Hospital doctor turnover and retention: a systematic review and new research pathway.

PURPOSE: Society is critically dependent on an adequate supply of hospital doctors to ensure optimal health care. Voluntary turnover amongst hospital doctors is, however, an increasing problem for hospitals. The aim of this study was to systematically review the extant academic literature to obtain a comprehensive understanding of the current knowledge base on hospital doctor turnover and retention. In addition to this, we synthesise the most common methodological approaches used before then offering an agenda to guide future research. DESIGN/METHODOLOGY/APPROACH: Adopting the PRISMA methodology, we conducted a systematic literature search of four databases, namely CINAHL, MEDLINE, PsycINFO and Web of Science. FINDINGS: We identified 51 papers that empirically examined hospital doctor turnover and retention. Most of these papers were quantitative, cross-sectional studies focussed on meso-level predictors of doctor turnover. RESEARCH LIMITATIONS/IMPLICATIONS: Selection criteria concentrated on doctors who worked in hospitals, which limited knowledge of one area of the healthcare environment. The review could disregard relevant articles, such as those that discuss the turnover and retention of doctors in other specialities, including general practitioners. Additionally, being limited to peer-reviewed published journals eliminates grey literature such as dissertations, reports and case studies, which may bring impactful results. PRACTICAL IMPLICATIONS: Globally, hospital doctor turnover is a prevalent issue that is influenced by a variety of factors. However, a lack of focus on doctors who remain in their job hinders a comprehensive understanding of the issue. Conducting "stay interviews" with doctors could provide valuable insight into what motivates them to remain and what could be done to enhance their work conditions. In addition, hospital management and recruiters should consider aspects of job embeddedness that occur outside of the workplace, such as facilitating connections outside of work. By resolving these concerns, hospitals can retain physicians more effectively and enhance their overall retention efforts. SOCIAL IMPLICATIONS: Focussing on the reasons why employees remain with an organisation can have significant social repercussions. When organisations invest in gaining an understanding of what motivates their employees to stay in the job, they are better able to establish a positive work environment that likely to promote employee well-being and job satisfaction. This can result in enhanced job performance, increased productivity and higher employee retention rates, all of which are advantageous to the organisation and its employees. ORIGINALITY/VALUE: The review concludes that there has been little consideration of the retention, as opposed to the turnover, of hospital doctors. We argue that more expansive methodological approaches would be useful, with more qualitative approaches likely to be particularly useful. We also call on future researchers to consider focussing further on why doctors remain in posts when so many are leaving.

Working through a pandemic: The mediating effect of nurses' health on the relationship between working conditions and turnover intent.

AIM: While research has demonstrated that nurses' health and working conditions are important predictors of turnover in COVID-19, the relationship between these factors is not well understood. Our study investigated the mechanism through which working conditions and nurses' physical and mental health could impact intent to leave the nursing profession. DESIGN: Secondary data from a cross-sectional survey of 3478 nurses in British Columbia administered in May 2021 were analysed using structural equation modelling. METHODS: Two models were assessed utilizing workplace conditions as the predictor, nurses' health as the mediator, and reported turnover intent (Model 1), and anticipated time to turnover (Model 2) as the outcomes. RESULTS: Nurses' health partially mediated the relationship between working conditions and turnover intent, where poorer workplace conditions were directly and indirectly associated with greater likelihood of leaving the profession. Nurses' health fully mediated the relationship between working conditions and nurses' anticipated time to turnover, after controlling for age. The findings from this study underscore the importance of enhancing working conditions and improving nurses' mental health and safety on the job. PATIENT OR PUBLIC CONTRIBUTION: The British Columbia Nurses' Union provided the data for this study; survey data from 3478 nurses were utilized in our study.

Research Topic Trends on Turnover Intention among Korean Registered Nurses: An Analysis Using Topic Modeling.

This study aimed to explore research topic trends on turnover intention among Korean hospital nurses by analyzing the keywords and topics of related articles. Methods: This text-mining study collected, processed, and analyzed text data from 390 nursing articles published between 1 January 2010 and 30 June 2021 that were collected via search engines. The collected unstructured text data were preprocessed, and the NetMiner program was used to perform keyword analysis and topic modeling. Results: The word with the highest degree centrality was "job satisfaction", the word with the highest betweenness centrality was "job satisfaction", and the word with the highest closeness centrality and frequency was "job stress". The top 10 keywords in both the frequency analysis and the 3 centrality analyses included "job stress", "burnout", "organizational commitment", "emotional labor", "job", and "job embeddedness". The 676 preprocessed key words were categorized into five topics: "job", "burnout", "workplace bullying", "job stress", and "emotional labor". Since many individual-level factors have already been thoroughly investigated, future research should concentrate on enabling successful organizational interventions that extend beyond the microsystem.

An employee retention model using organizational network analysis for voluntary turnover.

Contemporary research of employee social network analysis has grown far beyond the conventional wisdom of network and turnover theory; however, what is missing is a comprehensive review highlighting new perspectives and network constructs from a retention viewpoint. Since turnover is a concurrent component of retention, the analysis of the factors of quit propensity can result in a pre-emptive strategy for retention. This paper aims to capture the current state of the field and proposes a conceptual model for retention by exploring network position, centrality measures, network type, and the snowball effect. We identified 30 papers exploring voluntary turnover in social network constructs. Findings show that central network position is not always associated with negative turnover. Eigenvector, structural holes, and K-shell also prove to be a strong predictor of turnover. The snowball turnover of employees in similar network positions is pronounced in scenarios where employee sentiment is negative with poor group efficacy, entrepreneurship, and group values. This paper focuses on several themes to coalesce different determinants of an organizational network to demonstrate how social network theory has evolved to predict employee turnover. The resulting conceptual model suggests how to identify star performers and propose retention strategies.

Effective machine learning, Meta-heuristic algorithms and multi-criteria decision making to minimizing human resource turnover.

Employee turnover is one of the most important issues in human resource management, which is a combination of soft and hard skills. This makes it difficult for managers to make decisions. In order to make better decisions, this article has been devoted to identifying factors affecting employee turnover using feature selection approaches such as Recursive Feature Elimination algorithm and Mutual Information and Meta-heuristic algorithms such as Gray Wolf Optimizer and Genetic Algorithm. The use of Multi-Criteria Decision-Making techniques is one of the other approaches used to identify the factors affecting the employee turnover in this article. Our expert has used the Best-Worst Method to evaluate each of these variables. In order to check the performance of each of the above methods and to identify the most significant factors on employee turnover, the results are used in some machine learning algorithms to check their accuracy in predicting the employee turnover. These three methods have been implemented on the human resources dataset of a company and the results show that the factors identified by the Mutual Information algorithm can show better results in predicting the employee turnover. Also, the results confirm that managers need a support tool to make decisions because the possibility of making mistakes in their decisions is high. This approach can be used as a decision support tool by managers and help managers and organizations to have a correct insight into the departure of their employees and adopt policies to retain and optimize their employees.

Do Embedded and Peripheral Corporate Social Responsibility Activities Lower Employees' Turnover Intentions?

Corporate social responsibility (CSR) remains a topic of interest for both theory and practice due to its multifaceted avenues and potential for growth. We have chosen embedded CSR and peripheral CSR measures to evaluate how these activities affect the employee turnover intentions via a mediation mechanism of organizational citizenship behavior (OCB). In doing so, this study addresses important stakeholder concerns and provides meaningful managerial contributions for the employers to encourage more employee participation (through lowering turnover intention) toward sustainable corporate performance. This study incorporates four hypotheses that are tested in a structural equation modeling framework by employing Warp-PLS software. Data were collected from 297 employees working in firms that are renowned for their CSR initiatives. We found support for our key hypotheses leading to strong theoretical contributions to the stakeholder theory. We have addressed the main issues of stakeholders' response to the CSR tradeoffs and have tried to develop a deeper understanding of managers in initiating peripheral and embedded CSR activities for their firms.

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

AIM: To examine and synthesize the noneconomic and economic impacts of nurse turnover in acute hospitals. BACKGROUND: Nurse 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. METHODS: The 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. RESULTS: Among 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. CONCLUSION: Most studies investigated the turnover cost, which is costly. The negative noneconomic impact of nurse turnover was partially supported. IMPLICATIONS FOR NURSING PRACTICE AND NURSING POLICY: To 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.

Workplace Conflict in Applied Behavior Analysis: Prevalence, Impact, and Training.

Conflict, albeit normal in every relationship, can increase stress and tension. Workplace conflict is highly prevalent in the field of health care and has been correlated with lowered job satisfaction and burnout. However, little is known about workplace conflict for practicing Board Certified Behavior Analysts® (BCBAs®). We distributed an electronic survey through the Behavior Analysis Certification Board® (BACB®) to determine the impact and prevalence of workplace conflict for practicing BCBAs. Most of our participants reported various levels of conflict with different workplace professionals including teachers, caregivers, colleagues, and supervisees. We found that a high proportion of practitioners reported losing cases and wanting to leave their jobs because of workplace conflict. Most of our participants did not feel that they had the training they needed to have sufficient skills to resolve workplace conflict effectively. Therefore, in this article we outlined the component skills necessary to manage conflict effectively and made recommendations for training these skills.

Effect of Despotic Leadership on Employee Turnover Intention: Mediating Toxic Workplace Environment and Cognitive Distraction in Academic Institutions.

Despotic leadership builds adverse emotions and turnover intentions in the employees of an educational organization. This study investigated the relationships among despotic leadership, toxic workplace environment, cognitive distraction, and employee turnover intention. This study is based on social exchange theory (SET), social psychology theories of behavioral intention formation (such as the theory of reasoned action and the theory of planned behavior), and of the despotic leadership style. A survey questionnaire containing 28 items was completed by 240 faculty members from four Chinese universities. The responses were documented on a seven-point Likert scale. We applied PLS-SEM (partial least squares structural equation modeling) to measure the effects. The outcomes showed that despotic leadership influenced employee turnover intention in academic institutions. Toxic workplace environment correlates with employee turnover intention. Cognitive distraction also correlates with employee turnover intention. Toxic workplace environment mediates the relationship between despotic leadership and employee turnover intention. Similarly, cognitive distraction mediates the relationship between despotic leadership and employee turnover intention. The study concluded that despotic leadership, toxic workplace environment, and cognitive distraction might increase employee turnover intention. This study adds to the literature in the field of despotic leadership, toxic workplace environment, cognitive distraction, and employee turnover intention in academic institutions. Furthermore, it offers valuable and practical implications along with recommendations for future research.

The last resort: Workplace bullying and the consequences of changing jobs.

This study investigated the consequences of changing jobs for employees subjected to workplace bullying. First, we hypothesized that bullied employees would be more likely to change jobs than non-bullied employees. Moreover, we hypothesized that changing jobs would result in a reduction of exposure to bullying behaviors and an alleviation of mental health problems for those bullied at baseline. The study was based on a longitudinal probability sample of the whole Swedish workforce (n = 1,095). The time lag was 18 months. The results supported all hypotheses except one. Those employees who were bullied at baseline were more likely to have changed jobs at follow-up. Also, for the changers there was a reduction in exposure to subsequent bullying. The actual drop in exposure to bullying behaviors was significant and substantial. This gives further support for the work environment hypothesis, suggesting the work context may be a more important cause than individual characteristics. As for mental health problems, the association between bullying and subsequent anxiety was not significant for those changing jobs, suggesting that leaving a toxic workplace may reduce anxiety relatively quickly. However, depression symptoms were not affected by the change of jobs, and the association between bullying and subsequent depression was the same 18 months later. The conclusion is that changing jobs can be a useful, last resort on an individual level, improving the situation for the victim of bullying. However, it is important to note that it does not solve any underlying organizational problems and risk factors.

A systematic review of the research on telework and organizational economic performance indicators.

Introduction: A systematic review is conducted in the study to investigate the relationship between telework and organizational economic performance indicators such as self-reported employee performance, organizational performance, actual employee turnover rates, or intentions. Methods: The databases Scopus, Business Source Premier, and Web of Science were used to conduct a literature search. Original articles published from 2000 and up to May 2021 were selected. Studies were screened for inclusion independently by review pairs and data were extracted. The Mixed Methods Appraisal Tool (MMAT) was used to evaluate the quality of the studies included. Results: Forty-three studies were included with some addressing multiple outcomes. Self-reported performance was higher for teleworking employees compared to those working in the ordinary workplace. The extent of the change in performance was dependent on individual characteristics and the extent of the teleworking practice in the organization. Telework was also associated with increased organizational performance, particularly in homogenous samples with unique work tasks. When telework is voluntary, it appears that both actual employee turnover rates and intentions to leave the organization are lower. Discussion: Further research with high-quality prospective designs is necessary to properly understand the contribution of telework to organizational economic performance indicators.

Association between nursing home staff turnover and infection control citations.

OBJECTIVE: To describe the association between nursing home staff turnover and the presence and scope of infection control citations. DATA SOURCES: Secondary data for all US nursing homes between March 31, 2017, through December 31, 2019 were obtained from Payroll-Based Journal (PBJ), Nursing Home Compare, and Long-Term Care: Facts on Care in the US (LTC Focus). STUDY DESIGN: We estimated the association between nurse turnover and the probability of an infection control citation and the scope of the citation while controlling for nursing home fixed effects. Our turnover measure is the percent of the facility's nursing staff hours that were provided by new staff (less than 60 days of experience in the last 180 days) during the 2 weeks prior to the health inspection. We calculated turnover for all staff together and separately for registered nurses, licensed practical nurses (LPNs), and certified nursing assistants. DATA COLLECTION/EXTRACTION METHODS: We linked nursing homes standard inspection surveys to 650 million shifts from the PBJ data. We excluded any nursing home with incomplete or missing staffing data. Our final analytic sample included 12,550 nursing homes with 30,536 surveys. PRINCIPAL FINDINGS: Staff turnover was associated with an increased likelihood of an infection control citation (average marginal effect [AME] = 0.12 percentage points [pp]; 95% confidence interval [CI]: 0.05, 0.18). LPN (AME = 0.06 pp; 95% CI: 0.01, 0.11) turnover was conditionally associated with an infection control citation. Conditional on having at least an isolated citation for infection control, staff turnover was positively associated with receiving a citation coded as a "pattern" (AME = 0.21 pp; 95% CI: 0.10, 0.32). Conditional of having at least a pattern citation, staff turnover was positively associated with receiving a widespread citation (AME = 0.21 pp; 95% CI: 0.10, 0.32). CONCLUSIONS: Turnover was positively associated with the probability of an infection control citation. Staff turnover should be considered an important factor related to the spread of infections within nursing homes.

What drives pharmacists’ turnover intention: A systematic review

Background: Pharmacist turnover can negatively impact not only on work efficiency, organizational performance, work productivity and customer satisfaction, but also on the quality of pharmaceutical services and patient safety. Turnover intention is a core antecedent of turnover. Turnover intention of the pharmacists is affected by many factors related to their organization or job. Objective: To elaborate the factors affecting the pharmacists’ turnover intention and their associations. Studies related to any factors affecting pharmacists’ turnover intention in all pharmacy settings were included. The QualSyst assessment tool was used for assessing the quality of the included studies. Result: For this systematic review, 3,822 studies were identified. Of these studies, 20 studies were included. Thirty factors were explored and a model for pharmacists’ turnover intention was produced. Organizational commitment, job satisfaction, career commitment, job stress, perceived organizational support, and work climate were frequently found as drivers to pharmacist turnover intention. Some of 24 other factors had both direct and indirect effects on pharmacist turnover intention via organizational commitment, job satisfaction, career commitment, job stress, and perceived organizational support. Many studies have reported that organizational commitment and job satisfaction had significant influence on pharmacist turnover intention in all settings. Job stress and work climate had direct and indirect effects on turnover intention of hospital pharmacists. Career commitment and perceived organizational support had direct and indirect effects on community pharmacist turnover intention (AU)

Corporate Social Responsibilities, Psychological Contracts and Employee Turnover Intention of SMEs in China.

As an important organizational strategy and action that affects employee perception and attitude, corporate social responsibility is essential for small and medium-sized enterprises (SMEs) to reduce turnover rate and achieve sustainable growth. This paper integrates social identity theory and social exchange theory to construct an external reputation mechanism and internal trust mechanism to explore the influence mechanism of corporate social responsibility on employee turnover intention and the intermediate transmission mechanism of psychological contract. The research results show that corporate social responsibility has a significant negative impact on employee turnover intention. Compared with external corporate social responsibility, internal corporate social responsibility has a stronger negative impact on employee turnover intention; corporate social responsibility has a significant negative impact on employee transactional psychological contract, while corporate social responsibility has a significant positive impact on employee relational psychological contracts; transactional psychological contract has a significant positive effect on employee turnover intention, while relational psychological contract has a significant negative effect on employee turnover intention; psychological contract has a significant and complete mediating effect on the relationship between external corporate social responsibility and employee turnover intention, and the psychological contract plays a significant part of the intermediary role between the internal corporate social responsibility and the employee turnover intention. The conclusions enriches the complex relationship between corporate social responsibility and employee turnover intentions, and provides a reference for SMEs to effectively perform internal and external social responsibilities and reduce employee turnover rates.

The Challenge of Employee Retention in Medical Practices across the United States: An Exploratory Investigation Into the Relationship between Operational Succession Planning and Employee Turnover.

Employee turnover is a growing challenge for health-care providers delivering patient care today. US population demographics are shifting as the population ages, which leaves the field of health care poised to lose key leaders and employees to retirement at a time when patient care has grown more complex. This means health care will lose its core of key employees at a time when skilled leadership and specialized knowledge is most needed and directly impacts health care's ability to deliver quality care. Operational succession planning (OSP) may be one solution to manage this looming challenge in health care, as the process identifies and develops the next generation of leadership. Thus, this exploratory national study used a quantitative and cross-sectional design to examine the relationship between OSP and employee turnover. Demographic and 10-point Likert scale data were collected from n = 66 medical practices, using an online survey instrument. Data were analyzed using various descriptive and inferential statistical methods. Distribution (frequency and chi-square) analyses of the study sample, one-way analysis of variance (ANOVA), and regression analyses were performed across seven demographic characteristics of the medical practices: Specialty, Ownership Structure, Number of full-time equivalent (FTE) Physicians, Number of FTE Clinical Employees, Number of FTE Nonclinical Employees, Number of FTE Employees Left Position, and Region. Study results provided statistically significant evidence to support the relationship between OSP and employee turnover, highlighting that OSP was associated with lower employee turnover. The finding suggests that OSP can serve as an effective mechanism for increasing employee retention.

Why do veterinarians leave clinical practice? A qualitative study using thematic analysis.

BACKGROUND: Veterinarians have an important role in society and having an adequate veterinary workforce is important not only for their communities but also nationwide. Lately, there have been anecdotal reports regarding veterinary practices struggling to find clinicians as well as evidence of mental ill-health in veterinarians. Furthermore, the Australian Veterinary Association annual workforce survey shows an increased percentage of veterinarians intending to leave practice from 2017 to 2019. Although many factors for attrition have been described in other professions, reasons for veterinarians to leave practice are not well understood. METHODS: This study investigated why veterinary clinicians leave clinical practice by using Thematic Analysis to analyse 26 semi-structured interviews of former veterinary clinicians in relation to their work experiences and reasons for leaving. Interviews were done from February-April 2018 either face to face, via teleconferencing, or telephone. Participants were recruited from each Australian state except for New South Wales. RESULTS: The results showed that a combination of personal and work-related factors influenced the participants to leave clinical practice. In Personal Factors, participants described the internal and external circumstances that impacted on their personal lives such as personal relationships, experiencing negative thoughts and emotions, physical and mental health, core motivations and beliefs, alternative professional and personal interests. On the other hand, Work Experiences described situations, experiences, and statements directly related to the participant's veterinary clinical work such as workplace relationships, employment conditions including remuneration and working hours and clinical experiences such as negative clinical outcomes. Furthermore, interlinkages between these two themes were revealed in participants' responses. CONCLUSION: This study highlights factors that contribute to attrition from veterinary clinical practice. The narrative indicates that the interlinking of such factors influenced the decision-making process to leave clinical practice in this cohort of former veterinary clinicians. Further research is required to understand the full implications for veterinary clinical practice and inform intervention strategies for retention.

Person-organization fit and turnover intentions: organizational trust as a moderator / Compatibilidade indivíduo-organização e intenção de rotatividade: moderação da confiança na organização / Compatibilidad individuo-organización y la intención de salida: moderación de la confianza en la organización

This study examined the relationship between person-organization fit and turnover intentions, along with the moderating effect of organizational trust. The sample consisted of 381 workers of both genders (61% female) and average age of 39.23, who answered the on-line versions of organizational values, organizational trust and turnover intention measures. The results showed that the higher the person-organization fit related to conservatism and harmony values, the lower the turnover intention. Trust in the organization's ethical standards moderated the relationship between person-organization fit related to dominance and autonomy values and turnover intention. It was concluded that a reduced trust in the organization's ethical standards contributes to accentuate the negative relation between person-organization fit associated with such values and turnover intention. (AU)

O estudo investigou a relação da compatibilidade indivíduo-organização com a intenção de rotatividade, e o efeito moderador da confiança do empregado na organização. A amostra compôs-se de 381 trabalhadores de ambos os sexos (61% do sexo feminino), com idade média de 39,23 anos, que responderam às versões on-line de medidas de valores organizacionais, de confiança do empregado na organização e de intenção de rotatividade. Os resultados indicaram que quanto maior a compatibilidade entre o indivíduo e a organização, relacionada aos valores de conservadorismo e harmonia, menor a intenção de rotatividade. A confiança nos padrões éticos da organização moderou a relação da compatibilidade indivíduo-organização associada aos valores de autonomia e de domínio com a intenção de rotatividade. Concluiu-se que a baixa confiança nos padrões éticos da organização contribui para acentuar a relação negativa entre a compatibilidade associada a tais valores e a intenção de rotatividade. (AU)

El estudio examinó la relación entre la compatibilidad individuo-organización e la intención de salida, moderada por la confianza en la organización. La muestra fue compuesta por 381 trabajadores de ambos sexos (61% sexo femenino) con edad media de 39,23 años. Los participantes respondieron a la versión online de los instrumentos de valores organizacionales, confianza del empleado en la organización e intención de salida. Los resultados indicaron que cuanto mayor es la compatibilidad individuo-organización en lo que se refiere a valores de conservadurismo y armonía, menor es la intención de rotatividad. La confianza en los patrones éticos de la organización moderó la relación de la compatibilidad individuo-organización asociada a los valores de autonomía y dominio y la intención de rotatividad. Se concluyó que la baja confianza en los patrones éticos de la organización contribuye a acentuar la relación negativa entre la compatibilidad asociada a tales valores y la intención de rotatividad. (AU)

Risk factors associated with veterinary attrition from clinical practice: a descriptive study.

A sustainable workforce is important for the veterinary profession to meet the demands of society. To maintain a sustainable workforce, it has been recommended to retain veterinary clinicians. However, there seems to be an increasing issue with retention of veterinarians in clinical practice. In the following study, the researchers sought to understand the associations between demographic and work-related factors and attrition of veterinarians from clinical practice. Responses to an online cross-sectional survey of 881 current and former Australian veterinary clinicians were analysed. A logistic regression model was used to identify and describe associations between attrition from veterinary clinical practice and salary, working hours, role in practice, years of experience, field of work, interaction with regulatory authorities, region of work and on-call duties. Lower salary, longer working hours, having on-call duties and having worked in both rural and metropolitan regions were found to significantly (P < 0.05) increase the likelihood of leaving clinical practice. The results may inform intervention strategies to assist the industry to retain veterinarians in clinical practice.

Turnover events of animal caretakers and its impact on productivity in swine farms.

Attracting and retaining quality animal caretaking personnel is one of most pressing issues the US swine industry currently faces. On-farm employee turnover can be costly and have an impact on productivity. The primary objectives of this study were to describe the amount of animal caretaker turnover events that occurred in a single year in eleven swine farms, and to investigate associations between employee turnover events and two subsequent production parameters of interest: number of pigs weaned per sow (PWS) and pre-weaning mortality (PWM). A retrospective cohort study was conducted with eleven commercial farrow-to-wean swine farms belonging to two vertically integrated multi-site production systems within two swine production companies. Human resources and production data for the year of 2019 were obtained monthly from each farm. The primary predictor of interest was the occurrence of an employee turnover event, defined as 'voluntary' (employee decided to leave or quit) or 'involuntary' (employee was terminated by company decision). The primary outcomes of interest included the monthly average PWS and PWM. These associations were assessed with 1-, 2-, 3-, and 6-months between the turnover events and the outcome. Linear mixed effects models were fit in STATA 15, with system and farm included as random effects. To account for temporal and seasonal trends of production, season and the monthly production were included in the models. There were a total of 152 turnover events, with 4 and 148 turnover events in systems 1 and 2, respectively. The average turnover, calculated as a percent of total turnover among full time employee positions, was 92 % (SD = 62 %; Range = 8-217 %). Improved production efficiency in both monthly PWS (p = 0.01) and PWM (p = 0.02) was observed with the occurrence of an involuntary turnover event two months prior, after controlling for season, previous month production, farm, and system. For the PWS outcome, there was a significant interaction between an involuntary turnover event two months prior and monthly county-level unemployment rate (p = 0.02), indicative of the improved performance being most profound at the lowest levels of unemployment rate and diminishing at the highest levels. Turnover of animal caretaking personnel in farrow-to-wean farms was confirmed to be highly variable and high for the majority of farms in this study. Furthermore, animal caretaker turnover was associated with subsequent trends of production efficiency, warranting closer consideration of prioritizing managerial efforts in worker recruitment, training and retention.

A meta-analysis on predictors of turnover intention of hospital nurses in South Korea (2000-2020).

AIMS: To identify the predictors of Registered Nurses' turnover intention and analyse the effect sizes. DESIGN: A systematic review and meta-analysis of previous research, conducted to comprehensively identify the predictors of turnover intention. METHODS: In total, 417 studies from 1 January 2000 to 30 April 2020 that investigated predictors of turnover intention of South Korean nurses were reviewed. The data were analysed using the R statistical package. Network graphs were used to analyse the relationships among turnover predictors, and meta-analysis was performed to determine the effect sizes of the correlations. RESULTS: This review analysed common predictors identified in previous studies. Burnout (0.541), emotional exhaustion (0.511), job stress (0.390) and career plateau (0.386) showed positive effect sizes, while organizational commitment (-0.540), person-organizational fit (-0.521), career commitment (-0.508), work engagement (-0.503), job satisfaction (-0.491) and job embeddedness (-0.483) showed negative effect sizes.