The shocking cost of turnover in health care

Waldman, J. Deane; Kelly, Frank L.; Arora, Sanjeev; Smith, Howard L.

doi:10.1097/hmr.0b013e3181e3940e

Cited by 155 publications

(53 citation statements)

References 7 publications

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“…For decades, employee turnover has been one of the main challenges of managers because of the costs involved in recruiting and training new employees (Lee, Gerhart, Weller, & Trevor, 2008). In healthcare organizations, total turnover costs are to a large extent caused by nurse turnover rates because of the considerable size of the workforce (Waldman, Kelly, Arora, & Smith, 2010). Both costs and, importantly, gaps in the supply of care and patient outcomes are a problem.…”

Section: Introductionmentioning

confidence: 99%

Turnover prevention: The direct and indirect association between organizational job stressors, negative emotions and professional commitment in novice nurses

Hoeve

Brouwer

Kunnen

2019

Journal of Advanced Nursing

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Aims Getting insight in the most crucial organizational job stressors for novice nurses' professional commitment and whether the job stressors are mediated through negative emotions. Design The study used an observational cohort design. Methods Organizational job stressors were derived from 580 diary entries by 18 novice nurses combined with measures on emotions and commitment. The diaries were collected from September 2013–September 2014. Results Path modelling revealed that lack of support from colleagues, negative experiences with patients and confrontations with existential events were most strongly negatively related to professional commitment through negative emotions. Other indirectly and negatively related organizational job stressors to commitment were complexity of care, lack of control and work‐life imbalance; only conflicting job demands, and lack of control related to professional commitment directly. Conclusion(s) To enhance professional commitment, it is important to reduce negative emotions in novice nurses by collegial support in dealing with negative experiences with patients, complexity of care and existential events and to prevent lack of control and an imbalance between private life and work. Nurse supervisors and managers can encourage nurses to share negative patient experiences, issues related to complexity of care and existential events. Impact Considering the worldwide nursing shortage and early turnover, more understanding is needed about how negative emotions mediate the relationship between organizational negative job stressors and professional commitment and the relative impact of organizational job stressors to professional commitment. The study stresses the importance of a supportive role of supervisors and nurse managers to improve the work environment and hence increase novice nurses' commitment and retention.

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Section: Introductionmentioning

confidence: 99%

Turnover prevention: The direct and indirect association between organizational job stressors, negative emotions and professional commitment in novice nurses

Hoeve

Brouwer

Kunnen

2019

Journal of Advanced Nursing

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“…Research in the related area of the antiretroviral therapy scale-up has pointed to the importance of limiting burnout and attrition, in addition to maintaining providers’ level of job performance and satisfaction, to achieve maximum program efficiency [6]. Previous studies, in other settings, also show high monetary costs are associated with the decreased productivity and turnover caused by health care provider burnout [7]. The physical strain of standing for many hours, potential for monotony with repeating the same procedure in high volume overextended time periods, and emotional exhaustion, are thought to contribute to burnout and attrition among VMMC providers.…”

Section: Introductionmentioning

confidence: 99%

Work Experience, Job-Fulfillment and Burnout among VMMC Providers in Kenya, South Africa, Tanzania and Zimbabwe

et al. 2014

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BackgroundHuman resource capacity is vital to the scale-up of voluntary medical male circumcision (VMMC) services. VMMC providers are at risk of “burnout” from performing a single task repeatedly in a high volume work environment that produces long work hours and intense work effort.Methods and findingsThe Systematic Monitoring of the Voluntary Medical Male Circumcision Scale-up (SYMMACS) surveyed VMMC providers in Kenya, South Africa, Tanzania, and Zimbabwe in 2011 (n = 357) and 2012 (n = 591). Providers self-reported on their training, work experience, levels of job-fulfillment and work fatigue/burnout. Data analysis included a descriptive analysis of VMMC provider characteristics, and both bivariate and multivariate analyses of factors associated with provider work fatigue/burnout. In 2012, Kenyan providers had worked in VMMC for a median of 31 months compared to South Africa (10 months), Tanzania (15 months), and Zimbabwe (11 months). More than three-quarters (78 – 99%) of providers in all countries in 2012 reported that VMMC is a personally fulfilling job. However, 67% of Kenyan providers reported starting to experience work fatigue/burnout compared to South Africa (33%), Zimbabwe (17%), and Tanzania (15%). Despite the high level of work fatigue/burnout in Kenya, none of the measured factors (i.e., gender, age, full-time versus part-time status, length of service, number of operations performed, or cadre) were significantly associated with work fatigue/burnout in 2011. In 2012, logistic regression found increases in age (p<.05) and number of months working in VMMC (p<.01) were associated with an increased likelihood of experiencing work fatigue/burnout, while higher career total VMMCs decreased the likelihood of experiencing burnout.ConclusionGiven cross-country differences, further elucidation of cultural and other contextual factors that may influence provider burnout is required. Continuing to emphasize the contribution that providers make in the fight against HIV/AIDS is important.

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“…Third, due to the difficulty of attributing revenues and costs, the net effect of the turnover is almost noncalculable. 13 Therefore, in this case study, we will consider the out-of-pocket costs that have been mentioned in Waldman et al 13 …”

Section: Resultsmentioning

confidence: 99%

“…Waldman et al 13 used several databases at an academic medical center as a foundation for measuring costs of employee selection, hiring, and training, as well as qualitative and quantitative yardsticks used to measure employee productivity. The study by Waldman et al 13 drew accounting records and data for specific organizational units within the academic medical center and categorized the costs of turnover by phase of recruiting process: hiring, training, working, and termination. Estimates have been made in few instanced.…”

Section: Resultsmentioning

confidence: 99%

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A Framework for Determining the Return on Investment of Simulation-Based Training in Health Care

Bukhari

Andreatta

Goldiez

et al. 2017

INQUIRY

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This article describes a framework that has been developed to monetize the real value of simulation-based training in health care. A significant consideration has been given to the incorporation of the intangible and qualitative benefits, not only the tangible and quantitative benefits of simulation-based training in health care. The framework builds from three works: the value measurement methodology (VMM) used by several departments of the US Government, a methodology documented in several books by Dr Jack Phillips to monetize various training approaches, and a traditional return on investment methodology put forth by Frost and Sullivan, and Immersion Medical. All 3 source materials were adapted to create an integrated methodology that can be readily implemented. This article presents details on each of these methods and how they can be integrated and presents a framework that integrates the previous methods. In addition to that, it describes the concept and the application of the developed framework. As a test of the applicability of the framework, a real case study has been used to demonstrate the application of the framework. This case study provides real data related to the correlation between the pediatric patient cardiopulmonary arrest (CPA) survival rates and a simulation-based mock codes at the University of Michigan tertiary care academic medical center. It is important to point out that the proposed framework offers the capability to consider a wide range of benefits and values, but on the other hand, there are several limitations that has been discussed and need to be taken in consideration.

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The shocking cost of turnover in health care

Cited by 155 publications

References 7 publications

Turnover prevention: The direct and indirect association between organizational job stressors, negative emotions and professional commitment in novice nurses

Turnover prevention: The direct and indirect association between organizational job stressors, negative emotions and professional commitment in novice nurses

Work Experience, Job-Fulfillment and Burnout among VMMC Providers in Kenya, South Africa, Tanzania and Zimbabwe

A Framework for Determining the Return on Investment of Simulation-Based Training in Health Care

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