Protecting healthcare through organizational support to reduce turnover intention

Why Are Healthcare Providers Leaving Their Jobs? A Convergent Mixed-Methods Investigation of Turnover Intention among Canadian Healthcare Providers during the COVID-19 Pandemic

BACKGROUND

Staffing shortages across the healthcare sector pose a threat to the continuity of the Canadian healthcare system in the post-COVID-19 pandemic era. We sought to understand factors associated with turnover intention as well as Canadian healthcare providers' (HCPs) perspectives and experiences with turnover intention as related to both organizational and professional turnover.

METHOD

A convergent questionnaire mixed-methods design was employed. Descriptive statistics and ordinal logistic regressions were used to analyze quantitative data and ascertain factors associated with turnover intention. Thematic analysis was used to analyze qualitative open-field textbox data and understand HCPs' perspectives and experiences with turnover intention.

RESULTS

Quantitative analyses revealed that 78.6% of HCPs surveyed (N = 398) reported at least a 25% turnover likelihood regarding their organization, with 67.5% reporting at least a 25% turnover likelihood regarding their profession. Whereas regression models revealed the significant impact of years worked, burnout, and organizational support on turnover likelihood for organizations, age, sex, burnout, and organizational support contributed to the likelihood of leaving a profession. Patterns of meaning drawn from participants' qualitative responses were organized according to the following four themes: (1) Content to stay, (2) Drowning and no one cares, (3) Moral stressors, and (4) Wrestling with the costs and benefits.

CONCLUSIONS

Many HCPs described weighing the costs and benefits of leaving their organization or profession during the COVID-19 pandemic. Although challenging working conditions, moral stressors, and burnout may play a significant role in HCPs' experiences of turnover intention, there is ample room to intervene with organizational support.

Explaining the experiences of health care providers regarding organizational factors affecting health education: a qualitative study

BACKGROUND

Health education is considered the most important component of primary health care. Paying attention to organizational factors can help to improve the quality of health education. Therefore, the present study was conducted to explain organizational factors affecting health education among health care providers.

METHOD

This is a qualitative, descriptive, and phenomenological study that was conducted between 2020 -2022 on 50 health care workers who had been selected by purposeful sampling method in different settings including hospitals, GP office, behavioral disease counseling center, universities, and comprehensive health centers in the south and the center region of Iran. Data were collected by in-depth, semi-structured, and individual interviews, as well as focus group discussion, and continued until data saturation. Data were analyzed by MAXQDA software using qualitative content analysis in three stages: preparation, organization, and reporting. To evaluate the scientific accuracy of the findings in this study, 4 criteria of Lincoln & Guba were used.

RESULTS

The results revealed that every practice and policy in a health care organization from assessing needs, setting goals, planning activities, implementations and measurement outcome could affect health education practice and subsequently the health of population; nevertheless, the crucial role of health education practice is being neglected in health organizations. Organizational factors affecting health education were classified into three categories of planning, organizing, and also monitoring and evaluating. The category of planning had three subcategories of infrastructure planning, manpower planning, and design and planning for implementation of health education programs. The categories of organizing had two subcategories of coordination between different units of the Minister of Health and coordination between the health sector and other sectors of society. The categories of monitoring and evaluation had three subcategories of proper feedback, bureaucracy system, reward or reinforcement, failure to define health education as part of the job description, and the impact of electronic health records on the quality of evaluation.

CONCLUSION

The results offer expertise and preliminary tools to help with evidence-based health education program planning and evaluation. The Support of managers, like providing manpower in accordance with the target population and infrastructure, can improve health education in the health system. In addition, intra- and inter-sectoral coordination at different levels of the health system to implement tailored programs according to the needs of clients by health education professionals, and the use of health education theories seem necessary. It is also recommended to review the monitoring system with appropriate feedback, define health education as a healthy activity, and develop appropriate criteria for better implementation of health education.

The impact of organizational commitment on turnover intention of substitute teachers in public primary schools: Taking psychological capital as a mediator

This research aimed to explore the impact of organizational commitment on turnover intention of substitute teachers in public primary schools in Xuzhou, and applied psychological capital as a mediator variable to establish a research model. A questionnaire was conducted with 400 substitute teachers using convenience sampling. The results show that organizational commitment has a negative yet significant effect on turnover intention. It also shows positive impact on psychological capital. Furthermore, psychological capital is shown to negatively impact turnover intention, while having a mediating effect between organizational commitment and turnover intention.

Living with Infection Risk and Job Insecurity during COVID-19: The Relationship of Organizational Support, Organizational Commitment, and Turnover Intention

The COVID-19 outbreak caused a stressful process for hospitality employees in terms of both being infected and experiencing the risk of losing their jobs. Stressful working conditions increase employees' turnover intentions (TI). This study aims to analyze the relationship among perceived organizational support (POS), organizational commitment (OC), and turnover intention (TI) within the context of employees' infection status and perceived job insecurity (JI). In this context, the study tests a moderated mediation research model. Having adopted a quantitative research method, data were acquired from 490 respondents who work at five-star accommodation companies in Alanya, Turkey. Findings show that the impact of POS on OC and IT differ according to employees' infection status during the COVID-19 outbreak and their perceived JI. The findings of the study reveal empirical results in understanding employee attitudes toward companies alongside perceived job insecurity for those who are infected as well as for those who are not. Moreover, the study presents theoretical and practical contributions to reduce the negative impact of job insecurity and risk of infection on turnover intentions, which have been considered to be main sources of stress throughout the pandemic.

EFFECT OF FAMILY-FRIENDLY PRACTICES ON EMPLOYEES’ INTENTION TO QUIT: THE MEDIATING ROLE OF ORGANIZATIONAL CITIZENSHIP BEHAVIOR

Turnover intention has become one of the most serious issues in organizations around the world. Hence, most organizations encourage family-friendly practices (FFPs) to retain employees and to reduce high turnover risk. A plethora of research has confirmed FFPs as a fruitful predictor of turnover intention. However, what is not yet known is whether FFPs directly influence turnover intention or indirectly through organizational citizenship behavior (OCB). To fill the gap, the present study examined the effect of FFPs on employees’ intention to quit. On top of that, the mediating role of OCB in the purported link was also examined. Data were collected from 338 health sector employees using a structured questionnaire. The results of the structural equation modeling using AMOS indicated a significant negative relationship between FFPs and employees’ intention to quit. Moreover, OCB negatively influences employees’ intention to quit and partially mediates the path between family-friendly practices and intention to quit. Based on theoretical and empirical evidence, this study advances existing knowledge and further understanding of organizational work practices. This study recommends that organizations should encourage FFPs to mitigate turnover rate among employees.

Positive Affect Predicts Turnover Intention Mediated by Online Work Engagement: A Perspective of R&D Professionals in the Information and Communication Technology Industry

Remote work has become the most popular approach during the COVID-19 lockdown; however, remote work engagement is an issue which creates challenges for human resource management. Some individuals engage in work no matter how difficult the job is, but some people's minds wander, no matter how simple the job is. To address this issue, this study drew on trait activation theory, which indicates that one's positive disposition may affect one's turnover intention mediated by work engagement, to formulate a research model to test the associations among R&D professionals. Questionnaires were distributed to R&D professionals working in China information and communication technology (ICT) through several Instant Message groups. In total, 386 valid questionnaires were collected for confirmatory factor analysis with structural equation modeling to verify the research model. The study found that positive affect can positively predict three types of remote work engagement: the cognitive, emotional, and behavioral engagement of R&D personnel. All three types of remote work engagement of R&D personnel can negatively predict their turnover intention. The results suggest that if human resource managers working in the ICT industry want to reduce the turnover intention rate of R&D workers under pressure from COVID-19, they should enhance workers' remote engagement by selecting R&D workers with a high level of positive affect.

The Interactive Effect of COVID-19 Risk and Hospital Measures on Turnover Intentions of Healthcare Workers: A Time-Lagged Study

COVID-19 has led to a global health emergency worldwide. As a result, healthcare workers undergo distress mainly due to the perceived risk of contracting the virus. Such stress might cause them to leave their jobs. In this context, the current study: (1) introduced the concept of perceived risk of COVID-19 and measured it by adapting and validating an existing scale available on the risk of infectious diseases and (2) investigated its outcomes, underlying mechanisms, and boundary conditions for healthcare workers. With the support of conservation of resources theory, the current study aimed to investigate the association between perceived risk of COVID-19 and turnover intentions among healthcare workers, particularly Doctors, nurses, and paramedics staff. This study also aimed to investigate the mediating role of perceived fear of COVID-19 between perceived risk of COVID-19 and turnover intention. The current study also aimed to examine the buffering role that perceptions of hospital measures against COVID-19 could have on diminishing workers’ turnover intentions. Data were collected through a three time-lag email survey of healthcare workers in Pakistan (N = 178) who currently provide treatment to COVID-19 patients. The results supported the hypothesis that perceived risk of COVID-19 enhances fear of COVID-19 among healthcare workers and, consequently, their turnover intentions. Perceptions of hospital measures against COVID-19 weaken the relationship between perceived risk of COVID-19 and fear of COVID-19, which reduces turnover intentions of health care workers. The current study offers implications for theory, practitioners, and society.

How workplace bullying affects nurses’ well-being? The roles of burnout and passive avoidant leadership

Purpose

This study aims to investigate individual-related consequences of workplace bullying among the health-care section. Specifically, this study examined the mediating role of burnout between workplace bullying and nurses’ well-being. Moreover, passive avoidant leadership is examined as a conditional variable between workplace bullying and burnout.

Design/methodology/approach

This study collected data from 314 nurses working in various hospitals through a questionnaire-based survey using Google Form in two waves.

Findings

Structural equation modeling confirmed the negative effect of workplace bullying on nurses’ well-being, whereas burnout mediates this relationship. In addition, passive avoidant leadership was identified as a conditional variable that strengthens the positive association between workplace bullying and burnout.

Research limitations/implications

Although data for the study were collected in two waves, still cross-sectional design limits causality.

Practical implications

This study suggests management to focus on developing and implementing counter-bullying rules to avoid the adverse consequences of workplace bullying (e.g. capital loss, recruitment costs, burnout, well-being, etc.). In addition, leaders/supervisors must be trained to fulfill their responsibilities to reduce negative consequences.

Originality/value

Studies on workplace bullying in high-power distance cultures are scant. Therefore, drawing upon conservation of resource theory, to the best of the authors’ knowledge, this is the first study that has investigated the moderating role of passive avoidant leadership on the association between workplace bullying and burnout.

Work environment and performance among nurses: a significant way to overcome violation of human rights in the health sector

Purpose

The study aims to purpose the role of the work environment (WE) towards employees’ performance (EP) in Pakistan’s health sector.

Design/methodology/approach

Data-wise, the study is cross-sectional and random sampling was used to glean the response from the trained health nurses in Pakistan. The survey questionnaire was used as a primary tool to collect the data. In total, 306 usable samples as used to infer the final consequences.

Findings

The structural equation modeling through AMOS 26.0 for windows resulted in a positive and significant effect of an organizational learning culture, supervisor support on EP. On the other hand, the impact of peer support on EP is not significant among the nurses in Pakistan.

Practical implications

The policymakers and planners in the health sector and government may address unemployment – are willing to join the health sector. Better performance through the WE would provide equity in health and would not violate fundamental human rights. This work may help human resource management bring advancement in organizational and social determinants of health equity and practical interventions to overwhelm health-care barriers.

Originality/value

The study overcomes the gaps in terms of the cross-sectional survey to measure nurses’ performance in Pakistan.

Model of Organizational Commitment Applied to Health Management Systems

In this paper, we try to build on the problems surrounding the management of human resources in health care organizations worldwide. After the analysis of the reviewed literature, we detected that the scientific community considers several recurring themes that need attention: stress, burnout, and turnover intention. Based on this, we developed a model of organizational commitment that aims to achieve performance and health quality, its main result the establishment of the appropriate management policies in order to avoid the abandonment of the organization through the search for commitment and job satisfaction. Amongst our main conclusions, we highlight the need to implement a human resources model for hospital administrators based on the relationships with "patients" not "clients" through the maintenance of a positive and strong atmosphere of staff participation. It is important to develop innovative practices related to clear job design that eliminate reasons for ambiguity and stress in executing the tasks of the healthcare system. Finally, we urge training programs in transformational leadership to promote the well-being and organizational commitment of employees.

Enhancing nurses well-being through managerial coaching: a mediating model

Purpose

Workplace well-being has emerged as an important aspect in the field of health care. Therefore, this paper aims to investigate the role of managerial coaching on nurses’ well-being through psychological ownership and organizational identity.

Design/methodology/approach

The authors approached 284 nurses working in both public and private hospitals (between December 2019 and February 2020) on convenience basis, and data were collected through an online questionnaire-based survey.

Findings

The data were analyzed using AMOS version 24 and structural equation modeling confirmed psychological ownership and organizational identity as explanatory variables between managerial coaching and well-being.

Research limitations/implications

The study used self-reported data using convenience sampling which may raise a question on causality. The findings suggest the management to consider the importance of managerial coaching in shaping positive workplace behaviors of employees.

Originality/value

Drawings on social exchange theory, this study extends past studies to examine the mediating roles of psychological ownership and organizational identification between managerial coaching and workplace well-being among nurses. The study has theoretical and practical implications.

Resistance to change and turnover intention: a moderated mediation model of burnout and perceived organizational support

Purpose

The purpose of the paper is to study the turnover intention of employees during the phenomenon of resistance to change. The paper examines the mediating role of burnout in the relationship of resistance of change to turnover intention and the moderating role of perceived organizational support in this relationship.

Design/methodology/approach

The empirical data of the study has been collected via cross-sectional data collection method and include responses from 410 employees. The moderation mediation analysis has been done using the SPSS macro process.

Findings

The paper finds that resistance to change is an antecedent to the turnover intention which often represents employees' voluntary turnover in the future. This relationship of resistance to change and turnover intention is explained by burnout. However, the study establishes perceived organizational support as moderator, and with high POS, strength of this relationship will be reduced.

Originality/value

This paper contributes by examining the burnout as an intervening variable in the relationship of resistance to change and turnover intention and perhaps establishes for the first time the moderating role of perceived organizational support in reducing the influence of resistance to change on turnover intention, since retaining employees is of value to the organization.

Transformational leadership and four-dimensional commitment

Purpose

The purpose of this paper is to investigate the mechanism between transformational leadership (TL) and organizational commitment (OC) using job characteristics as a mediator and participative and directive leadership (DL) as moderator.

Design/methodology/approach

The authors used a questionnaire-based survey to collect data from 563 employees working in the banking industry.

Findings

The data were analyzed using structural equation modeling. The findings confirmed the mediating role of job characteristics and moderating role of both participative and DL styles between TL and OC.

Research limitations/implications

The data for this study were collected at one point of time and it has implications for the policymakers and bankers.

Originality/value

The study is novel as it highlights the importance of job characteristics, participative and DL styles in understanding the relationship between TL and OC.