Actual Turnover Research Articles

Using Stay Interviews as a Quality Improvement Tool for Healthcare Workforce Retention

Background and Objectives: The novel coronavirus of 2019 (Covid-19) pandemic exacerbated already persistent health care workforce issues—eg, overwhelming workloads, chronic understaffing, and burnout—associated with turnover intent and actual turnover. While turnover may be inevitable, strategies that help organizations anticipate and mitigate its impact require knowledge about how employees are experiencing their work (not just performing) on an ongoing basis. Unlike performance appraisals, “stay interviewsing” is a proactive management approach to assess the organizational and personal factors that influence current employees’ retention in their roles (ie, why they stay). We describe our process of developing and using a stay interview guide with current Women’s Health Patient-Aligned Care Teams (WH-PACT) employees and comment on the feasibility of conducting these interviews, their acceptability by participating employees, and their potential application to inform retention strategies in learning health systems (LHS) like the Veterans Health Administration (VA). Methods: We conducted 24 stay interviews with current WH-PACT employees, including women’s health primary care providers (WH-PCPs, n = 7), registered nurses (RNs, n = 6), licensed practical nurses (LPNs, n = 6), and medical support assistants (MSAs, n = 5) with established tenure (greater than 3 years for MSAs and LPNs, and greater than 5 years for RNs and WH-PCPs) at VA medical centers and community-based outpatient clinics. Using rapid qualitative analysis, we summarized interview transcripts for preliminary insights that describe the utility of stay interviews to collect feedback on clinician and non-clinician employees’ experiences of work in VA women’s health primary care. Results: The responses and feedback from our participants indicate that stay interviews are potentially feasible for LHS to use as a retention tool and are acceptable to employees for sharing their perspectives. Conclusion: We discuss who should conduct stay interviews and the potential ethical implications organizations must consider before conducting them.

The impact of moral resilience on nurse turnover intentions: the mediating role of job burnout in a cross-sectional study

BackgroundHigh nursing staff turnover is a critical issue that negatively impacts the quality of care and patient safety. Turnover intentions, a key predictor of actual turnover, reflect an individual’s likelihood of leaving their current position. Understanding the underlying mechanisms driving nurse turnover intentions is crucial for developing targeted interventions to stabilize the nursing workforce globally.ObjectivesThis study aims to explore the relationship between moral resilience, job burnout, and turnover intentions among nurses, focusing on the mediating role of job burnout in this relationship.DesignThis study employed a quantitative, cross-sectional design.MethodsA convenience sample of 322 registered nurses was recruited from two tertiary hospitals in China between August and October 2023. Data were collected using the Chinese version of the Rushton Moral Resilience Scale (Chi-RMRS), the Maslach Burnout Inventory (MBI), and the Turnover Intention Scale. Data analyses were conducted using SPSS 26.0 and Amos 21.0. The study followed the STROBE guidelines for observational research.Ethical considerationBefore the commencement of data collection, the Institutional Review Board of Hunan Traditional Chinese Medical College (YXLL202401004) granted ethical approval.ResultsThe proposed model exhibited an excellent fit to the data, with fit indices as follows: χ2/df = 1.819, CFI = 0.977, TLI = 0.961, RMSEA = 0.072 (90% confidence interval [CI]: 0.033 to 0.107). The structural equation model revealed that moral resilience was inversely associated with job burnout and turnover intentions. Furthermore, job burnout fully mediated the relationship between moral resilience and turnover intentions (β = −0.473, p = 0.007). Further analysis indicated that the depersonalization component of job burnout was the sole mediator in the relationship between moral resilience and turnover intention (β = -3.934, 95% CI [-5.837, -1.932]).ConclusionThe findings indicate that moral resilience among nurses is negatively associated with turnover intentions, with this effect fully mediated by the depersonalization dimension of job burnout. Enhancing moral resilience in nurses may be valuable strategy for healthcare administrators to mitigate job burnout and subsequently reduce turnover intentions.

Political uncertainty, bank loans, and corporate behavior: New investigation with machine learning

This paper investigates how uncertain term length, a novel source of political uncertainty, affects the behaviors of banks and firms using a machine-learning approach. China's local authorities do not have a fixed term, creating an ideal environment for studying how economic agents react to their perception of political uncertainty without an actual political turnover. We implement a machine-learning method to predict the term length of city leaders by observing others with similar backgrounds. Combining this new measurement of political uncertainty and bank- and firm-level data, we find an inverted U-shaped relationship between city leaders' predicted remaining term length and bank loans, corporate liabilities, and investment, which matches the change of political uncertainty over the term. We also record the potential adverse consequences of the politically motivated loan and investment expansion, such as a loss of corporate efficiency and a disruption in market order.

A bibliometric analysis on intended and actual turnover in higher education

A bibliometric analysis on intended and actual turnover in higher education

The Effect of Person-Organization Fit on Turnover Intentions of Employees in Steel Companies

Turnover intention can be effectively used to predict the actual turnover behavior of employees (Zhang, X. et al., 2020). Employers and policymakers can provide intervention if employees’ turnover intentions can be correctly predicted, thus prevent actual turnover behavior from occurring (Matilde, L. et al.,2022). One of the main reasons employees leave their jobs is the mismatch between the individual and the organization. Kristof defined person-organization fit as compatibility between an individual and an organization that includes congruence and complementarity, where congruence is a consistent match between the individual and the organization's characteristics, and complementarity includes demand-supply fit and demand-ability fit (Kristof-Brown, A. et al., 2023). Study shows that individual-organizational fit is negatively associated with employees' willingness to leave (Kakar et al.,2019; Bernardo, A. L. et al., 2023). However, further research is necessary to confirm whether the finding is valid for different companies and to what extent is the effect, if there is. A study on the steel industry, having a big labor force may be considered as focus of the study.

Polarization and the Ties That Bind: Congressional Staff Turnover

Congressional staff serve as the “invisible force” in Congress by helping draft legislation and conduct oversight. Given this, excessive turnover among staff is a loss of institutional memory and inhibits legislators’ ability to effectively conduct their constitutional duties. Using a mixed methods research design of interviews and a new survey of staff in the 115th session of Congress, I capture staffer intent to leave their current position and track whether they actually left their position 12 months later. Similar to civil servants, staff who report dissatisfaction with coworkers report higher levels of turnover intention, while the type of office, age, and level of education impact actual turnover. However, the extent to which polarization impacts staffers’ job satisfaction impacts both intention and actual exit. My study makes a unique contributions to the growing body of literature devoted to understanding congressional staff by providing important insights into how to recruit and retain staff.

INVESTIGATING THE MEDIATING INFLUENCE OF WORK MEANINGFULNESS, JOB SATISFACTION, AND JOB STRESS ON TURNOVER INTENTION AMONG MALAYSIAN COMMUNITY PHARMACISTS

Turnover is a challenging issue for many organizations. Turnover caused organization suffer a loose of competent employees as well as costs associated with employee turnover and hiring new employees. High turnover among community pharmacists presents a significant concern due to its potential negative impact on the quality of pharmaceutical care and patient safety. Addressing this issue requires a thorough investigation of turnover intention, as it has been found to be positively associated with actual turnover. Turnover intention, although not synonymous with immediate departure, serves as a critical indicator of an employee's inclination to leave their current position. Therefore, the purpose of this study was to examine the job satisfaction and job stress, that affect turnover intention among community pharmacists in northern region of Malaysia. The meaningfulness of work was added as mediator. A quantitative study was conducted with 228 community pharmacists who participated in this study voluntarily. The data collection based on self-administered questionnaire. The findings emphasize the critical role of job satisfaction and job stress in influencing turnover intention. The insights offered by this research are valuable for top management in community pharmacies, providing them with the necessary knowledge to formulate effective strategies for managing employee turnover intention. Implementing these strategies can foster a more stable and engaged workforce, ultimately benefiting both employees and the organization as a whole.

Overqualified Employees’ Actual Turnover: The Role of Growth Dissatisfaction and the Contextual Effects of Age and Pay

AbstractOverqualified employees are those with more knowledge, skills, and abilities than their job requires. While these competent workers can bring benefits to firms, they also pose a high risk of turnover. However, the evidence is insufficient on whether, why, and when they actually leave and how organizations can manage their turnover effectively. Based on self-determination theory, we propose that unfulfilled internal aspirations for personal growth can be a major driving force of turnover among overqualified employees. Moreover, we explore how such a mechanism varies by employee’s age and whether pay can exert a mitigating influence. Using longitudinal data over three years (from 2017 to 2019) with a large sample of workers (N = 2473), we found an indirect effect where perceived overqualification reduces growth satisfaction, which in turn leads to actual turnover. Further, we found a three-way moderating effect of pay and age on the relationship between growth satisfaction and turnover, indicating that pay’s effect of deterring turnover was stronger for older employees. This study has theoretical implications for a better understanding of overqualified employees’ turnover driven by their internal impetus, as well as implications for pay policies that effectively manage overqualified workers in age-diverse modern organizations.

Meaning of Work-life Balance for Workers With Disabilities

BackgroundThis article aims to show that work-life balance (WLB) for workers with disabilities can have important meanings that can affect turnover intention and exclusion from the labor market. MethodsUsing the Korean Panel Survey of Employment for the Disabled (1st–8th), panel logit models were applied to analyze the effect of WLB on the voluntary turnover intention and behavior of workers with disabilities. WLB types were categorized into four groups (Work-Life Dissatisfaction Group, Only Work Dissatisfaction Group, Only Life Dissatisfaction Group, and Work-Life Balance Group) based on the integration of job satisfaction and life satisfaction. ResultsTurnover intention was significantly higher in the work-life imbalance groups (Work-Life Dissatisfaction Group, Only Work Dissatisfaction Group), which is commonly associated with job dissatisfaction. The effect of WLB on turnover intention was 1.38 times higher in Only Work Dissatisfaction Group (β: 2.25, 99% confidence interval [CI]: 1.50, 2.31), characterized by dissatisfaction solely with their job, than in Work-Life Dissatisfaction Group (β: 1.90, 99% CI: 1.97, 2.53), which was experiencing dissatisfaction with both work and life. Only Work Dissatisfaction Group resulted in actual turnover, with females (β: 0.73, 95% CI: 0.37, 1.09) more likely to exit the labor market and males (β: 0.66, 99% CI: 0.41, 0.89) showing a higher tendency to change jobs. ConclusionWLB policy should focus on job dissatisfaction, a key predictor of turnover intention that leads to actual turnover behavior. Furthermore, women workers with disabilities are a priority policy target group to prevent exclusion from labor.

A Mediating Effect of Intention on the Relationship between Attitude, Subjective Norm, and Perceived Behavioural Control and the Turnover Intention Actual Usage among the SME Service Sectors Employees in Beijing, China

This study explores the mediating role of intention in the relationship between attitude, subjective norm, and perceived behavioral control on turnover intention and actual turnover behavior among employees in the SME service sector in Beijing, China. Drawing on the Theory of Planned Behavior (TPB), we hypothesize that employee attitudes towards their job, the influence of subjective norms, and their perceived control over leaving their job collectively influence their turnover intentions, which in turn affect their actual turnover behavior. Data were collected through a structured questionnaire administered to a sample of SME service sector employees in Beijing. Structural equation modeling (SEM) was employed to test the proposed hypotheses and the mediating effect of intention. The findings reveal that intention significantly mediates the relationship between the three TPB components (attitude, subjective norm, and perceived behavioral control) and turnover behavior. Specifically, employees with negative job attitudes, high subjective norms favoring turnover, and high perceived control over leaving are more likely to form strong turnover intentions, which subsequently lead to actual turnover. These results offer valuable insights for SME management in Beijing on the importance of addressing employee attitudes, norms, and perceived control to mitigate turnover rates. The study contributes to the broader literature on employee turnover by highlighting the critical mediating role of intention and providing a nuanced understanding of the TPB in the context of SME service sectors in China.

Comparing Teacher Turnover Intentions to Actual Turnover: Cautions and Lessons for the Field

Many studies rely on teachers’ reported career intentions instead of measuring actual turnover, but research does not clearly document how these variables relate to one another. We test how measures of teacher intentions relate to turnover. Using nationally representative data on 102,970 public school teachers, we conduct a descriptive and regression analysis to probe how teachers’ turnover intentions are and are not associated with moving schools and leaving teaching. While there is some variation across measures of intent, we find evidence that intention is distinct from, but strongly related to, turnover. We advise that surveys continue to capture intention as it provides meaningful information, but we recommend intention not be used as proxy for turnover.

Assessing the Anaesthetic Time on Operation Theatre Utilisation and Case Cancellation

The time to perform an anaesthesia-related procedure at induction and emergence is often overlooked as part of the operation theatre (OT) utilisation time. This prospective observational study aimed to assess the estimation done by the surgeons and anaesthetists on anaesthesia times and the overall OT utilisation in our centre. This prospective observational study included elective cases from 13 surgical disciplines. The trainees, specialists and consultants from surgical and anaesthesia teams estimated the anaesthesia times separately before the surgical procedures. The actual anaesthesia, surgical, total procedural and turnover durations taken to complete the cases were documented. Operation theatre utilisations of those various surgical disciplines involved in the study were also analysed. We analysed 128 elective cases. The average mean time spent for anaesthesia procedures was 28.4 ± 14.1 min, with the mean induction time was 16.0 ± 9.8 min and the mean emergence time was 12.5 ± 8.6 min. Both anaesthetists and surgeons overestimated the anaesthetic times, but anaesthetists estimated closer to the actual anaesthetic times (r = 0.64 vs r = 0.49, respectively). There was no significant difference in the estimated anaesthetic times between different experience levels. All the surgical disciplines had average OT utilisation exceeding 90%, indicating overutilisation. A total of 12 cases (7.1%) were cancelled. Most cases were cancelled due to exceeded allocated block OT times (7 cases) or unavailability of ICU beds (2 cases). We concluded that OTs exceeding the given OT time is the most frequent reason for cancelling elective surgical cases on the day of surgery.

Why Do Child Care Teachers Leave? Why Do They Stay? – Pre-Pandemic Evidence

ABSTRACT Turnover of child care staff is associated with lower care quality and compromised children’s development. While turnover rates in the child care sector have steadily been high, the COVID-19 pandemic has compounded the global staffing crisis. This article therefore aims to explore the correlates and reasons for turnover intention, turnover, and retention among child care teachers in two steps: The first study tested the Job Demands-Resources model using structural equation modeling. The second study assessed actual turnover and retention and explored the reasons for teachers staying and leaving in a smaller subsample 3 years later using correlational and content analyzes. Research Findings: The theoretical model fit the data well, indicating that job demands and job resources predict turnover intention mediated via job satisfaction and burnout. Overall, the motivational pathway was stronger than the energetic pathway. Furthermore, turnover intention predicted turnover 3 years later. The content analysis revealed that the team climate was a main reason for retention; leadership quality and a lack of advancement opportunities were crucial for job and occupational turnover. Practice or Policy: The results inform policy makers about measures to retain child care teachers and hence ensure care quality.

US nurse practitioner voluntary turnover: Development of a framework for analysis.

There is growing interest in nurse practitioner (NP) turnover with some reports indicating it is as high as 15% annually. However, there is a lack of generalizability and other conceptual weaknesses in the literature. These weaknesses support the development of a framework to operationalize NP turnover for administrators to develop workplace initiatives to reduce turnover. To describe the demographic and job characteristics of four NP voluntary turnover groups (i.e., dynamic leavers, static leavers, dynamic stayers, and static stayers) representing voluntary turnover intention and actual turnover among US NPs. A cross-sectional, descriptive secondary analysis of NPs ( N = 86,632) from the 2018 National Sample Survey of Registered Nurses (NSSRN) was used to delineate and describe four NP voluntary turnover groups. Nurse practitioners who left nursing (static leavers) were older and had the most work experience. Nurse practitioners who changed jobs and stayed in nursing (dynamic leavers) were younger, less experienced, and reported the least job satisfaction. Nurse practitioners who remained in their positions (stayers) regardless of whether they reported turnover intentions or not earned the most and reported the most job satisfaction. Four NP voluntary turnover groups were defined and described to distinguish voluntary turnover intentions from actual turnover. Characterizing NP voluntary turnover can help administrators mitigate losses and project organizational needs associated with NP turnover. A framework developed from the 2018 NSSRN can be used to research and develop key initiatives to strengthen the NP workforce.

Turnover intention and associated factors among health workers in Christian Health Association of Ghana hospitals: An institution-based cross-sectional study

ABSTRACT Background Identifying the key factors that may be associated with turnover intention could enable organizations to proactively identify the major determinants of actual turnover and design strategies to reduce voluntary turnover. The aim of this study was to assess turnover intention and its associated factors among health professionals working in Christian Health Association of Ghana (CHAG) affiliated hospitals. Methods An institution-based cross-sectional study was conducted among 630 health workers in 30 CHAG hospitals from April to September 2022. A structured questionnaire was used to collect data on the respondents’ socio-demographic variables, turnover intention, and organizational and job-related factors predicting their turnover intention. Multiple logistic regression analysis was conducted to identify significant predictors of turnover intention. Results The overall turnover intention rate was 67.4%. Being younger increased the odds of turnover intention among the health professionals. On the other hand, being male, having a high level of organizational commitment, perceiving organizational support to be high, being satisfied with one’s job, and being autonomous at work decreased the health professionals’ intention to leave their current place of work. Conclusions This study provids valuable information that could inform policy decisions and strategies aimed at improving health worker retention in CHAG affiliated hospitals in Ghana.

Turnover Rates and Factors Associated With Turnover: A Longitudinal Analysis of the Retention Period of Clinical Nurses in Korea Using National Data.

Many countries, including Korea, are struggling with a nursing workforce shortage. This study aimed to identify the actual turnover rate of Korean clinical nurses and the factors affecting the turnover rate, considering the time required for nurses to gain experience at their current medical institution. This longitudinal study followed up on a cohort consisting of all 107,682 nurses from January 1, 2017 to July 30, 2020. Differences in the distribution of retention and turnover according to the medical institutions' and nurses' characteristics were analyzed using the chi-square test. The hazard ratios (HRs) for turnover in each analysis interval were analyzed using multilevel Cox proportional-hazards analysis. The mean turnover rate was 10.0% within 1 year and 33.4% within 3.5 years. Several organizational characteristics (the type and ownership of the hospital, its location, and the bed-to-nurse ratio) and individual characteristics (gender, age, and clinical experience) were found to be associated with turnover risk. Among these factors, compared to hospitals with a bed-to-nurse ratio in general wards of 6.0 or more, those with a ratio of 3.5-3.9 had an HR for 1-year turnover of 0.81 (95% confidence interval [CI] = 0.67-0.98), and those with a ratio of 2.5-2.9 had an HR for 3.5-year turnover of 0.77 (95% CI = 0.66-0.90). The bed-to-nurse ratio is a condition that can be modified through collaboration between government policy-makers and medical institutions. To reduce nurse turnover and retain experienced nurses, appropriate staffing should be implemented.

Turnover intention and associated factors among nurses working at governmental hospitals in Bahir Dar city at the time of war, northwest Ethiopia, 2022

IntroductionTurnover intention measures the likelihood that a nurse may soon depart from their current job or that the organization might be considering terminating nurses from their positions. It serves as a reliable predictor of actual turnover. Turnover intention results in deterioration in the standard of nursing care, compromise in patient safety, drop in customer service standards, and inadequate healthcare management. MethodsA cross-sectional study was conducted among 385 nurses employed in three selected government hospitals located in Bahir Dar city, Amhara region. Data collection employed a self-administered questionnaire, with entries managed through EpiData version 4.6 and subsequently transferred to STATA version 14 for coding, cleaning, and analysis. Binary logistic regression was employed to assess the association between dependent and independent variables. Variables with a p-value < 0.05 at a 95 % confidence interval were considered to exhibit statistically significant associations. ResultThe findings of this study revealed that 77.7 % of nurses had turnover intention. Multivariable binary logistic regression showed that age (20–27 years) [AOR = 0.36; 95 % CI (0.13, 0.95)], family-to-work conflict [AOR = 2.43; 95 % CI (1.34, 4.41)], salary expectation [AOR = 5.99 (95 % CI: 1.24–27.70)], and job satisfaction [AOR = 5.39 (95 % CI: 1.34–21.64)] were significantly associated with nurses' turnover intention. ConclusionIn this study, the prevalence of turnover intention among nurses working in Bahir Dar governmental hospitals was found to be high. Numerous factors emerged as statistically significant predictors of nurses' turnover intention, encompassing age, salary, and job satisfaction.

High performance work practices and turnover intentions: A case of call Centre employees

Staff turnover is a major problem in call centers due to various factors leading to unfavorable outcomes including operational problems, poor customer service, higher training costs, and lack of competitiveness. In the present study, we investigated this issue by using the High-Performance Work System (HPWS) as a theoretical lens. We hypothesized that the extent of HPWS can negatively influence the staff turnover intention which we used as a proxy measure for actual turnover. The data is collected from selected call center employees (n=159). The results indicate that participants perceive a moderate level of HPWS components. Furthermore, the component of HPWS exerts a negative and significant influence on staff turnover intentions including recruitment and selection (β=-.412, P&lt;.05); training and development (β=-.552, P&lt;.05); job security (β=-.418, P&lt;.05); and autonomy (β=-.306, P&lt;.05); whereas, results for promotion (β=.051, P&gt;.05); and communication (β=.107, P&gt;.05) turned out to be insignificant. The result shows that HPWS is a significant predictor of employee turnover intention in the particular context of the call center, thus implying that the management of the call center should give attention to the employee management-related issues.

Quiet Quitting among Nurses Increases Their Turnover Intention: Evidence from Greece in the Post-COVID-19 Era.

As turnover intention is a strong determinant of actual turnover behavior, scholars should identify the determinants of turnover intention. In this context, the aim of this study was to assess the effect of quiet quitting on nurses' turnover intentions. Additionally, this study examined the impact of several demographic and job characteristics on turnover intention. A cross-sectional study with 629 nurses in Greece was conducted. The data were collected in September 2023. Quiet quitting was measured with the "Quiet Quitting" scale. In this study, 60.9% of nurses were considered quiet quitters, while 40.9% experienced high levels of turnover intention. Multivariable regression analysis showed that higher levels of quiet quitting increased turnover intention. Moreover, this study found that turnover intention was higher among females, shift workers, nurses in the private sector, and those who considered their workplace understaffed. Also, clinical experience was associated positively with turnover intention. Since quiet quitting affects turnover intention, organizations, policymakers, and managers should address this issue to improve nurses' intentions to stay at their jobs.

Factors impacting turnover intention of Catholic priests in the Eastern region of the United States

ABSTRACT Turnover intention is positively associated with actual turnover. The purpose of this study was to examine the factors that impact turnover intention of Catholic priests. The participants (n = 333) were Catholic priest from the Eastern region of the United States who completed a demographic, Vocational intention, and Physical Symptoms Inventory. Frequency analysis and logistic regression analyses were conducted. A majority (85.3%) of Catholic priests surveyed had never considered leaving active ministry, while 14.7% had either considered or are planning to leave the priesthood. Compared to their peers, priests of colour (OR = 4.99), those living in community with other priests (OR = 4.42), and with 11–30 years of ministry (OR = 3.39) were significantly more likely to report turnover intentions. More (arch)diocesan support and retention efforts should be provided for the minority priests, those with less than 30 years active ministry, and those living alone or with another priest.