Dalla Lana School of Public Health, Institute of Health Policy, Management and Evaluations, University of Toronto, Toronto, ON, Canada.
Ontario Hospital Association, Toronto, ON, Canada.
J Clin Nurs. 2018 Apr;27(7-8):e1451-e1461. doi: 10.1111/jocn.14263. Epub 2018 Mar 25.
To increase understanding of the relationships between organisational justice, affective commitment and turnover intention in health care.
Turnover in health care is a serious concern, as it contributes to the global nursing shortage and is associated with declines in quality of care, patient safety and patient outcomes. Turnover also impacts care teams and is associated with decreased staff cohesion and morale.
A survey was developed and administered to frontline nurses working in the Province of Ontario, Canada. The data were used to test a hypothetical model developed from a review of the literature. The relationships amongst the three constructs were evaluated using structural equation modelling and mediation analysis.
The hypothesised model was generally supported, although we were limited to considerations of interpersonal justice, affective commitment to one's organisation and turnover intention. Interpersonal justice is associated with affective commitment to one's organisation, which is negatively associated with turnover intention. Interpersonal justice was also found to be directly and negatively associated with turnover intention. Affective commitment to one's organisation was also found to mediate the relationship between interpersonal justice and turnover intention.
The examination of relationships within the "employee retention triad" in a single, comprehensive model is novel and provides new information regarding relational complexity and insights into what healthcare leaders can do to retain employees.
Reducing turnover may help to decrease some of the stressors related to turnover for clinical staff remaining at the organisation such as constant onboarding and orientation of new hires, working with less experienced staff and increased workload due to decreased staffing.
提高对医疗保健中组织公平、情感承诺和离职意向之间关系的理解。
医疗保健中的离职是一个严重的问题，因为它导致了全球护理短缺，并与护理质量下降、患者安全和患者结果下降有关。离职还会影响护理团队，并与员工凝聚力和士气下降有关。
开发并向加拿大安大略省的一线护士进行了一项调查。使用这些数据来测试从文献综述中开发的假设模型。使用结构方程模型和中介分析评估了这三个结构之间的关系。
假设模型得到了普遍支持，尽管我们仅限于考虑人际公平、对组织的情感承诺和离职意向。人际公平与对组织的情感承诺有关，而情感承诺与离职意向呈负相关。人际公平也被发现与离职意向呈直接负相关。对组织的情感承诺也被发现是人际公平与离职意向之间的中介变量。
在单一、全面的模型中检查“员工保留三联体”内的关系是新颖的，为关系复杂性提供了新的信息，并深入了解医疗保健领导者可以采取哪些措施来留住员工。
减少离职可能有助于减少与离职相关的一些压力源，例如为组织内留下的临床工作人员提供持续的入职和新员工培训、与经验较少的员工合作以及由于人员减少而增加工作量。
