Exploring the Impact of Division of Labor among Health Workforce on Compassionate, Respectful, And Caring Health Professional implementation at Felege-Hiwot Referral Hospital, Amhara Region, North-West Ethiopia

Background: Creating Compassionate, respectful and caring (CRC) health professionals (CRC) is  very important to build a sustainable, equitable and healthy future for all divisions of labour and service delivery in their respective practices. The aim of the study was to explore the impacts of labour division in Felege-Hiwot specialized hospital on CRC implementation.

Methods: A phenomenological study design with purposive sampling, observational and document review data collection techniques was used to explore the impacts of division of labour on CRC implementation, and to explore barriers and enablers of division of labour among health workforces in Felege-Hiwot Specialized Hospital from March 15 to 30, 2021 by three well experienced data collectors. Twenty-seven participants were interviewed in the study. Patient participants were interviewed at exit time. Audio recording and field notes were taken from key-informant interviews and patient exit in-depth interviews. A thematic framework analysis was applied for data analysis.

Results: Based on the data analysis, six themes were investigated; labour division, workflow, and enablers of labour division for CRC implementation, effects of labour division on CRC implementation, barriers of labour division, and strategies to improve labour division. The result indicated that the labour division has direct influence on CRC implementation. Poor workflow, excessive workload, weak departmental and professional integration, limited administrative motive were identified. These in turn brought lack of motivation on health care providers, delay of service, weak patient -care provider relationship. Providing training, preparing and updating guidelines, promoting good role models, working on motivational activities for staff, strengthening professional skills, and regular supportive supervision were the most recommended solutions to improve division of labor status and CRC implementation.

Conclusion: According to the findings of this study, excessive workload, inadequate infrastructure, lack of responsibility, absence of supportive supervision and weak administrative issues were identified barriers for proper division of labour and CRC implementation. This study also highlighted the need for having clear scope of practice and work description, increasing integration among professionals and departments, managing hospital work flow, balancing patient flow and number of care providers, and increasing administrative motivations to implement CRC services properly.