Identification of Issues
Belmont Village is a long-term care facility for older people, which provides the necessary support to fulfill its residents’ needs. Healthcare workers, including nurses, form a significant share of workers, as they provide needs-specific medical assistance to Belmont Village residents. Older adults living in the facility face a variety of health issues. For instance, brain disorders such as Alzheimer’s disease and heart diseases, cancer, and diabetes are among the leading causes of death in the older adult populations in the United States (CDC, 2013).
Older adults can also suffer from chronic conditions that reduce their quality of life, such as chronic kidney disease, arthritis, asthma, and osteoporosis (CDC, 2013). Depression is also a widespread issue in the elderly population of the United States (CDC, 2013).
Other widespread conditions among older adults and require medical care and assistance include hypertension, hyperlipidemia, ischemic heart disease, and COPD (CDC, 2013). Healthcare workers in communities such as Belmont Village can help people live a fulfilling life despite their health concerns by providing assistance, prescribed medication, and creating a calm and friendly environment.
The main issue that prompted this research proposal was that Belmont Village had experienced an unusually high employee turnover rate in the past four months. Employee loss has also triggered several other problems, such as decreasing treatment quality and productivity and client dissatisfaction. A high turnover rate means that the workers decide to leave the organization due to certain internal factors.
For example, a study by Qureshi et al. (2013) showed that increased job stress and workload are among the major factors affecting employees’ intentions to leave the organization, thus increasing turnover rates. This finding is important as it shows the complex nature of high turnover: the more employees leave, the higher is the workload of the existing employees, which can prompt them to leave, too. Thus, it is necessary to address increasing turnover before the workload of the existing employees becomes unmanageable, and they decide to leave the organization, too. Yücel (2012) has also provided an exploration of the factors affecting high turnover.
For instance, the study found that higher levels of job satisfaction and commitment can decrease most organizations’ turnover rate (Yücel, 2012). This result prompts for the exploration of job satisfaction levels among the employees of Belmont Village. Low job satisfaction rates indicate the failure of HR and management strategies; therefore, altering these strategies could be among the possible solutions to high turnover.
Another study by Laschinger (2012) specifically addressed the causes of high turnover in nursing jobs. The researcher concluded that burnout was one of the most significant predictors of turnover decisions among the nurses (Laschinger, 2012). Burnout can result from poor management strategies, a low number of available workers, and an abundance of physically or mentally difficult tasks. Other predictors of turnover among nurses were empowerment and work engagement (Laschinger, 2012).
Overall, it is clear that high turnover indicates a number of other, more significant organizational issues, which prompted this research. These issues have a significant impact on workers, organizations, and patients. The following section will discuss the possible implications of organizational issues, including work engagement, burnout, stress, and employee loss on the quality of patient care provided at the facility and the organization in general.
Discussion of Issues
This section aims to discuss the connection between the possible organizational causes of high turnover, determining which is one of the core aims of the study, and the quality of care received by patients.
Nurse burnout is one of the important factors that prompt for higher turnover, as indicated above, and results from it, as the loss of workers puts more pressure and workload on the remaining employees. Burnout can also affect patient outcomes as reported by nurses, according to a study by Van Bogaert et al. (2014). The researchers found that emotional exhaustion, low social capital, and depersonalization, which are the core dimensions of burnout, lead to an increase in the rate of medical errors, poor patient outcomes, as well as complaints and abuse from patients and their family members (Bogaert et al., 2014).
The authors also state that nurse management at the unit level plays an important role in patient outcomes, emphasizing the relationship between management strategies, turnover, and patient outcomes at Belmont Village.
Job satisfaction also has a strong influence on nurses’ productivity and the quality of care provided. Cicolini, Comparcini, and Simonetti (2013) summarize the previous research findings regarding the impact of job satisfaction and perceived work environment among nurses on patient health outcomes. For instance, the authors state that workplace structures that aim to reduce stress and promote higher job satisfaction have also been useful in improving productivity and patient outcomes (Cicolini et al., 2013).
This connection can be explained by the fact that job dissatisfaction results from other organizational issues, including lower pay, higher workload, poor management strategies, and stress, which impair the nurses’ ability to respond to the patient’s needs and challenges effectively. For instance, poor management strategies obstruct empowerment and reduce motivation, which can lower the work engagement and morale, leading to medical errors and impaired patient care.
Employee engagement is another predictor of both turnover intentions and patient outcomes, according to Laschinger (2012). West and Dawson (2012) also explore the issue, explaining that employee engagement includes several components: a positive work-related state of mind, proactivity, enthusiasm, involvement in decision-making, commitment, and positive feedback. The relationship between employee engagement and performance, according to the authors, is evident: “When employees are engaged, they are more likely to put energy into interactions with clients, and there may be a spillover effect onto colleagues, creating a more engaged workplace generally” (West & Dawson, 2012, p. 9).
On the other hand, patient perception of care was also found to be positively associated with employee engagement (West & Dawson, 2012). Another significant positive outcome of employee engagement is reduced patient mortality. Nurses who are more proactive and involved in their work are likely to show lower rates of medical errors and higher effectiveness in decision-making.
Overall, it is evident that higher turnover impairs the quality of care provided due to the lower availability of experienced workers, increased workload of the remaining employees, and the overall disruption of the organizational processes. However, high turnover is complex as it is prompted by a variety of internal organizational factors, including job satisfaction, employee engagement, and burnout, which are also connected to poor patient outcomes and decreased customer satisfaction rates. Addressing the full range of research design issues can help to indicate the characteristics of Belmont Village organizational structure and leadership schemes that cause the said issues, thus allowing to improve turnover rates and promote better patient outcomes.
Centers for Disease Control and Prevention (CDC). (2013). The state of aging and health in America 2013. Web.
Cicolini, G., Comparcini, D., & Simonetti, V. (2014). Workplace empowerment and nurses’ job satisfaction: A systematic literature review. Journal of Nursing Management, 22(7), 855-871.
Laschinger, H. K. S. (2012). Job and career satisfaction and turnover intentions of newly graduated nurses. Journal of Nursing Management, 20(4), 472-484.
Qureshi, M. I., Iftikhar, M., Abbas, S. G., Hassan, U., Khan, K., & Zaman, K. (2013). Relationship between job stress, workload, environment and employees turnover intentions: What we know, what should we know. World Applied Sciences Journal, 23(6), 764-770.
Van Bogaert, P., Timmermans, O., Weeks, S. M., Van Heusden, D., Wouters, K., & Franck, E. (2014). Nursing unit teams matter: Impact of unit-level nurse practice environment, nurse work characteristics, and burnout on nurse reported job outcomes, and quality of care, and patient adverse events — A cross-sectional survey. International Journal of Nursing Studies, 51(8), 1123-1134.
West, M., & Dawson, J. (2012). Employee engagement and NHS performance. The King’s Fund 2012, 1-23.
Yücel, İ. (2012). Examining the relationships among job satisfaction, organizational commitment, and turnover intention: An empirical study. International Journal of Business and Management, 7(20), 44-58.