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医院医生流动率和保留率:系统评价与新的研究途径。

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

机构信息

Cork University Business School, University College Cork, Cork, Ireland.

出版信息

J Health Organ Manag. 2024 Feb 27;38(9):45-71. doi: 10.1108/JHOM-04-2023-0129.

Abstract

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.

摘要

目的

社会对医院医生的充足供应有很大的依赖性,以确保提供最佳的医疗保健。然而,医院医生的自愿离职是医院面临的一个日益严重的问题。本研究的目的是系统地回顾现有学术文献,全面了解目前关于医院医生离职和留任的知识基础。此外,我们综合了之前使用的最常见的方法,并提出了一个指导未来研究的议程。

设计/方法/方法:采用 PRISMA 方法,我们对四个数据库(CINAHL、MEDLINE、PsycINFO 和 Web of Science)进行了系统的文献检索。

发现

我们确定了 51 篇实证研究医院医生离职和留任的论文。这些论文大多是定量的、横断面研究,侧重于医生离职的中观预测因素。

研究局限性/影响:选择标准集中在在医院工作的医生,这限制了对医疗保健环境中一个领域的了解。该综述可能忽略了相关文章,例如那些讨论其他专业医生(包括全科医生)离职和留任的文章。此外,仅限于同行评议的已发表期刊会排除论文、报告和案例研究等灰色文献,这些文献可能会带来有影响力的结果。

实际影响

在全球范围内,医院医生离职是一个普遍存在的问题,受到多种因素的影响。然而,对留在工作岗位上的医生缺乏关注,阻碍了对这一问题的全面理解。对医生进行“留任访谈”可以提供有价值的见解,了解是什么激励他们留任,以及可以采取什么措施来改善他们的工作条件。此外,医院管理层和招聘人员应该考虑工作场所之外的工作嵌入性方面,例如促进工作之外的联系。通过解决这些问题,医院可以更有效地留住医生,并加强他们的整体留任工作。

社会影响

关注员工留在组织的原因可能会产生重大的社会影响。当组织投资于了解是什么激励员工留在工作岗位上时,他们就能更好地建立一个积极的工作环境,这可能会促进员工的幸福感和工作满意度。这可以提高工作绩效、提高生产力和提高员工留任率,这对组织及其员工都有利。

原创性/价值:该综述得出的结论是,很少有研究考虑医院医生的留任问题,而不是离职问题。我们认为,更广泛的方法可能会很有用,更多的定性方法可能特别有用。我们还呼吁未来的研究人员进一步关注为什么这么多医生离职,而有些医生却留任。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0dc/10986676/10dbb91fdb1b/jhealthorganmanag-38-0045-g001.jpg

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