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FACTORS INFLUENCING EMPLOYEE TURNOVER IN PRIVATE
HOSPITALS: A CASE OF TRANSCOM WENDO HOSPITAL IN RUIRU
KIAMBU KENYA
Background of the Study
Employee turnover remains a great concern for most organizations including the
government entities. Smith (2007) urged that institution spend over USD 200 billion
every year on recruitment and replacement of the employees. According to Schneider et
al., (2003) high employee turnover forces school, for example, to devote attention, time
and financial resources on replacing staff. Khatri et al., (1999) study of employee found
out that a number of aspects influence worker renewal rate, namely; demographic
governable and ungovernable factors. Demographic elements would comprise; age,
sexual orientation, academic ranks, economic levels, executive and non- executive
statuses.
In the 21st century, the human resource management is responsible for employee
recruitment and firing. In addition, the human resource department have the responsibility
to invent strategies of retains the staff. However, the skill to hire and retain employee’s
overtime has been a consistent challenge in the hiring process. Human Resource
Practitioners report that organizations a having trouble retaining the employees. The
problem translates into the efficiency and effectiveness of a company. Some of the
uncontrollable include other employment opportunities and employment leaping.
Governable elements include; remuneration, occupation type, regulation, structural
obligation, distributive fairness, and procedural impartiality (Armstrong, 2004).
The study was anchored in Herzberg two factor theory and the turnover. While the former
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deduces that hygiene factors can lead to employee dissatisfaction and thus affect
employee turnover as well as emphasize on motivator factors, the latter examines the
rate at which staff members enters and leaves an organization. The study establishes the
theoretical foundation by using Herzberg two factor theory and employee turnover model
to provide an understanding of factors that influence turnover in Transcom Wendo
Hospital.
The motivation towards the study in Transcom Wendo hospital is because of the
challenges observed as a result of workers’ turnover. Among the challenges include
difficulties in following up patient’s history for better treatment because of high
employee turnover. The problem impacts on the capacity to attain consumer loyalty who
felt that the services offered by the institution were inadequate.
Concept of Employee Turnover
Werner et al., (2008) describe employee renewal rate as the movement of workers in and
out of the limits of the firm. They also distinguish manageable and unmanageable
renewal rate. As per Nel et al., (2008), manageable turnover alludes to throughput which
can be determined by the management in an organization. It comprises both deliberate
abdications and expulsions. Deliberate abdications are manageable in light of the fact that
administration can propose enhanced remunerations, operating environment and chances
to hold workers (Kwamboka, 2015). Unmanageable employee renewal rate alludes to
throughput which is beyond the administration regulation, for example those resulting
from retrenchments, incapacitation, and death.
Globally withholding of talented workers has been of grave concern to administrators in
light of regularly increasing rate of worker renewal. The present business condition has
turned out to be extremely focused, consequently creating experienced workers the key
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distinguishing aspect for majority of firms. Firms, both open and private, depend on the
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capability of their workers so as to contend positively and certainly achieve an upper
hand in the global arena. On the other hand contemporary investigations have
demonstrated that maintenance of profoundly experienced workers has turned out be a
daunting duty for administrators as these class of personnel are being enticed by more
than one firm at any given moment with different sorts of incentive (Netsweraa et
al.,2005)
Factors that Influence Employee Turnover
Worker renewal is the throughput of an employee in the organization (Maquis, 2008).
They also differentiate between governable and ungovernable turnover. Human
Resources are the most vital aspect of any organization. Kwamboka (2015) report found
out Human Resource expense is usually the largest single item in at the recurrent budget
in health care sectors. Turnover remains a challenging issue for most organizations,
especially the health care sectors. Organization should establish why these high staff
turnover. They should investigate it, know the factors that lead to these expensive
exercises of hiring and recruiting to replace the employees, especially in our case the
nurses.
According to Nel et al., (2008) his are some of the factors that might influence nurses
turnover an employee personal reasons, salary problem, promotion and transfer issues,
extreme work pressure or stress, getting a better opportunity, training, workplace conflict,
communication, working conditions, leadership and other factors that might influence
nurses turnover (Maquis, 2008). Cox (2013) showcased how lack of training undermines
employee motivation increasing the chances for turnover. Authors such as Albaker,
(2008); Igbal et al., (2017) observed that as long as the working conditions are not
welcoming, employees will leave a firm. Such conditions included availability of
resources, proper working space and friendly regulations. Ng’ang’a (2013) stated that the
quality of leadership directly influence employee turnover.
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Factors such as work conflict, which are associated with unresolved work issues impacts
on employee morale. Bosses who talk about much of the time with agents diminish the
threat of making a workforce that feels disparaged and underestimated. Keeping
specialists taught about various levelled changes, staffing plans and fluctuating business
demands is one way to deal with assurance delegates remain with the association
(Nganga, 2013). Igbal et al., (2017) also provided employee tenure, rewards and
compensation strategies implemented by a firm as determining factors of turnover.
Private Hospitals in Kenya
In Kenya the health department includes both the public scheme and the private scheme.
The MOH and state corporations forms the key actors in the public sector whilst, NGO,
FBO facilities which are mostly non-profit falls into the private sector. These services are
delivered in a linkage of more than 4,700 health amenities spread throughout the country,
with the public sub-sector representing approximately 51% of these amenities. The
general wellbeing sub-division contains the accompanying dimensions of prosperity
workplaces: national referral specialist's offices, basic general centers, territory
specialist's offices, prosperity Centre's, and dispensaries.
In 1994, the Government of Kenya (GOK) endorsed the Kenya Health Policy Framework
(KHPF) as a layout for making and running prosperity organizations. It includes the long-
run key essentials and moreover the arrangement for Kenya's prosperity part. To
operationalize the chronicle, the Ministry of Health (MOH) developed the Kenya Health
Policy Framework Implementation Action Strategy and set up the Health Sector Reform
Secretariat (HSRS) in 1996 underneath a Ministerial Reform Committee (MRC) in 1997
to lead and direct the execution method. A defense program inside the MOH was likewise
begun.
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Transcom Wendo Private Hospital in Kiambu
Transcom Wendo hospital was started by Madam Priscah Munyua back in 2008 as a
private outpatient health care provider. Transcom Wendo has grown into a full pledged
hospital in Ruiru Kiambu county in Kenya. The hospital has 84 members of staff among
them 67 nurses, 2 full time doctors and 15 consultants. The hospital has established a
branch in Thika providing both outpatient and inpatient medical services. It sits on 3
hectares land with 20 beds capacity and a fully equipped and functional theatre.
Transcom Wendo hospital is one of the biggest hospitals in Kiambu County. The nurses
are involved in the community health projects and their newly started branch.
However, the hospital has experienced high rates of staff turnover especially the nurses.
There has been deterioration in the number of employees in the hospital. The outcome
limits or constrains the growth of the hospital for reasons such as a lack of consistency in
proper treatment of the patience. Between 2016 and 2017, the number of employee
turnover was 29 and 23 respectively. Presently, the numbers of employees retained are
112 while 82 staff members left. The condition is what has prompted research in the
hospital for the purpose of understanding ways to improve employee retention rate.
Research Problem
Staff turnover has been regarded as a general degree or sign of the firm functionality.
Once workers are disgruntled with their job, they have a tendency to pull back so as to
limit their presentation to the work. Worker renewal rate is further aggravated by the fact
that dropping extraordinary accomplishing people affect the output of the firm, as the
firm misses the venture that was made in their advancement. As the percentage of the
workforce in the professional or highly technical work increases, understanding and
effective
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management of the occupation affiliation amongst specialized personnel and their hiring
firms turns out to be progressively essential (Cox, 2012). Disproportionate worker
renewal rate generates an unsteady personnel, escalates expenses and impacts negatively
on organizational performance.
Early studies in the nursing department in different parts of the world have seen turnover
as a problem. For instance a study by Burns and Grove in UK in 2001 explored the pap of
knowledge required in the nursing practice and uncovered turnover as a major challenge.
A similar study by Morrel (2005) in UK identified tremendous nurse shortage as a result
of turnover. Lephalala (2003) study of turnover in England acknowledged that a lack of
recognition, irregular promotions, inability to recognize autonomy as leading reasons for
nurse turnover. Lephalala (2003) research also covered non-European countries as similar
results were determined.
Kenya has also conducted studies in both public and private hospitals regarding employee
turnover. For instance Ndemaki (2014) conducted a study to “determine the factors
influencing turnover among doctors at the Aga Khan Hospital, Kisumu” where he found
grouped the factors organizational, individual, environmental and job related factors.
Another study was conducted by Omondi in (2010) to “determine the factors influencing
turnover of medical doctors at the Nyanza provincial general hospital” where he
identified environmental, job, individual and organizational factors as key influencers. In
2015, Ofunya Afande tried to determine the “factors that contribute to the high turnover
among nurses working in MP Shah” were resulted confirmed both extrinsic and intrinsic
factors as influential. With the identified factors that can influence turnover among
doctors and
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nurses, this study seeks to identify the factors that contribute the most or the least to
turnover in Wendo Private Hospital, Kiambu County.
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