| Course | HLTH 4313 Leading and Decision-Making in Health Services |
|---|---|
| Module | Module 2 |
| Paper type | Organizational behavior analysis |
| Length | 1,240 words, about 5 pages plus title and reference pages |
| Format | APA 7 student paper |
| School | American College of Education |
| Program | B.S. in Healthcare Administration |
| Updated | September 2026 |
Free sample paper for HLTH 4313 Module 2
Invisible at 3 A.M.: A Motivation Analysis of a Night Environmental Services Crew Using Self-Determination Theory and Relational Job Design
Student Name
American College of Education
HLTH4313: Leading and Decision-Making in Health Services
Module 2 Assignment
Instructor Name
October 12, 2026
The Problem
On the night environmental services crew I supervise at a composite 300-bed hospital, motivation is uneven and fragile. Rooms are cleaned to standard when someone is watching, and less reliably when no one is. Sick calls cluster on weekends. In exit interviews, the four people who left last year did not mention pay first; they said they felt like nobody noticed their work unless something went wrong, and that nurses treated them as if they were in the way. One wrote, in a comment I have kept, that she had cleaned rooms in the same hospital for three years and no patient had ever looked at her.
Low motivation in this department is not a minor morale problem. Environmental services workers disinfect the surfaces that carry health care associated infections, and the quality of a discharge clean depends on steps no one checks in real time. Understanding what drives the crew's effort is therefore a question of patient safety as well as of management.
Self-Determination Theory
Self-determination theory, as summarized by Ryan and Deci (2000), holds that people have three basic psychological needs, for autonomy, competence and relatedness, and that workplaces meeting those needs tend to produce motivation that is self-sustaining, along with better well-being, while environments that thwart them undermine motivation and lead to passivity or alienation. The theory also distinguishes kinds of extrinsic motivation. Behavior done only to avoid punishment or gain a reward is weakly internalized and fragile, while behavior whose value a person has accepted as their own is sustained without constant monitoring.
The pattern on the night crew fits the theory closely. Autonomy is low: routes, room priorities and even the order of cleaning steps are dictated, and the previous supervisor's clipboard inspections taught the crew that the goal was to pass the check. Competence is supported for some tasks but not others; new hires were never shown why contact times for disinfectants matter, only told to follow them. Relatedness is weakest of all. The crew works when the building is quiet, has little contact with the clinical staff except when a nurse is waiting for a room, and hears from managers mainly about errors. People who are only ever corrected learn to clean for the inspection, not for the patient.
Relational Job Design
Self-determination theory explains why motivation is low but says less about the specific missing piece the exit interviews point to: contact with the people the work helps. Grant (2007) proposed that the relational structure of a job, particularly the opportunities it gives workers to have contact with and see the impact of their work on its beneficiaries, shapes their motivation to make a prosocial difference. Workers who know how their work affects others, and who have some contact with those others, are more likely to care about doing it well and to persist when it is hard.
Environmental services work is almost perfectly designed to hide its impact. The crew cleans rooms after patients leave and before new ones arrive, so they rarely meet the people they protect. Infections that do not happen are invisible. The worker who wrote that no patient had ever looked at her was describing exactly the absence of contact that Grant's theory identifies.
Conflict With Nursing
Motivation on the crew is also shaped by conflict with nursing staff. At night, emergency department boarding often depends on how fast a discharged room is cleaned, and nurses under pressure sometimes call the crew repeatedly or complain to the house supervisor. The crew experiences this as disrespect, and some members respond by avoiding the units where it happens most. The conflict has structural causes. The two groups have different measures of success, speed for nursing and thoroughness for environmental services, and no shared information about which rooms are coming. Neither group is wrong to care about what it cares about, and blaming individuals will not help.
Why Motivation Here Is an Infection Control Issue
Motivation on a cleaning crew is sometimes treated as a matter of morale alone, but research on hospital environmental services suggests it reaches patients. Litwin et al. (2017), combined infection reports with information on how California's general acute care hospitals organize and employ their staff, and found that outsourcing environmental services work was associated with higher rates of health care associated infections, and they explained the pattern by the likelihood that contracted cleaners receive less pay and training and have weaker ties to the hospital and its clinical teams. My crew is employed by the hospital, not a contractor, but the mechanism the authors describe does not depend on who signs the paychecks. A crew that feels detached and unrecognized is at risk of the same drift in quality, whatever its employment arrangement.
That finding changes how I present the problem to my own manager. A request for time to join nursing huddles, or for infection prevention to meet with the crew, is not a request for a perk. It addresses one of the conditions that research links to infections, and it costs far less than a single infection. Framing motivation this way also gives the crew a truthful answer to the question of why their work matters, which is the answer the relatedness and impact changes are meant to deliver.
What the Manager Can Change
The analysis suggests five changes within my authority. To support autonomy, crew members who have been signed off on a task will plan their own routes and cleaning order within the standards, and the crew will help decide how to handle surges. To support competence, training will explain the reason behind each step, such as why a disinfectant must stay wet for a set contact time, and fluorescent marker audits will be shared as feedback rather than as grades. To support relatedness, the crew will join the night nursing huddle on two units once a week, and I will ask unit managers to introduce the crew member assigned to their unit.
To make the work's impact visible, I will ask infection prevention to share, each quarter, the unit-level infection rates and what they mean, and I will pass along every compliment from patients and staff by name. To reduce conflict with nursing, I will propose that the bed placement coordinator share expected discharges with our crew lead at the start of each shift, so that the crew can plan instead of reacting to calls, and that both groups agree on a target time for a standard discharge clean.
None of these changes costs much money. Pay matters, and I will present the department's wage comparison to human resources separately, but the exit interviews suggest that pay is not the first reason people leave.
Measuring the Effect
The changes will be evaluated over six months with four measures: the fluorescent marker audit pass rate, reported for audits the crew does not know about in advance, which tests whether quality holds without monitoring; weekend sick calls; turnover; and a short survey in three languages based on the three needs, asking whether crew members feel they have a say in their work, understand why it matters and feel respected by the clinical staff. If audit results improve only when the crew knows an audit is coming, motivation is still being driven by inspection, and the relatedness and impact changes will need more attention.
References
Grant, A. M. (2007). Relational job design and the motivation to make a prosocial difference. Academy of Management Review, 32(2), 393-417. https://doi.org/10.5465/amr.2007.24351328
Litwin, A. S., Avgar, A. C., & Becker, E. R. (2017). Superbugs versus outsourced cleaners: Employment arrangements and the spread of health care-associated infections. ILR Review, 70(3), 610-641. https://doi.org/10.1177/0019793916654482
Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55(1), 68-78. https://doi.org/10.1037/0003-066X.55.1.68
The HLTH 4313 Module 2 assignment instructions
Module 2 of HLTH 4313 often focuses on organizational behavior, the study of how people act inside organizations. Prompts usually ask you to choose one issue in a health care department, such as motivation, communication, conflict, teamwork or culture, explain it with one or more theories, and recommend what a manager could do. Some versions provide a case; others ask you to use your workplace. Expect about three to four pages in APA 7, with the theory drawn from its original or a scholarly source rather than a management website. Check Canvas for whether the prompt names a theory, such as Maslow, Herzberg or expectancy theory, since some sections require a specific one.
How this HLTH 4313 Module 2 example is built
This example starts with evidence from the department: audit behavior, sick call patterns and the words of workers who left. It explains self-determination theory accurately and then applies each of its three needs to what the crew experiences, including the old supervisor's clipboard. Because the theory does not fully explain the workers' sense of invisibility, a second theory on relational job design is brought in and tied to the exit interviews. A short section treats conflict with nursing as a structural problem. The recommendations map one-to-one onto the needs and causes, stay within a supervisor's authority and treat pay separately. The measures include unannounced audits designed to show whether motivation has become internal.
Where the points sit in the HLTH 4313 Module 2 rubric
Organizational behavior rubrics generally score three things heavily: understanding of the theory, quality of the analysis and usefulness of the recommendations. Full marks on theory need an accurate account from a credible source, including its key distinctions. The analysis criterion rewards papers that apply each part of the theory to real evidence from the setting, as the example does need by need. Recommendations earn top ratings when each one follows from the analysis and is within a manager's power. Some rubrics also reward measures that test whether the change worked. Clear organization, correct grammar and accurate APA 7 citations make up the balance of the grade.
Common HLTH 4313 Module 2 mistakes, and how to avoid them
Students often lose points on this assignment by summarizing a motivation theory and then listing generic fixes, such as pizza parties, team building and employee of the month, with no link to the theory or the setting. Another frequent issue is blaming individuals for what the organization's design produces. Using Maslow's hierarchy without any research support can also draw comments, since graders prefer theories with evidence behind them. Remember that pay is real but rarely the whole story, and say so honestly. Draw on what workers actually say where you can. For a Module 2 analysis built on your own department and the theory your instructor assigned, a custom sample is available from the desk.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official American College of Education document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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HLTH 4313 Module 2 questions, answered
What does HLTH4313 Module 2 usually ask for?
HLTH4313 Module 2 often asks you to analyze an organizational behavior issue, such as motivation, communication, conflict or culture, in a health care department, using theory to explain it and propose changes. Your classroom's instructions decide the issue.
What is self-determination theory?
A theory of motivation holding that people need autonomy, competence and relatedness, and that workplaces supporting those needs foster motivation that lasts without constant monitoring.
Why use two theories in one paper?
When one theory leaves part of the problem unexplained. The example adds relational job design to explain the workers' lack of contact with the patients their work protects.
Where can I find a free HLTH 4313 Module 2 sample paper?
You are looking at it. The complete Module 2 organizational behavior analysis of motivation on a night cleaning crew is on this page with its title page, six sections, notes in the margin and references.
How can a manager raise motivation without raising pay?
By giving people more say in how they work, explaining why tasks matter, connecting them with the people their work helps and recognizing good work specifically, while addressing pay separately if it is a problem.