Factors Affecting Turnover of Advanced Practice Providers: A University Teaching Hospital Review

Abstract

Goal: Retention of advanced practice providers (APPs) is an issue of critical importance to healthcare leaders. High APP turnover negatively affects an organization's ability to meet patient needs, maintain quality of care, and control costs. Our goal was to identify any association between intent to leave and specific survey factors; analyze the distribution of scale factors from the survey; and describe differences among the APP roles, specialties, and length of employment. Methods: This study used a self-administered questionnaire for APPs at a large university medical center to determine job satisfaction rates and intent to resign. The survey used a modified Misener Nurse Practitioner Job Satisfaction Scale and Anticipated Turnover Scale. Principal Findings: We received surveys from 102 providers (for a 38.9% response rate). Results were used to determine the correlation between job satisfaction and intent to leave and to identify possible factors involved in APP commitment to the hospital and intent to stay. We found that APPs reported the most satisfaction in benefits, followed by time (i.e., time available for answering messages, reviewing laboratory and other test results, seeing patients, scheduling work). Intrapractice partnership/collegiality received the lowest satisfaction score. Extrinsic factors such as monetary bonuses available in addition to salary, reward distribution, involvement in research, conflict resolution, and opportunity to receive compensation for services performed outside normal duties were common dissatisfiers. Practical Applications: This survey may help hospitals identify in real time the triggers of APP dissatisfaction and intent to resign. In addition, the results may guide possible revisions to hospital policies and practice procedures to improve APP commitment and decrease turnover intent. Additional surveys in similar university teaching hospital systems could confirm comparable intrinsic and extrinsic factors that are relevant to the satisfaction and turnover of APPs.

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

“…The findings on the relationship between RC, job satisfaction, and intention to resign are consistent with the identified key satisfaction and dissatisfaction factors influencing turnover among advanced practice providers in university teaching hospitals [33]. Similar to their identification of factors such as benefits, time, and collegiality within the practice, our study suggests that improving aspects of RC, such as the frequency of communication, shared goals, and mutual respect, could be critical in increasing job satisfaction and reducing turnover intention among healthcare professionals.…”

The Evolution of Employee Assistance Programs to Best Support Healthcare Organizations

“…Inclusion in workplace relationships supports employees, informs them, and confers other advantages such as faster career progression, whereas exclusion can lead to the opposite results (Sias & Shin, 2019). EAPs support an inclusive culture through conflict resolution, which can improve job satisfaction and prevent turnover (Venegas et al, 2023).…”