Population and sample of the study

Sekaran (2003) defines the population as the group of people or things of interest under investigation by the researcher. In the current study, the target population includes the managers, supervisors, leaders, clinical staff, nursing staff, and technicians from different nations and cultures. Due to the nature of the mixed methods approach, the quantitative and qualitative phases of the study used same sampling methods. Both phases of the study used stratified random sampling of the groups of KFSH employees listed above. Clinical and supervisory staffs were included in this sample because they often have leadership responsibilities.

163 According to Saunders et al. (2009) stratified random sampling is a modification of random sampling in which the researcher divides the population into two or more relevant and significant strata based on one or a number of attributes. A random sample is then produced from each of the strata. Dividing the population into a series of relevant strata means that the researcher ensures that each of the strata is represented proportionally within his sample. The sample is stratified based on the proportion size of employees in each department. This aims to ensure correct representation within the sample. Thus, each department is represented equally in the sample.

6.3.1 Quantitative sample size

The survey was conducted on employees of KFSH based on their job role and the proportion of those in that role in the total population. Table 6.1 reports the distribution of staff based on their categories. A total of 1000 questionnaires were distributed among the staff according to the proportion of the group from the total population. The number of questionnaires distributed to each group/category is shown in Table 6.1. Of the 1000 questionnaires sent out, 400 were completed and returned.

Table 6. 1 The distribution of KFSH staff and the number of questionnaires delivered Departments Consultants/

Clinicians Nurses Technicians

General staff

Admin

staff Total The distribution of staff as

in 2006 (n) 561 1819 1185 2100 1787 7452 The % of staff in each

department from the total population

8% 24% 16% 28% 24% 100%

Number of questionnaires delivered per department (n)

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6.3.2 The quantitative response rate

The most important feature for a sample is that it adequately represents the target population. It is important that the research sample is sufficiently large to give the necessary confidence in our result. Therefore, as showing the table above, 1000 questionnaires were distributed to secure a high response rate. The researcher also applied many techniques to ensure that responses were collected as efficiently as possible.

To increase trust, and therefore improve the chances of participant cooperation, the researcher showed the ethical approval document issued by the University of Bradford to each participant when conducting this research. In addition to this, the researcher explained to all participants that they or the KFSH as an organisation could not be harmed as a result of their participation. The researcher established a trust with the respondents and increased interest, awareness and enthusiasm by stating how the results would be used to help the respondents and their departments.

The questionnaire booklet was designed with clear colours to make the questionnaire more readable and attractive. In addition, a request to participate in the survey was presented on the first page of the questionnaire book. In this request, the researcher introduces himself, gives a brief of the study and the title of the thesis, and identifies the sponsoring body. The researcher also used the opportunity to reiterate the time frame required for the response, the potential risks resulting from participation; the importance of the study to the KFSH; and the contact details of the research for feedback.

A postal follow-up reminder was also used to enhance the questionnaire response rate, along with a once weekly telephone call. This process resulted in the return of 220 questionnaires in the first month, 150 questionnaires in the next month,

165 and 30 questionnaires in the last month. In total, 400 questionnaires were received from different departments.

Table 6.2 shows that of the total 1000 distributed questionnaires 400 were

returned and of these 70 were excluded because they were deemed to be useless/ineffective. In general, the causes of non-response include: refusal to respond, or contact failure. The most common reason for non-response was refusal to participate or be involved in the survey, without offering a reason. The researcher excluded 70 questionnaires because many of them were incomplete and missing demographic information. The number of refusals was not significant compared with the number of valid questionnaires. Hence, the quality of our analysis is not affected. After exclusion, the total number of useful questionnaires was 330 (33%).

The number of responses collected from each group ranged from 32 to 118 which represents 10 to 36%. Table 6.2 shows that the general staff represent 36% of the collected and usable questionnaires, followed by nursing and administrative staff, 29% and 15%, respectively. The distribution of response rates in Table 6.2 matches the percentage of staff from the total population in Table 6.1. For instance, the general staff have the highest response rate and are also the most highly represented group. The distribution of the response rate matches the portion of staff from each category in the total population; hence, it adequately represents the target population.

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Table 6. 2 Response rates of distributed questionnaires

Departments Consultants _{/ Clinicians} Nursing _staff Technicians General _staff Admin _staff Total Eligible questionnaire

Distributed 80 322 140 365 93 1000

Collected 400 400

Non-usable 70 70

Completed and Useful 32 97 35 118 48 330

Response rate 10% 29% 11% 36% 15% 33%

Response rate = 𝑁𝑢𝑚𝑏𝑒𝑟𝑜𝑓𝑐𝑜𝑚𝑝𝑙𝑒𝑡𝑒𝑑 𝑞𝑢𝑒𝑠𝑡𝑖𝑜𝑛𝑛𝑎𝑖𝑟𝑒𝑠 𝑤𝑖𝑡ℎ 𝑟𝑒𝑠𝑝𝑜𝑛𝑑𝑖𝑛𝑔 𝑢𝑛𝑖𝑡𝑠_{𝑁𝑢𝑚𝑏𝑒𝑟𝑜𝑓𝑒𝑙𝑖𝑔𝑒𝑏𝑙𝑒 𝑟𝑒𝑠𝑝𝑜𝑛𝑑𝑎𝑛𝑡𝑠 𝑖𝑛 𝑡ℎ𝑒 𝑠𝑎𝑚𝑝𝑙𝑒} Response rate = _{1000 = 33%}330

Table 6.3 presents the mathematical method for calculating the response rate.

Table 6.3 Presents the mathematical method for calculating the response rate Eligibility requirement

Total number of sampling units 1000

Total number of responses 400

Total number of eligible responses 330

Total number of ineligible responses 70

Percentage of eligible responses

0.82

Total number of non- respondents

670††

Expected percentage of eligible responses in Non-respondents 552.75†††

Response Rate 37.38%††††

†is calculated as 330/400, ††is calculated as 1000-330, ††† is calculated as 670*(330/400), and †††† is calculated as (330*100)/ (330+553).

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6.3.3 Employee demographic characteristics

Table 6.4 reports the key demographic characteristics of the survey respondents.

Administration (30%) and nursing (26.4%) staff represent more than half of the sample, which is similar to their distribution in the 2006 annual report, the year BSC was introduced in KFSH. Similarity between employee distribution in the report and our analysis, lends credibility to the correct allocation of questionnaires to representative groups. Table 6.4 also shows that 58% of the sample was female, giving a fairly equal gender distribution. We categorised job roles into senior level, middle level, and junior level. It is clear in Table 6.4 that the junior level dominated the sample, with a 59.4% representation. We also classified staff by nationality. Saudis (42.1%) followed by Asians (36.7%), were the most common nationalities in the sample. Table 6.4 also shows that 38.5% of the respondents were between 30 to 39 years old, and 30% of the respondents were between 40-49 years old.

The distribution of clinical staff; doctors, nurses, and paramedical, shows that the make up the majority of the sample (69.6%) The distribution of non-clinical staff; top management, middle management, and support management, shows that support management staff are the most abundant at 45.8% of the sample, followed by middle and top management, respectively. The sample also shows 53.6% of the sample holds a first degree, 22.7% hold a two-year diploma, and the rest hold higher degrees. The length of stay distribution shows that 31.3% of the respondents have experience between 21 and 25 years, 28.% of the respondents have experience between 11-15 years, and 25.8% of the respondents have experience between 16 and 20 years.

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Table 6.4 The demographic specifications

Domain Category Frequencies (F) as in ₂₀₀₆ %

Departments Clinical staff 73 22.4 Nursing staff 87 26.4 Supportive staff (Technicians & Paramedics) 35 10.6 Administration staff 98 29.7 Managers 36 10.9

Gender Female _Male 191 ₁₃₉ 58 ₄₂

Clinical / Non-Clinical staff Clinical _Non-clinical 179 ₁₅₁ 54 ₄₆

Job role Senior level 40 12.1 Middle level 94 28.5 Junior level 196 59.4 Nationality Saudi 139 42.1 Middle East 31 9 Asian Countries 121 36.7 Others 39 12.2 Age 20-29 47 14.2 30-39 127 38.5 40-49 99 30 50-59 57 17.3 Qualification PhD 25 7.6 Master Degree 53 16.1 First Degree 177 53.6 Diploma 75 22.7 Length of employment 5-10 Years 49 14.8 11-15 Years 93 28.2 16-20 Years 85 25.8 21-25 Years 103 31.3

Table 6.4, conveys the message that the majority of staff are from Saudi Arabia

(local nationals) (F=139; 42%) followed by staff from Asian countries (F=121; 37%). Employees from the Far East make up 12.2% (F=39) of the sample, whereas only 9% (F=31) are from the Middle East.

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6.4 Data analysis used