Exploring the Interplay of Professionalism and Organizational Commitment in Enhancing Human Resource Productivity: Evidence from a Military Hospital
Abstract
This study examines the roles of professionalism and organizational commitment as predictors of human resource (HR) productivity in a military hospital (Hospital X) in the Special Region of Yogyakarta, Indonesia. A descriptive qualitative single case study was employed. Data were collected through semi-structured interviews with ten purposively selected informants representing multiple organizational levels, supported by participant observation and document review. Data were analyzed using Braun and Clarke's (2006) six-phase thematic analysis with source and method triangulation. Data saturation was achieved at the eighth informant. The findings reveal that HR professionalism was generally adequate but constrained by cross-assignment practices involving 60% of nursing staff, nurse-to-patient ratios exceeding recommended standards (1:10 versus 1:4–1:6), and administrative tasks consuming approximately 40% of nurses' working time. Affective commitment emerged as the strongest dimension of organizational commitment, while continuance commitment remained the weakest, particularly among younger and civilian personnel. The study also identified a synergistic interaction between professionalism and organizational commitment in enhancing HR productivity, rather than a simple additive effect. Furthermore, military-specific contextual factors, including command hierarchy, dual workforce composition, and dual operational demands, moderated these relationships. Based on these findings, the study proposes a conceptual model in which affective commitment mediates the relationship between professionalism and HR productivity, while hierarchical structure and role duality function as contextual moderators. These findings extend conventional human resource management models and provide practical implications for developing integrated managerial strategies to improve workforce productivity in military healthcare organizations.
References
Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., Griffiths, P., Busse, R., ... & Sermeus, W. (2014). Nurse staffing and education and hospital mortality in nine European countries: A retrospective observational study. The Lancet, 383(9931), 1824–1830. https://doi.org/10.1016/S0140-6736(13)62631-8
Allen, N. J., & Meyer, J. P. (1990). The measurement and antecedents of affective, continuance and normative commitment to the organization. Journal of Occupational Psychology, 63(1), 1–18. https://doi.org/10.1111/j.2044-8325.1990.tb00506.x
Badriyah, M. (2013). Manajemen sumber daya manusia. CV Pustaka Setia.
Blau, G. J., & Boal, K. B. (1987). Conceptualizing how job involvement and organizational commitment affect turnover and absenteeism. Academy of Management Review, 12(2), 288–300. https://doi.org/10.2307/258216
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa
Bricknell, M., & Cain, P. (2020). Understanding the Whole of Military Health Systems: The Defence Healthcare Cycle. RUSI Journal, 165(3), 40–49. https://doi.org/10.1080/03071847.2020.1784039
Carayon, P., Wetterneck, T. B., Rivera-Rodriguez, A. J., Hundt, A. S., Hoonakker, P., Holden, R., & Gurses, A. P. (2014). Human factors systems approach to healthcare quality and patient safety. Applied Ergonomics, 45(1), 14–25. https://doi.org/10.1016/j.apergo.2013.04.023
Creswell, J. W., & Poth, C. N. (2018). Qualitative inquiry and research design: Choosing among five approaches (4th ed.). SAGE Publications.
Ministry of Health of the Republic of Indonesia. (2020). Indonesia health profile 2020. Kemenkes RI.
Dubois, C. A., & Singh, D. (2009). From staff-mix to skill-mix and beyond: Towards a systemic approach to health workforce management. In Human Resources for Health (Vol. 7). https://doi.org/10.1186/1478-4491-7-87
Hsu, H. C., Wang, P. Y., Lin, L. H., Shih, W. M., & Lin, M. H. (2015). Exploring the Relationship between Professional Commitment and Job Satisfaction among Nurses. Workplace Health and Safety, 63(9), 392–398. https://doi.org/10.1177/2165079915591400
Kabene, S. M., Orchard, C., Howard, J. M., Soriano, M. A., & Leduc, R. (2006). The importance of human resources management in health care: A global context. Human Resources for Health, 4. https://doi.org/10.1186/1478-4491-4-20
Krijgsheld, M., Tummers, L. G., & Scheepers, F. E. (2022). Job performance in healthcare: a systematic review. BMC Health Services Research, 22(1). https://doi.org/10.1186/s12913-021-07357-5
Larson, M. S. (1977). The rise of professionalism: A sociological analysis. University of California Press.
Listiyono, R. A. (2015). Studi deskriptif tentang kualitas pelayanan kesehatan di Rumah Sakit Umum Dr. Wahidin Sudiro Husodo Kota Mojokerto pasca menjadi Rumah Sakit Tipe B. Jurnal Kebijakan dan Manajemen Publik, 1(1), 7.
Matahelumual, N. P., Adolfina, & Kawet, R. (2019). Pengaruh budaya organisasi dan komitmen organisasi terhadap produktivitas kerja pegawai pada Biro Organisasi Sekretariat Daerah Provinsi Sulawesi Utara. Jurnal EMBA, 7(1), 641–650.
Mathieu, J. E., & Zajac, D. M. (1990). A review and meta-analysis of the antecedents, correlates, and consequences of organizational commitment. Psychological Bulletin, 108(2), 171–194. https://doi.org/10.1037/0033-2909.108.2.171
Meyer, J. P., Stanley, D. J., Herscovitch, L., & Topolnytsky, L. (2002). Affective, continuance, and normative commitment to the organization: A meta-analysis of antecedents, correlates, and consequences. Journal of Vocational Behavior, 61(1), 20–52. https://doi.org/10.1006/jvbe.2001.1842
Rabie, T. (2019). Construct validity and internal consistency of Hall’s Professionalism Scale: Tested on South African nurses. BMC Research Notes, 12(1). https://doi.org/10.1186/s13104-019-4515-6
Rani, F. K. G., Lambey, L., & Pinatik, S. (2018). Pengaruh profesionalisme terhadap produktivitas kerja karyawan bagian akuntansi pada PT. Bank Mandiri (Persero) Tbk. Manado. Jurnal Riset Akuntansi Going Concern, 13(4), 212–222.
Sedarmayanti. (2017). Perencanaan dan pengembangan sumber daya manusia untuk meningkatkan kompetensi, kinerja, dan produktivitas kerja. PT Refika Aditama.
Sedarmayanti. (2018). Manajemen sumber daya manusia: Reformasi birokrasi dan manajemen pegawai negeri sipil (Rev. ed.). PT Refika Aditama.
Strauss, A., & Corbin, J. (1998). Basics of qualitative research: Techniques and procedures for developing grounded theory (2nd ed.). SAGE Publications.
Tajfel, H., & Turner, J. C. (1986). The social identity theory of intergroup behavior. In S. Worchel & W. G. Austin (Eds.), Psychology of intergroup relations (2nd ed., pp. 7–24). Nelson-Hall.
Tett, R. P., & Meyer, J. P. (1993). Job Satisfaction, Organizational Commitment, Turnover Intention, And Turnover: Path Analyses Based On Meta-Analytic Findings. Personnel Psychology, 46.
Tilley, S. (2008). Competency in Nursing: A Concept Analysis. The Journal of Continuing Education in Nursing, 39(2). https://doi.org/https://doi.org/10.3928/00220124-20080201- 12?urlappend=%3Futm_source%3Dresearchgate.net%26utm_medium%3Darticle
Vermeeren, B., Steijn, B., Tummers, L., Lankhaar, M., Poerstamper, R. J., & van Beek, S. (2014). HRM and its effect on employee, organizational and financial outcomes in health care organizations. Human Resources for Health, 12(1). https://doi.org/10.1186/1478-4491-12-35
Waterkamp, C. I. A., Tawas, H., & Mintardjo, C. (2017). Effect of professionalism, organizational commitment and work satisfaction to employees performance in PT. Bank Rakyat Indonesia (Persero) Tbk Manado Branch. Jurnal EMBA, 5(2), 2808–2818.
Wieck, K. L., Dols, J., & Northam, S. (2010). What nurses want: The nurse incentives project. Nursing Economics, 28(4), 233–243.
Wirjayanti, F. (2014). Analisis profesionalisme pegawai Dinas Sosial Kota Pekanbaru [Undergraduate thesis]. Universitas Islam Negeri Sultan Syarif Kasim Riau.
Yin, R. K. (2018). Case study research and applications: Design and methods (6th ed.). SAGE Publications.
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