Healthcare under pressure: organizational choices, violence concern, and job satisfaction in Emergency Departments

Emergency departments (EDs) witnessed a significant rise in workplace violence, with serious implications for healthcare professionals' job satisfaction. Addressing this key issue, this study adopts Affective Events Theory (Weiss & Cropanzano, 1996) and the concept of vulnerability (as in Butler, 2004) to explore how individual, organizational, and job related factors influence workplace violence concerns and job satisfaction in EDs. The research adopts an exploratory sequential mixed-methods approach. First, qualitative interviews were conducted with 11 healthcare executives (including chief medical, administrative and general officers) and head of EDs in two Italian hospitals, investigating work organization factors such as, for example, excessive workload, inadequate working spaces, and employees’ skills. Second, a quantitative phase involved the submission of a questionnaire to the population of EDs workers of the two hospitals, collecting 131 responses (with a response rate of 68%). The data was then analyzed using Structural Equation Modeling (SEM) to examine the influence of individual, job related, and organizational determinants on job satisfaction, mediated by workplace violence concerns. The study provides empirical evidence collected in high pressure environments to enrich Affective Events Theory with the vulnerability framework. The findings highlight several areas of intervention to tackle workplace violence concern. These include managing workloads to prevent excessive burden, cultivating effective communication and interpersonal skills, and ensuring adequate working spaces, all of which contribute to improved job satisfaction.