Impact of Relational Coordination on Job Satisfaction and Willingness to Stay: A Cross-Sectional Survey of Healthcare Professionals in South Tyrol, Italy

Abstract

Job satisfaction and willingness to stay are critical for workforce stability in a challenging healthcare environment. This study examined how relational coordination, a key factor in teamwork and communication, influences outcomes among healthcare professionals in a bilingual, culturally mixed region of Italy. This cross-sectional survey included general practitioners, hospital physicians, nurses, and administrators from the South Tyrol Health Service, using the 'Relational Coordination Survey' and additional measures of job satisfaction and willingness to stay. The analytical methods used included descriptive statistics, correlations, and regression analyses. This study applied path analysis, including mediation and moderation techniques, to investigate the roles of relational coordination and job satisfaction in influencing the willingness to stay. It employs Conditional Process Analysis with the PROCESS macro in SPSS, focusing on models for moderated mediation analysis. The results indicated a critical influence of relational coordination on both job satisfaction and willingness to stay among the 525 healthcare professionals. Job satisfaction varied by health district and years of service, with midcareer professionals being the least satisfied. The findings highlight the central role of relational coordination in job satisfaction and willingness to stay and confirm that low job satisfaction increases turnover intentions. Relational coordination directly enhanced job satisfaction and willingness to stay, while also serving as a mediating factor that amplifies the impact of job satisfaction on retention intentions. This study reinforces the need for strong teamwork and communication to stabilize the healthcare workforce. Targeted interventions aimed at improving relational coordination could significantly enhance job satisfaction and retention among healthcare professionals, particularly in culturally diverse settings such as South Tyrol.

Keywords: health personnel; interprofessional relations; job satisfaction; organizational culture; relationship coordination; workforce retention.

Figure 1

Distribution of relational coordination and its sub-dimensions for the dichotomized variable “Job Satisfaction”: (A) relational coordination and (B) subdimensions of communication and relationship. Responses indicating ‘very satisfied’ and ‘completely satisfied’ were categorized as “satisfied”, while “very dissatisfied’, ‘dissatisfied’, and ‘average satisfaction’ were categorized as “not satisfied”. RC: relational coordination; RCS: relational coordination survey. ** p < 0.01, *** p < 0.001.

Figure 2

Distribution of relational coordination and its sub-dimensions for the dichotomized variable “Willingness to Stay” (box blots): (A) relational coordination and (B) subdimensions of communication and relationship. Responses of ‘completely agree’ and ‘somewhat agree’ to continue working with the current employer were classified as “willing” to stay, while ‘strongly disagree’, ‘somewhat disagree’, and ‘neither agree nor disagree’ were classified as “undecided”. RC: relational coordination; RCS: relational coordination survey. Abbreviation: n.s., not significant; * p < 0.05, *** p < 0.001.

Figure 3

Mediation and moderation models calculated with PROCESS: Model 1 is a moderation model where ‘M’ modifies the effect of ‘X’ on ‘Y’. In Model 4, ‘M’ acts as a mediator, conveying the indirect effect of ‘X’ on ‘Y’ (a·b), alongside the direct effect (c’). Models 7, 8, 14, and 15 expand on Model 4 by incorporating ‘W’ as a moderator that affects the relationships between ‘X’, ‘M’, and ‘Y’ at different points in the path analysis. These models collectively aim to dissect the intricate relationships between variables in the context of predicting an outcome.