perception of working from home was below 3 (1.68±0.39), indicating limited adoption of working from home. The study revealed that the perception of working from home significantly influenced both individual performance (t=9.623>1.96) and organizational performance (t=6.368>1.96). Specifically, the perception of Working from Home accounted for 42.2% of the variations in job performance and 26.7% of the changes in organizational performance.

Conclusion: Enabling healthcare workers to work from home has a substantial impact on their performance.

Keywords

Remote Working
job Performance
Health Personnel
Work Performance
Subjects
Introduction
In the contemporary era, organizations heavily rely on information technology, leading to a reduced emphasis on physical workplace locations [1]. Working from Home (WFH) or remote working has emerged as a flexible work arrangement in the 21st century, widely adopted by organizations [2]. WFH enables employees to work from diverse locations, including their homes, utilizing advanced information and communication technologies to fulfill their responsibilities without being physically present [3]. The concept of WFH has attracted significant interest from scholars and corporate leaders as an innovative approach to work organization [4]. This model offers advantages for both employees and employers, empowering employees to utilize their diverse skill sets, boosting motivation, cutting costs, and promoting work-life balance [5]. Another key benefit of remote work is enhanced employee productivity [6]. Through remote work, employees can dedicate longer hours to tasks with fewer interruptions from colleagues, leading to increased efficiency [7, 8]. WFH also affords employees more focused time for work responsibilities and reduces unnecessary communication with others [9]. Studies have demonstrated that WFH results in fewer disruptions and enhances the autonomy of remote workers in task execution, decision-making, and time management [10].
Studies have indicated that telecommuting has a positive impact on individuals and organizations [9, 11, 12]. Remote work provides several advantages, including reducing commuting time and stress [13], enhancing time management and job satisfaction [5], and creating more job opportunities for women with children and students [9, 14]. However, telecommuting also comes with negative consequences [15]. For instance, healthcare organizations employing remote workers must devise alternative scheduling strategies, management plans, and communication methods with providers and patients [2]. Additionally, remote work can lead to a loss of control among colleagues or supervisors, potentially resulting in work avoidance and decreased responsiveness to errors [2]. Healthcare organizations have long been exploring remote work to reduce costs, focusing on technology and human resources management [16]. A review of research literature has highlighted the numerous benefits that remote work offers to employees [17].
The primary reason for employee satisfaction with this work arrangement is the increased independence and improved work-life balance [18, 19]. Telecommuting provides greater flexibility in choosing when, where, and how to work, resulting in enhanced job flexibility [20]. Many individuals prefer this work style to achieve a better balance between their professional and personal lives [21]. The ability to schedule work and increased self-efficacy enables employees to better manage their workday [20]. Additionally, research suggests that employees’ WFH experience fewer family conflicts and demonstrate an improvement in work ethics [22]. Therefore, it can be argued that WFH can enhance commitment, motivation, and job performance [23].
Research on telecommuting indicates that remote work offers significant advantages to organizations. This is attributed to the heightened productivity of employees and reduced office space requirements [24]. Allowing staff to work from home helps minimize commuting-related expenses, leading to positive outcomes for the organization [25]. Experts in organizational behavior have conducted studies emphasizing the benefits of remote work on productivity. Remote work enhances concentration during available work hours, reduces social distractions, and provides flexibility in terms of location and schedule. Consequently, this can result in increased efficiency and decreased absenteeism [19].
Furthermore, companies are eager to implement remote work policies to reduce administrative costs. Remote work also plays a crucial role in retaining the top talent within organizations [26]. Research indicates that businesses can face significant expenses when relocating employees [7, 26]. With information technology playing an increasingly important role in gaining a competitive advantage, there is a growing demand for skilled professionals. Companies that do not offer remote work options may need to outsource their workforce to third-party entities [27]. Conversely, businesses that have embraced remote work have observed heightened levels of trust [28] and commitment [29] among their employees. This positive trend has led to decreased employee turnover rates [30].
However, the COVID-19 pandemic has rendered remote work essential for numerous organizations. Even the Hamadan University of Medical Sciences, tasked with safeguarding public health, has transitioned to WFH wherever feasible. Extensive discussions have revolved around the pros and cons of telecommuting in medical settings, particularly within administrative and support departments. Due to these divergent viewpoints, there have been conflicting opinions regarding the implementation of decision support systems that align with remote work. This study was undertaken to address the research gap concerning the potential advantages of telecommuting. The research also investigated the current prevalence of remote work within administrative and support departments and its impact on individual and organizational performance. This inquiry underscores the innovative nature of this study. Consequently, this study assessed the influence of WFH perception on the performance of healthcare workers at Hamadan University of Medical Sciences.

Instrument and Methods
This cross-sectional study involving employees from three medical training centers affiliated with Hamadan University of Medical Sciences was conducted during the COVID-19 pandemic. These individuals were tasked with carrying out specific job responsibilities remotely, and those who were not employed during that period or declined to participate were excluded from the study.
Following consultations with nursing service management in the investigated centers, approximately 230 individuals from administrative and support departments were identified. Employing the Morgan table, 140 samples were selected to receive the questionnaire. Data collection took place from December 2021 to June 2022. A researcher-designed survey was employed to assess individuals’ perceptions of WFH, comprising ten primary questions. Job performance was evaluated using a tool developed by Nakrošienė et al. [5], encompassing ten questions that addressed overall satisfaction, perceived advantage, subjective career opportunity, and self-reported productivity. Furthermore, a researcher-designed survey containing five questions was utilized to evaluate organizational performance.
The survey employed a rating scale from 1 to 5 to calculate the average score for each category. Scores below three were categorized as poor, a score of three denoted average performance and scores above three were considered satisfactory. Participants were assessed based on their perceptions of WFH, job performance, and organizational performance, resulting in three distinct scores. To ensure the validity of questionnaires, experts, including faculty members and staff, were consulted, and its construct validity was verified. Furthermore, the questionnaire’s reliability was confirmed through the Cronbach’s alpha test. A pilot study involving a sample size of 35 was conducted to ensure participant comprehension of the questionnaire. The outcomes indicated that the questionnaire exhibited high internal consistency and reliability, as indicated by Cronbach’s alpha values of 0.82 for organizational performance, 0.86 for perception of WFH, and 0.84 for job performance. Once the questionnaire’s validity and reliability were established, it was distributed to the designated University of Medical Sciences personnel.
Demographic variables were analyzed using SPSS 22 software, while Smart PLS software and structural equation modeling were employed to ascertain the relationship between variables. Figure 1 illustrates the conceptual model of the research based on the provided content. The partial least squares (PLS) path modeling is characterized by two sets of linear equations, including the inner and outer models. The inner model delineates the relationships between unobserved or latent variables, whereas the outer model specifies the relationships between a latent variable and its observed or manifest variables. PLS path modeling involves two sets of linear equations, including measurement models (outer model) and structural models (inner model). The evaluation typically begins with the measurement model, and once sufficient evidence is gathered based on the validity and reliability of the measurement models, the structural model (inner model) can be examined [31].
Cronbach’s alpha values for each variable in the pre-sample and total sample indicate that the questionnaire is reliable, with scores exceeding 0.7. To further ensure the reliability of all collected questionnaires, we employed the CR method (Dillon Goldstein’s rho) in conjunction with PLS path modeling [32]. Also, to verify the construct’s validity, the Fornell-Larcker criterion and AVE were utilized [33]. Additionally, the divergent validity of the model was confirmed by calculating the AVE value for each construct and ensuring it is greater than the square of that construct’s correlation with other constructs in the model [34].


Figure 1. Proposed conceptual model of the research

Findings
Descriptive findings
The majority of respondents were women. The largest age group falls between 31 and 40 years old, and the highest number of respondents hold a Bachelor’s degree. Moreover, the most common range of work experience was between 11 and 15 years (Table 1).

Table 1. Frequency of demographic parameters of participants


Analytical findings
Test for a population mean
The test for a population mean is used to assess the condition of research parameter in a given group. A t-test was used to compare the means of two groups regarding the significance of the parameters’ differences (Table 2).

Table 2. The results of the t-test


Upon analyzing the results and t-statistic values at a 95% confidence level for WFH, individual performance, and organizational performance, a notable difference was found between the mean and the value of three. Regarding the perception of WFH, a t-statistic below -1.96 suggests that the average value of this variable is below three, indicating that WFH is not extensively adopted within this organization. However, individual and organizational performance averages were positive at a 95% confidence level.
Outer model
The outcomes of the measurement model included indices, such as Cronbach’s alpha coefficient (for all collected samples), composite reliability (CR) coefficient, and the average variance extracted (AVE; Table 3).

Table 3. Reliability and validity evaluation indicators of the measurement model


The CR values for each variable were more than 0.7, further affirming the model’s reliability. The AVE index confirmed the model’s convergent validity, as each dimension’s AVE value exceeded 0.5. The measurement model’s quality was further assessed using commonality validity (CV), and the positive values demonstrated that the research model was of high quality (Table 3).
Inner model
After evaluating the measurement model, a structural model (inner model) should be presented to illustrate the relationship between the research variables. With the confirmation of the construct validity of the data collection tool, it becomes feasible to explore the relationships between these variables based on the research hypotheses (Figure 2).


Figure 2. Path coefficient and t-statistic in the structural model made by the Smart PLS 3 software.

Connections with t-statistics surpassing 1.96 were considered significant at a 95% confidence level. Additionally, the effectiveness of these connections can be evaluated by analyzing the implemented model and their relevance. A positive path coefficient on a line indicates a direct positive relationship between two variables.
Relationships with t-statistics exceeding 1.96 were considered significant at a 95% confidence level. Moreover, the effectiveness of these relationships can be evaluated by examining the implemented model and its relevance. When a path coefficient on a line is positive, it signifies a direct positive influence between job performance (R2=0.422) and organizational performance (R2=0.267).
The value of R2 for the variables of job performance and organizational performance was deemed acceptable. The perception of the WFH variable accounted for approximately 42.2% of the changes in the job performance variable and around 26.7% of the changes in the organizational performance variable.
Employees’ perception of WFH significantly influenced their job performance during the COVID-19 pandemic (t-value=9.623>1.96). Furthermore, the perception of WFH also played a crucial role in sustaining organizational performance during the pandemic (t-value=6.368>1.96). These results underscore the importance of ensuring a positive WFH experience and maintaining work continuity amid the ongoing pandemic.

Discussion
The objective of this study was to investigate the impact of WFH perception on employees’ performance at Hamadan University of Medical Sciences during the COVID-19 pandemic. Numerous organizations and companies have implemented WFH as a successful strategy to address the challenges posed by the COVID-19 pandemic. This approach has proven to be an effective method for enhancing the resilience of healthcare organizations against the spread of the disease.
The study revealed that employees’ perception of WFH significantly influenced their job performance. If an individual views WFH positively, their job performance is likely to improve. This finding aligns with a prior study conducted by Sutarto et al. on the impact of WFH on employee performance at the National Library of Indonesia [35]. Van der Lippe & Lippényi also reported that teleworking has positive effects on individual employee performance [2]. Another study by Susilo indicated that WFH can enhance job satisfaction during the COVID-19 pandemic [18]. While healthcare professionals are pivotal in treating and managing the pandemic, WFH can yield more positive outcomes than negative ones for roles that can be performed remotely. Consequently, managers in the healthcare sector should view WFH as a beneficial solution, particularly in critical circumstances.
Considering the nature of the job, the human resources management team should strategize and identify low-complexity roles that do not necessitate constant feedback, have low interdependence, and require minimal cooperation to be carried out remotely. When designing and planning job tasks, it is advisable to ensure they are conducive to remote work and that remote workers are in agreement. The participation of chosen individuals in the remote work initiative should be voluntary and without charge, with the option to return to the physical workplace as needed.
A recent study conducted at Hamadan University of Medical Sciences revealed that employees’ perception of teleworking significantly influences organizational performance. The study proposes that enhancing workers’ positive perception of WFH can boost organizational performance. These findings are consistent with a previous study by Chatterjee et al., which illustrated that flexible remote work, supported by top management, can enhance organizational performance [11]. Furthermore, Ipsen et al. examined the pros and cons of teleworking during the COVID-19 pandemic in European countries. Their research indicates that teleworking can benefit organizations by improving work-life balance, work efficiency, and increasing work control [15].
The research findings align with Nakrošienė et al.'s study, highlighting the positive outcomes of WFH for organizations [5]. However, Galanti et al. revealed that WFH during the COVID-19 pandemic can have a negative impact on productivity [8]. Therefore, it is recommended that human resource managers in healthcare systems concentrate on the work outputs of telecommuting roles when assessing performance. This involves evaluating the work performance of remote workers by establishing objective and time-bound criteria through work projects. Furthermore, future research should explore the impact of senior managers’ support for teleworking on enhancing organizational performance. While telecommuting has been shown to positively influence job performance, it may have adverse effects on other variables in the realm of human resource management that warrant further investigation in subsequent studies.
One limitation of the current study was the utilization of electronic questionnaires, which hindered the researchers from resolving any potential ambiguities with the respondents. Furthermore, the study was exclusively conducted on employees of Hamadan University of Medical Sciences in Iran. Therefore, any effort to generalize the findings to other provinces or countries should be approached with caution. Healthcare managers should prioritize remote work initiatives to enhance organizational resilience and deliver improved services to society. It is recommended that recruitment and selection processes prioritize candidates who value job autonomy and possess high self-efficacy traits, such as the ability to organize work plans and establish priorities.

Conclusion
The perception of WFH by administrative and support staff significantly influences their job performance and organizational effectiveness in three specialized clinical service centers of Hamadan University of Medical Sciences.

Acknowledgments: The researchers would like to express their gratitude to all the administrative and support staff who participated in the research by completing the questionnaires.
Ethical Permissions: This research was approved by the Hamadan University of Medical Sciences (IR.UMSHA.REC.1401.532).
Conflicts of Interests: The authors have no conflict of interest. There are no financial or non-financial interests to disclose.
Authors’ Contribution: Salehi R (First Author), Introduction Writer/Methodologist/Main Researcher/Statistical Analyst (35%); Gharaee H (Second Author), Introduction Writer/Methodologist/Assistant Researcher/Discussion Writer/Statistical Analyst (35%); Yousefi B (Third Author), Introduction Writer/Methodologist/Assistant Researcher/Discussion Writer (30%)
Funding/Support: This research was conducted with the financial support of the Health Research Committee in the Deputy of Development of Management and Resources of Hamadan University of Medical Sciences.
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Health Education and Health Promotion
Volume 12, Issue 2
Spring 2024
Pages 207-213