Institutional stress and job performance among hospital employees

Purpose The purpose of this study was to investigate if institutional stress is related to job performance among hospital employees, and if institutional stress is fully or partly mediated by motivational resources with regards to the relation with job performance. Design/methodology/approach A self-completion survey was distributed to four public hospitals in Norway, and had a response rate of 40% (N = 9,162). Structural equation modelling was conducted on two groups of hospital employees with (N = 795) and without (N = 8,367) managerial responsibilities. Findings Institutional stress was negatively related to job performance for hospital employees without managerial responsibilities. The motivational resources autonomy, competence development and social support partly mediated the relationship between institutional stress and job performance in the group of employees without managerial responsibilities. In the leader group, the motivational resources fully mediated the relationship between institutional stress and job performance. Social support from leaders had a non-significant influence on job performance in both groups. Research limitations/implications The main limitation with this study is its cross-sectional design. Originality/value The study enables us to extend how work-related stress is related to job performance and the mediating role of the job resources autonomy, competence development and social support. The focus on productivity, and top management’s wish to improve hospital performance, may have unintended consequences, leading to a gap between managerial and clinical worldviews and understanding of goals, policies, values and prioritizing. This can lead to institutional stress. The findings of this study suggest that institutional stress has negative effects on hospital employees’ work motivation and job performance.