Turnover Costs Research Articles

Noneconomic and economic impacts of nurse turnover in hospitals: A systematic review.

AimTo examine and synthesize the noneconomic and economic impacts of nurse turnover in acute hospitals.BackgroundNurse turnover occurs when nurses leave their jobs or the profession and is a major concern for the healthcare industry. Many studies have investigated the determinants of nurse turnover.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta‐Analyses checklist was utilized in the current review. Article search was conducted in June 2021. Research articles published since January 2000 were included. Eight databases (e.g., CINAHL, PubMed, PsycINFO, and Web of Science) were used. The following eligibility criteria were applied for inclusion: Articles that (1) were nonexperimental quantitative studies, (2) examined the impact of actual nurse turnover in acute hospitals, (3) were a peer‐reviewed original research article, and (4) were written in English or Korean.ResultsAmong 9,041 searched articles, 16 were included in the review. Seven studies investigated the association of nurse turnover with processes and outcomes (workgroup processes, nurse staffing, nurse outcomes, and patient outcomes), and partially supported the negative impact of turnover. Nine studies found that nurse turnover is very costly.ConclusionMost studies investigated the turnover cost, which is costly. The negative noneconomic impact of nurse turnover was partially supported.Implications for nursing practice and nursing policyTo prevent the adverse noneconomic and economic impacts of nurse turnover and retain nurses, healthcare organizations, nurse managers, and hospital staff nurses need to develop and implement prevention strategies and policies to address nurse turnover. Efforts to address nurse turnover can increase hospital competency to improve the quality of nursing care services and patient safety.

Impact of intensive peer coaching on physician performance

Physician performance in patient experience varies broadly. Physicians who are otherwise excellent clinicians may have lower than average patient experience scores and more frequent patient complaints. This raises the question, how do we assist physicians in improving their skills to provide a better patient experience? To address this problem, a team of physician peer coaches were matched with clinicians who were underperforming to local standards as measured by individual patient experience scores or by number and type of patient complaints. The peer coaches worked with their colleagues for six months, meeting on average every other week to review motivation, skills and performance barriers. Clinicians who were paired with trained peer coaches showed significant, sustained improvement in performance as measured by patient experience scores of the coached cohort. Clinician retention also outperformed manager estimates, and clinicians were highly satisfied with the process. It was concluded that physician performance can be positively impacted through peer coaching in a process that is satisfying to the client, improves estimated retention and reduces turnover costs. Peer coaching benefits patients, clinicians and hospitals by improving the experience of both patients and clinicians and supporting a stable clinician group. Coaching programmes are reproducible and measurable and produce short- and long-term results. Emergent themes recognised by coaches included not only skill development but also professional well-being and personal renewal activities. As clinicians face increased challenges to professional well-being personal and employerbased coaching programmes are one way to mitigate the risk to patients and clinicians.

Assessing benefits in the flexibility of refined oil logistics from pipeline network integration reform: A case from South China

• Propose a framework for flexibility quantification of oil logistics flexibility. • The framework based on MILP model contains both quantitative and qualitative parts. • Build a calculation method for the flexibility indicator of refined oil logistics. • Quantify the impact of the reform on logistics flexibility in South China. The pipeline network integration reform enables unified management of pipelines from different entities. For refined oil logistics, this paper proposes a framework based on the MILP optimization model to quantify its flexibility. Considering the uncertainty, three disturbances occur in the logistics concurrently, and 10,000 simulations are performed to obtain the turnover cost. The ratio of pipeline transportation cost to the calculated average turnover cost is defined as the flexibility indicator. Taking China's largest refined oil pipeline network as an example, the results show that the flexibility rises 8.9% after the reform. The paper also quantifies the impact of the reform on logistics flexibility in South China, which is embodied in achieving lower freights and GHG emissions, lower impact by fluctuations, higher pipeline utilization, more efficient oil product turnover, and the avoiding of depot shortages when facing logistical disturbances. The underlying reasons for the results and 3E analysis are analyzed.

ENSURING ECONOMIC SECURITY OF TRADE ENTERPRISES IN THE FORMATION OF PRICING POLICY

The article considers the problem of ensuring the economic security of trade enterprises by forming an optimal pricing policy. The methodology of formation the minimum and maximum selling prices of trade enterprise, maintenance of margin of economic security, which based on research of turnover costs and working capital of trade enterprise is offered. Based on statistical data of trade enterprises, the types of prices by product range are determined, which form a stable economic situation and ensure economic security of trade enterprise. The necessity of formation the optimal price policy and selling prices of trade enterprises with the use of Pareto efficiency tools and construction of single-criteria and multi-criteria tasks, indicators of quality of commodity resources of trade enterprises is substantiated. Using the Excel software processor and the “Regression” function, economic-mathematical models of optimal prices for the product range of trade enterprises are built. The results testified to the effectiveness of the proposed model of the optimal pricing policy of trade enterprises, as the obtained values are within the minimum selling prices, which provides economic security of trade enterprises. The process of forming the pricing policy of trade enterprises to ensure economic security is proposed, which is based on the principles of pricing, appropriate methodological tools and monitoring of market environment factors. Organizational, economic, legal, social and market (marketing) mechanisms for the formation of effective pricing policy of trade enterprises aimed at ensuring economic security are identified. This study is practically interesting for personnel of trade enterprises, regardless of organizational-legal forms of ownership and activities, and theoretically – for researchers dealing with pricing.

Low-emission hydrogen production via the thermo-catalytic decomposition of methane for the decarbonisation of iron ore mines in Western Australia

The Pilbara, located in Western Australia is one of the largest iron ore-mining regions in the world and will need to achieve significant emission reductions in the short term to conserve the limited carbon budget and abide by the Paris Agreement targets. Green hydrogen has been communicated as the desired solution, however, the high production cost limits the deployment of these systems. The thermo-catalytic methane decomposition (TCMD) process is an alternative solution, which could be implemented as a bridge technology to produce low-emission hydrogen at a potentially lower cost. This is especially attractive for iron ore mines due to the utilisation of iron ore as a process catalyst, which reduces the catalyst turnover costs and can increase the grade of spent iron ore catalyst. In this study, a preliminary techno-economic assessment was carried out in comparison with green hydrogen to determine the feasibility of the TCMD process for the decarbonisation of iron ore mine sites in the Pilbara. The results show that the TCMD process had a CO2 abatement cost between 25 and 40% less than green hydrogen, however, the magnitude of these costs was lowest for mining operations >60 Mt/yr at approximately $150 and $200 USD/t CO2 respectively. Since green hydrogen is expected to have significant cost reductions in the future, integrating renewables already into the mine could reduce emissions in the short term, which could then be extended for green hydrogen production once it becomes viable. The TCMD process, therefore, only has a narrow window of opportunity, although considering the uncertainty of the process and that green hydrogen is a proven technology with greater emission-reduction potential, green hydrogen may be the most suitable solution despite the model results presented in this work.

The Comparison of Financing Efficiency of Small and Medium Enterprises in Economically Underdeveloped Regions in China: A Perspective Study

Small- and medium-sized enterprises (SMEs) are important foundations to implement mass entrepreneurship and innovation and play an irreplaceable role in increasing employment, promoting economic growth, as well as scientific and technological innovations, and providing particularly social harmony and stability and imminently are strategic entities to the national economy and social development in underdeveloped regions. However, the low-efficiency financing of SMEs has gradually become a major factor that restricts the high-quality development of SMEs in the current conditions. In this paper, interest expenditure, gearing ratio, and the net debt ratio as input indicators and current asset turnover ratio, cost margin, and main business income as output indicators are used to conduct the DEA-BCC model. By utilizing the GEM-listed private enterprises between 2017 and 2020 in China, the nationwide financing efficiency of SMEs is firstly measured, and then the financing efficiencies of SMEs in economically developed regions and lagging regions are calculated separately. The comparison reveals that the financing efficiency of SMEs in economically underdeveloped regions is not only lower than the national average figure but also much lower than the financing efficiency level in economically developed regions, which is the result of the combined effect of internal and external factors that enterprises face. Further, this paper finds that unexpected public events, core technical personnel, and enterprise size have an impact on the financing efficiency of SMEs when running group testing. This paper puts forward rationalized suggestions to the institutions to improve the financing efficiency of SMEs in underdeveloped regions concerning the conducted research, which are called government, financial institutions, and enterprises.

The Relationship Between Family-Friendly Workplace Policies and Accountant Turnover

Prolonged high turnover rates have caused a shortage of accountants; unfortunately, managers have not successfully taken action to avoid these circumstances. Reducing the high turnover is necessary for accountant managers to replenish the accountant shortage, reduce turnover costs, and protect the accounting industry’s reputation for supporting its employees. Grounded in the social exchange theory, the purpose of this quantitative correlational study was to examine the relationship between three family￾friendly policies, childcare support, alternative work schedules, and work-family culture and accountant turnover intention. The participants comprised of 185 accountants who responded to the NSCW questionnaire. The results of the multiple regression analyses were significant, indicating that formal and informal family-friendly policies were significantly related to turnover intention. Further, demographic subgroups displayed different relationships between variables.

On the pure theory of wage dispersion

We study an equilibrium model of the labor market with identical firms and homogeneous workers, and with search and on-the-job search. Jobs are dynamic contracts that allow firms to match the worker's outside offers or let the job be terminated. For a non-degenerate distribution of wage offers to arise in the environment, it is necessary and sufficient that (i) there is a positive cost of job turnover, in terminating an existing job or posting a new one; and (ii) there is asymmetric information regarding the worker's outside offers. The model is calibrated to the U.S. labor market to match observed worker flows and the observed mean-min ratio in wages earned. The calibrated model predicts a unimodal distribution for both wages offered and wages earned.

FACTORS INFLUENCING EMPLOYEE TURNOVER IN THE NGO’S OF PAKISTAN

Non-government organization (NGO) sector in Pakistan is characterized by diversity and vibrancy. They provide employment opportunities in addition to the private sectors and government institutions.These days the cost of staff turnover becomes one of the major concerns of organizations both in for profit & Non for profit terms. Currently most of the NGOs in Pakistan are affected by high staffs turnover, due to this high staffs turnover most of the NGOs has been losing its experienced employees. The present research sought to investigate factors influencing employees’ turnover in the NGOs of Pakistan. This study is cross-sectional and quantitative. Data were collected by close-ended questionnaire based on a seven-point Likert-type scale comprising a total population of 200 people in most of the big cities in Pakistan. The study depicted a significant association between employee’s turnover and the pay package and employee motivation rewards provided by the organization. The study concludes that in order to ensure less people leave NGOs in Pakistan it is important that the organization must focus in increasing their pay packages and must offer certain motivational awards. KEYWORDS: Employees turnover, NGO, Co-relational analysis

Employees’ Turnover Intention in the Construction Industry in Indonesia

Employee turnover costs pose a big challenge for many companies. Studies show that employee turnover can cost about 20% of the salaries in hiring, training and lost productivity, although estimates give much higher figures. Therefore, company management must have a strategy in terms of retaining employees to avoid the desire of moving (turnover intention) from the company. This study aims to analyse the turnover intention of construction employees by extending the planned behaviour model’s theory. The research method used is a survey method with a quantitative descriptive approach. The population in this study are employees who work in construction companies in Indonesia. The sampling method using a non-probability sampling technique, namely using a convenience sampling technique is employed in the current study. A questionnaire was used to collect data from 197 respondents. The data were collected and analysed using structural equation modelling (SEM) techniques, using maximum likelihood estimation with covariance matrix as the input with Amos 24 software. The results indicated that attitude and perceived behavioural control had a positive and significant effect on turnover intention. In contrast, subjective norm had a positive but not significant effect on turnover intention. Subjective norms indirectly had a significant effect on turnover intention through attitude and perceived behavioural control.

KEY ASPECTS OF PRICING AS AN ELEMENT OF ENTERPRISE MARKETING POLICY

Introduction. The article examines the main key aspects of product pricing, which is the main element of marketing policy of the enterprise. The authors emphasize that pricing for the products of the processing plant is one of the important ways to use economic laws for further development of production. The main goals of the pricing policy at the enterprise are outlined, which include: maximization of the enterprise profit; ensuring the survival of the enterprise in market conditions; maintenance of the market segment in which the company operates. It is proved that raising the price of products can also increase or decrease the total profit of the enterprise, it all depends on the soundness of pricing policy, analysis of market sensitivity to prices and, most importantly, processing and analysis of information on the economic situation in the macro environment. After all, when forming an effective pricing policy, enterprises must have appropriate information support, take into account the principles of its formation, adhere to the current legal framework for state regulation of prices, monitor the factors of internal and external environment. enterprises to increase turnover, optimize turnover costs and increase net profit. The purpose of the article is to substantiate the theoretical aspects of pricing policy and commercial activities of enterprises and determine the features of the formation of pricing policy to achieve a high level of marketability and profitability of the enterprise. Method (methodology). In the process of conducting research, a systematic approach and the following methods were used: monographic (in the study of the problem; for theoretical generalizations, elaboration of conclusions); theoretical generalization, description (in the study of scientific issues on the pricing of enterprise products); abstract-logical (for theoretical generalization, formulation of conclusions, recommendations for improving pricing as an element of commercial activity). Results. As a result of the research, the elements of scientific novelty were obtained, which are as follows: the economic essence of the price as an instrument of commercial policy of the processing enterprise is revealed; the formation and implementation of the pricing policy of the enterprise are considered; methods of analysis of commercial activity and pricing policy at enterprises are determined; the characteristic of pricing as an element of commercial activity of the enterprise and prospects of improvement of its marketing activity is carried out. Therefore, the practical significance of the obtained results lies in the possibility of using theoretical and methodological developments and practical recommendations for improving pricing as an element of commercial activity

Burnout and Turnover among NICU Nurses.

In 2019, the national average turnover rate of registered nurses in the United States was approximately 17.8%. Each percentage increase in turnover costs a hospital, on average, $270,800. Although burnout is a known contributor to nurses' turnover intention, few studies have examined the relationship between nurse burnout and turnover, and there is little data on this relationship in neonatal intensive care environments. The purpose of this study was to examine the relationship between nurse burnout and turnover among neonatal intensive care unit (NICU) nurses. A secondary analysis of data collected from an observational study involving 136 nurses in a 52-bed NICU from 2013 to 2014. Multivariate logistic regression models were used to test for associations between measures of burnout and turnover. 16.9% of nurses turned over during the 11 months of the original study. Most nurses reported high (46%) to moderate (37%) levels of emotional exhaustion. Final models did not indicate a relationship between burnout and turnover. Although burnout has been associated with turnover intent among nurses, we did not observe an association between burnout and turnover among NICU nurses. Despite no direct relationship between burnout and turnover in the NICU, burnout may have other negative consequences. Nurse leaders should continue to prioritize reducing burnout among nursing staff to improve the well-being of the NICU nurse workforce.

Slavery versus Labor

AbstractSlavery has been a long-lasting and often endemic problem across time and space, and has commonly coexisted with a free-labor market. To understand (and possibly eradicate) slavery, one needs to unpack its relationship with free labor. Under what conditions would a principal choose to buy a slave rather than to hire a free worker? First, slaves cannot leave at will, which reduces turnover costs; second, slaves can be subjected to physical punishments, which reduces enforcement costs. In complex tasks, relation-specific investments are responsible for high turnover costs, which makes principals prefer slaves over workers. At the other end of the spectrum, in simple tasks, the threat of physical punishment is a relatively cheap way to produce incentives as compared to rewards, because effort is easy to monitor, which again makes slaves the cheaper alternative. The resulting equilibrium price in the market for slaves affects demand in the labor market and induces principals to hire workers for tasks of intermediate complexity. The available historical evidence is consistent with this pattern. Our analysis sheds light on cross-society differences in the use of slaves, on diachronic trends, and on the effects of current anti-slavery policies.

Protein turnover in the developing Triticum aestivum grain.

Summary Protein abundance in cereal grains is determined by the relative rates of protein synthesis and protein degradation during grain development but quantitation of these rates is lacking.Through combining in vivo stable isotope labelling and in‐depth quantitative proteomics, we have measured the turnover of 1400 different types of proteins during wheat grain development.We demonstrate that there is a spatiotemporal pattern to protein turnover rates which explain part of the variation in protein abundances that is not attributable to differences in wheat gene expression. We show that c. 20% of total grain adenosine triphosphate (ATP) production is used for grain proteome biogenesis and maintenance, and nearly half of this budget is invested exclusively in storage protein synthesis. We calculate that 25% of newly synthesized storage proteins are turned over during grain development rather than stored.This approach to measure protein turnover rates at proteome scale reveals how different functional categories of grain proteins accumulate, calculates the costs of protein turnover during wheat grain development and identifies the most and the least stable proteins in the developing wheat grain.

Mathematical modelling and simulation of the thermo-catalytic decomposition of methane for economically improved hydrogen production

The demand for low-emission hydrogen is set to grow as the world transitions to a future hydrogen economy. Unlike current methods of hydrogen production, which largely derive from fossil fuels with unabated emissions, the thermo-catalytic methane decomposition (TCMD) process is a promising intermediate solution that generates no direct carbon dioxide emissions and can bridge the transition to green hydrogen whilst utilising existing gas infrastructure. This process is yet to see widespread adoption, however, due to the high catalyst turnover costs resulting from the inevitable deactivation of the catalyst, which plays a decisive role in the feasibility of the process. In this study, a feasible TCMD process was identified and a simplified mathematical model was developed, which provides a dynamic estimation for the hydrogen production rate and catalyst turnover costs over various process conditions. The work consisted of a parametric study as well as an investigation into the different process modes. Based on the numerous simulation results it was possible to find the optimal process parameters that maximise the hydrogen production rate and minimise the catalyst turnover costs, therefore increasing the economic potential of the process and hence its commercial viability.

Clerical Turnover in the K–12 Campus Office

Clerical staff in the campus office (secretaries and registrars) perform critical functions essential to the operation of schools, yet do not receive research attention regarding their contributions. This study describes turnover rates of K–12 campus clerical employees in order to establish base information in the field. Eight years of employment data within a large suburban school district in Texas are examined to determine the number of clerks moving to different positions and/or leaving campus clerical employment. Findings reveal that the average clerical employee in this district is female, 50 years old, White or Hispanic, has 11 years of experience, changed positions at least once, and earns $15.61 an hour. The demographics of clerical staff more closely resembles student demographics that of than the teachers within the district. Turnover averaged 22% per year, with 16% representing leavers and under 7% representing movers; 25% of clerks left in their first year. Although teacher turnover is more frequent in high-poverty schools and varies based on level of campus, clerical staff turnover is significantly based on the level of position and pay. Results confirm findings from research on paraprofessionals (who have similar levels of pay) that level of pay and perceived lack of support are reasons for leaving. By providing induction activities and additional training, districts can reduce turnover costs of clerical staff despite the added cost of training.

Cultural perceptions of ethical leadership and its effect on intention to leave in the independent hotel industry

PurposeStudies have shown that due to the high direct and indirect costs of staff turnover, there is a need for managers to use approaches that engender a feeling that the organisation is fair to its employees and consequently reduce the intention to leave. However, to understand how to apply the research findings and theories from different parts of the world, we need to understand how employees’ perceptions of such factors as ethical leadership and organisational justice are affected by the national culture. Therefore, this study aims to compare the impact of ethical leadership on the intention to leave through justice, loyalty and satisfaction among employees of independent hotels from two Global Leadership and Organizational Behaviour Effectiveness (GLOBE) cultural clusters.Design/methodology/approachA total of 1,561 questionnaires were received from independent hotel employees, which were analysed using structural equation modelling. Data were collected in the USA, the UK, Italy and Spain whose national cultures fall into two different GLOBE regional clusters.FindingsThe results show similarities and differences between countries and within and between clusters. No relationship was found between procedural justice and intention to leave in any of the four countries. Ethical leadership had no significant impact on job satisfaction and organisational justice in the UK, which contrasts with results in the other three countries. The study findings also show that distributive justice has a significant relationship with the intention to leave in the USA and the UK (Anglo cluster), whereas no specific relationship was found between these two variables in Italy and Spain (Latin European cluster).Originality/valueThis study contributes to the literature of ethical leadership and its application to the hotel industry in two culturally different GLOBE clusters. This study shows how the relationships between organisational variables are affected by national culture and emphasises the importance for hotel managers of being aware of the specific characteristics of the culture of the country in which they are operating.

Socially Responsible Investing and Factor Investing, Is There an Opportunity Cost?

This article examines factor investing in the presence of an environment, social, and governance (ESG) screening overlay. The authors find that virtually no degradation in performance or turnover costs occur when using a negative-based ESG screen (i.e., removing only companies that have an actively bad ESG score). However, there are severe risk-induced performance issues and high transactions costs involved when the screening process becomes more active and includes only companies that are ESG-forward. The authors find that this is true for individually constructed factor portfolios, a composite benchmark of factor portfolios, and a stock selection model constructed from factor scores. Interestingly, they find that both screening methodologies produce significant improvement in ESG portfolio scores. They find very modest increases in turnover with the ESG screening of bad companies and significant costs with the more aggressive ESG screening techniques. In general, the authors conclude that ESG screening of negative companies is a positive way forward for agents who wish to add ESG to their factor-based investment portfolios and that the method of implementing ESG makes a large difference in outcomes.

Evaluating the Costs of Nurse Burnout-Attributed Turnover: A Markov Modeling Approach.

Burnout is a public health crisis that impacts 1 in 3 registered nurses in the United States and the safe provision of patient care. This study sought to understand the cost of nurse burnout-attributed turnover using hypothetical hospital scenarios. A cost-consequence analysis with a Markov model structure was used to assess nurse burnout-attributed turnover costs under the following scenarios: (1) a hospital with "status quo" nurse burnout prevalence and (2) a hospital with a "burnout reduction program" and decreased nurse burnout prevalence. The model evaluated turnover costs from a hospital payer perspective and modeled a cohort of nurses who were new to a hospital. The outcome measures were defined as years in burnout among the nurse cohort and years retained/employed in the hospital. Data inputs derived from the health services literature base. The expected model results demonstrated that at status quo, a hospital spends an expected $16,736 per nurse per year employed on nurse burnout-attributed turnover costs. In a hospital with a burnout reduction program, such costs were $11,592 per nurse per year employed. Nurses spent more time in burnout under the status quo scenario compared with the burnout reduction scenario (1.5 versus 1.1 y of employment) as well as less time employed at the hospital (2.9 versus 3.5 y of employment). Given that status quo costs of burnout are higher than those in a hospital that invests in a nurse burnout reduction program, hospitals should strongly consider proactively supporting programs that reduce nurse burnout prevalence and associated costs.

A higher mitochondrial content is associated with greater oxidative damage, oxidative defenses, protein synthesis and ATP turnover in resting skeletal muscle.

An unavoidable consequence of aerobic metabolism is the production of reactive oxygen species (ROS). Mitochondria have historically been considered the primary source of ROS; however, recent literature has highlighted the uncertainty in primary ROS production sites and it is unclear how variation in mitochondrial density influences ROS-induced damage and protein turnover. Fish skeletal muscle is composed of distinct, highly aerobic red muscle and anaerobic white muscle, offering an excellent model system in which to evaluate the relationship of tissue aerobic capacity and ROS-induced damage under baseline conditions. The present study used a suite of indices to better understand potential consequences of aerobic tissue capacity in red and white muscle of the pinfish, Lagodon rhomboides. Red muscle had a 7-fold greater mitochondrial volume density than white muscle, and more oxidative damage despite also having higher activity of the antioxidant enzymes superoxide dismutase and catalase. The dominant protein degradation system appears to be tissue dependent. Lysosomal degradation markers and autophagosome volume density were greater in white muscle, while ubiquitin expression and 20S proteasome activity were significantly greater in red muscle. However, ubiquitin ligase expression was significantly higher in white muscle. Red muscle had a more than 2-fold greater rate of translation and total ATP turnover than white muscle, results that may be due in part to the higher mitochondrial density and the associated increase in oxidative damage. Together, these results support the concept that an elevated aerobic capacity is associated with greater oxidative damage and higher costs of protein turnover.