A Review of the Factors Affecting the Employees Turnover in Private Health Care Organizations

A high turnover rate is viewed as a failure to achieve work-life balance, which is one of the methods that can be employed to enhance the quality of life for employees. This study, which included a complete literature review and an assessment of the current state of research on the causes of employee turnover in the private health care industry, was recently presented. Using the preferred reporting items for Systematic Reviews this paper concluded that organizational, personal, and job-related factors are major turnover antecedents. One of the suggestions is to conduct further research on employee turnover. This supplementary study should focus on the project, the organization


Introduction
As a result of globalization, the competitiveness of present and future businesses is intensifying.To remain competitive, organizations must use a range of initiatives, one of which is to retain their most skilled employees.As healthcare employees are regarded as the industry's pillars, healthcare organizations are currently faced with a scarcity of healthcare professionals.Hospitals require medical expertise to deliver public health services; but, as a result of the changing economy, healthcare professionals are unable to remain in one organization and are instead migrating to another.The turnover of personnel has an effect not only on the organization but also on the lives of individuals worldwide.Following the pandemic, the desire of employees to leave their jobs has become a major problem, particularly in the Indian healthcare industry.When an organization spends much in well-trained and seasoned professionals in development activities, it loses money when they depart (Juhdi, Pa'wan, & Hansaram, 2013).When an employee leaves his or her position voluntarily, this is known as employee turnover ( Ngamkroeckjoti et al., 2012).Furthermore, turnover intention is defined as a tendency or level at which an employee may leave the organisation voluntarily or involuntarily due to the unattractiveness of his current position and the availability of other employment opportunities (Robbins and Judge, 2018).Turnover entails both visible and intangible or "hidden" costs related with skill loss, inefficiencies, and replacement expenses (Lashley & Chaplain, 1999).According to the survey, employee turnover has proven to be one of the most expensive and persistent human resource problems confronting firms worldwide (Alubelkassaw Belete 2018; Shamsuzzoha and Shumon 2013).Currently, staff turnover is a major concern for human resource managers, particularly in India's private healthcare organizations.Rapid employee turnover reduces employee output and organization performance.WHO estimates a shortage of 12.9 million healthcare professionals by the year 2035.According to the Global Health Observatory's data repository, India's domestic private health spending (PVT-D) per capita in 2019 is 140.06PPP int$.India possesses 43,486 private hospitals, 1.18 million beds, 59,264 intensive care units, and 29,636 ventilators.There are 25,778 public hospitals with 713,986 beds, 35,700 intensive care units, and 17,850 ventilators.62% of India's health infrastructure is comprised of private infrastructure.In comparison, up to 80.9% of urban and 85.9% of rural Indians lack health coverage.Over 80 percent of Indians pay for private healthcare privately.Human resource managers in the private healthcare industry today confront the issue of keeping staff for extended periods of time and decreasing employee turnover.The production of an organization drops when both the staff turnover rate and the expense of acquiring new employees increase.Several studies have uncovered widespread HRM issues in the healthcare industry, including as a nurse shortage, low levels of commitment and job satisfaction among physicians and medical staff, and worries about the quality and safety of patient care (Srinivasan & Chandwani 2014; Leggat, Bartram and Stanton 2011; Townsend, Wilkinson and Bartram 2011).HR professionals must not only recruit nurses, but also provide for their retention (Sangeetha L 2016; Srinivasan & Chandwani 2014).In addition to being crucial for retaining personnel and ensuring the proper running of any firm, talent management is also critical for retaining employees.Therefore, managers should engage in regular talent retention meetings with employees to eliminate risk factors that could result in intents of voluntary departure (Mokgojwa, 2019).Changes in staff turnover may be indicative of an economic sector in decline.In addition, turnover rates have grown, particularly with the outbreak of COVID-19.The vast majority of healthcare workers are nurses, who spend the majority of their time with patients.The outbreak raised the demand for nurses and their workload in an already stressful work environment.Due to the unpredictability of the pandemic, the high fatality rate, and the horrible surroundings, nurses experience psychological stress.Studies have shown that COVID-19 has physical and psychological consequences on healthcare workers, with many worrying about catching the disease or infecting family members (Labrague et. al., 2020).The unprecedented pressure placed on every nation's healthcare system by the pandemic has presented nurses with challenges that may impact their health and ability to perform their duties, such as an increase in patient volume, an increase in patient load, and COVID-19 rules.Worse, in order to fulfil their tasks, nurses put their lives in jeopardy, causing a heightened dread of getting an infection or accidentally infecting others.Approximately 90,000 cases, or 6% of all verified COVID-19 cases worldwide, were reported by healthcare staff, according to the ICN.

Methodology
For a variety of reasons, using a systematic analysis approach to review a topic may be useful.Here are some further details: Objectivity: Systematic analysis reduces prejudice and subjectivity in decisionmaking by relying on empirical facts rather than personal thoughts or sentiments.While reviewing a situation, it is easy to jump to conclusions or make assumptions based on inadequate information.A systematic approach ensures that all relevant data is considered and objectively analyzed.Using a systematic procedure ensures that the analysis is consistent and reproducible, resulting in more accurate and reliable results.While assessing a problem, it may be difficult to maintain consistency and ensure that all elements are examined in the same manner.A systematic method provides a standardized framework that improves the consistency of the analysis and the dependability of the results.Systematic analysis encourages the evaluation of all important components and variables in order to ensure that the analysis is as complete and thorough as possible.While reviewing a problem, it may be difficult to identify all of the significant elements that may be contributing to it.A systematic process establishes a framework for identifying and evaluating all essential factors, ensuring that no critical features are overlooked.Systematic analysis can be an efficient technique to review a topic since it provides a set structure for completing the study.This can aid in accelerating the process and ensuring that the analysis is completed on time.A rigorous approach can also help in identifying areas where more data is needed, allowing for more targeted data collection and analysis.Better decision-making: Eventually, the goal of any problem evaluation is to make knowledgeable decisions on how to solve the problem.Systematic analysis can help ensure that decisions are made based on data and evidence rather than preconceived notions or personal biases.This can lead to more effective solutions and better outcomes.To summarize, employing a systematic analysis approach to analyses a topic can be beneficial since it gives a structured, objective, consistent, and thorough framework for studying the issue.This can lead to more efficient and effective problem solving and decision-making.The analysis in this review will be based on earlier qualitative and quantitative research.The inclusion and exclusion criteria were utilized for reviewing to choose the systematic review approach.The following criteria were chosen for inclusion and exclusion: Within the framework of the inclusion strategy the author will use Google scholar as the primary source of data for the systematic review of prior research, and the keywords will be Employee Turnover, Systematic Reviews, Meta-analysis and Private Health Care Organization.This will ensure that the review is comprehensive and accurate.The research team picked topics for further examination based on the findings of earlier studies.The exclusion method skipped over previous research because it was written in a language other than English, the paper was published before the time frame that was selected, it was repetitive and received low citations, and it was published in chapter proceedings, books, patents, and so on.

Thematic Analysis Nurses Are the Front End of the Private Health Care Organization
In private healthcare institutions, nurses play a significant role and they are accountable for delivering direct patient care, partnering with other healthcare professionals, and ensuring patients receive quality care (Mosadeghrad, 2013).The following are specific contributions made by nurses to private healthcare organizations: Nurses are responsible for analyzing, planning, implementing, and evaluating patient care as part of their patient care duties.This involves medicine administration, vital sign monitoring, assistance with activities of daily living, and patient education.Nurses collaborate closely with physicians, nurse practitioners, and other healthcare providers to offer patients with coordinated care.They share vital patient data with other team members and collaborate on treatment approaches (Arokiasamy, 2013).
Nurses are responsible for detecting potential safety concerns and executing preventative steps to protect patients.In addition, they monitor patients for changes in condition and respond to medical crises (Bhattacharya & Ramachandran, 2015).Nurses are responsible for managing healthcare resources, including pharmaceuticals and medical equipment, to guarantee their effective and efficient utilization (Abou Hashish, 2017).Advocates for patients, nurses are frequently their patients' primary advocates.
They ensure that patients' preferences and values are honored and that their views are heard.In conclusion, nurses perform a crucial role inside private healthcare institutions.They provide direct patient treatment, work with other healthcare professionals, maintain patient safety, manage healthcare resources, and serve as patient advocates (Khalid & Nawab, 2018).

Challenges of Nurse Personnel in Private Health Care Originations
Private healthcare organizations expose nurses to a number of pressures that may have an influence on their job satisfaction and wellbeing (Bonenberger et al., 2014).The following are examples of typical pressures nurses may face: As a result of the frequent emphasis on maximizing revenues and efficiencies in private healthcare organizations, nurses may have large workloads.As a result of caring for a high number of patients or working long hours, nurses may experience burnout and tiredness.In private healthcare organizations, nurses are usually obliged to provide high-quality care in a limited amount of time.This may cause nurses to feel rushed and upset, so diminishing their ability to provide quality care.Customer satisfaction: As private healthcare organizations are usually focused on patient satisfaction, nurses may feel pressure to provide excellent service.There may be pressure on nurses to priorities patient satisfaction over other aspects of care, such as patient safety or therapeutic efficacy.Owing to economic constraints or issues attracting and retaining experienced nurses, private healthcare organizations may experience staffing shortages (Terera,& Ngirande, 2014).As a result, nurses may be asked to work extra hours or take on additional responsibilities, which can impair their workload and job satisfaction.In private healthcare institutions, advanced technology and complex documentation systems are routinely employed, making it difficult for nurses to navigate.This can increase the difficulty for nurses to comprehend and effectively utilize new technologies (Choi et al., 2016).Overall, private healthcare organizations expose nurses to a number of pressures that may affect their job satisfaction, well-being, and capacity to provide high-quality care.It is vital for healthcare firms to tackle these problems and help their nursing staff in order to deliver the best possible care to their patients.

Reason behind the Turnover in Private Health Care Organization
In private healthcare facilities, staff turnover is a serious issue.High turnover rates can be costly and have an effect on the quality of patient treatment.The following are some of the most common causes of employee turnover in private healthcare organizations: Dissatisfied nurses may leave the organization in search of better employment opportunities.This could be due to factors such as workload, compensation, a lack of managerial assistance, or a feeling of under appreciation.Nurses may leave a workplace if they perceive there are no options for advancement or improvement in their careers.They may include opportunities for more education, professional growth, and advancement.High-stress and burnoutsuffering nurses may leave an organization in search of a less demanding employment.Burnout can be caused by overwork, a lack of support, and exposure to stressful circumstances (Mathieu et al., 2016).Nurses may leave an organization if they consider their services are not being compensated adequately.This is especially troublesome in healthcare organizations that priorities profitability before employee compensation.If nurses do not feel as though they fit in with the workplace culture, they may depart.This may be due to insufficient communication, a lack of collaboration, or a feeling of being unsupported by colleagues.To address turnover in private healthcare organizations, management must first determine the underlying causes of turnover and then take steps to resolve these issues.They may include opportunities for professional advancement and development, the resolution of workload and wage issues, the improvement of workplace culture and communication, and aid for employees facing burnout.By addressing staff turnover, private healthcare organizations can improve the quality of care provided to patients while reducing the costs associated with acquiring and training new employees (Jaharuddin & Zainol, (2019).

Factors Play an Important Role in affecting Employee Turnover in Private Health Care Organization
In private healthcare companies, employee turnover can be caused by a variety of factors.The following are some of the most crucial variables to consider: Dissatisfaction with One's Employment Employees in the healthcare industry who are unhappy with their jobs are more likely to quit their jobs.There are a number of factors that can contribute to this, including the amount of work that must be done, the absence of assistance from management, the absence of recognition or opportunities for promotion, and a feeling that one is not valued enough.Employees may decide to leave an organization if they feel that their managers are not providing them with the necessary support or advice.This may be the result of problems such as insufficient communication, excessive micromanagement, or a failure to recognize and appreciate employees (Yanez et al., 2020).Burnout is a risk for those working in the healthcare industry because their jobs are demanding and fraught with high levels of stress.The symptoms of burnout include mental and physical exhaustion, decreased job satisfaction, and increased employee turnover rates.Employees in the healthcare industry may leave an organization if they are unable to maintain a healthy balance between their professional and personal responsibilities (Zeffane, 2017).This can be due to factors such as having a rigid schedule, working long hours, and having limited time off for vacation.Compensation and benefits: Healthcare workers who feel that the organization they work for does not provide enough salary and benefits may leave that organization.This may be attributable to problems such as low salaries, restricted possibilities for growth, inadequate health insurance, and retirement benefits, or any combination of these factors.Environment of the workplace the atmosphere of the workplace is another factor that can impact employee turnover.Professionals in the healthcare industry may decide to leave an organization if they feel that the working atmosphere is unsanitary, threatening, or disorganized (Fletcher et al., 2018).Cultural fit: Healthcare staff members may decide to quit an organization if they do not feel as though they are a good match with the culture of the organization.This may be the result of factors like as low morale, a mismatch in values, or a lack of diversity in the workforce.Companies in the healthcare industry need to determine the factors that lead to employee turnover and find solutions to those factors.This can help to lower employee turnover rates, boost employee happiness and engagement, and ultimately lead to improved patient care (Huang et al., 2021).

Why lowering Private Health Care Employee Turnover is Important
In private healthcare organizations, high turnover rates can have a number of detrimental effects on both the organization and its staff.Let's examine each of these drawbacks in depth (Dhanpat et al., 2019).• As healthcare companies encounter high turnover rates, they frequently face personnel shortages, resulting in diminished patient care quality.This can result in an increased workload for the remaining employees, leading to burnout and exhaustion.Overworked personnel can compromise the quality of patient treatment.Personnel shortages can also result in the assignment of personnel to unfamiliar regions, which can lead to errors and other issues.This can also cause patients to wait longer for care, resulting in frustration and discontent (Papa et al., 2020).• For healthcare companies, high turnover rates might result in increased expenses.Significant expenditures might be associated with recruiting, training, and onboarding new e mployees.Moreover, high turnover rates can result in lost productivity and revenue, as it may take time for new employees to become proficient, resulting in a decline in the quality of care delivered and a decrease in patient satisfaction.These expenses can quickly build up and affect the organization's bottom line (Ojakaa et al., 2014).• High turnover rates might have a negative effect on the morale of the remaining staff members.
Workers may feel overworked and underappreciated, resulting in lower job satisfaction and higher departure rates.This can create a vicious cycle in which the remaining personnel becomes overworked and ultimately leaves, worsening the problem further (Ngethe, 2014).• High turnover rates can undermine the continuity of treatment provided to patients.Patients may be required to interact with many care providers, resulting in inconsistency and potentially decreasing care quality.This might be problematic for those with chronic diseases or those requiring continuing care (Ali et al., 2015).• High employee turnover rates can harm the reputation of healthcare businesses.Patients and their families may be less likely to choose an organization with a reputation for significant employee turnover, resulting in less revenue and fewer prospects for expansion.This can also affect recruitment efforts, as potential employees may be hesitant to join a company with a high turnover rate (Vasquez, 2014).Additionally, high turnover rates in private healthcare businesses can have negative consequences for both the organization and its personnel.It is essential for healthcare businesses to address the underlying reasons of employee turnover and foster a healthy work environment that encourages employee retention and job satisfaction.By doing so, healthcare organizations can enhance patient care quality, save costs, maintain staff morale, encourage continuity of treatment, and safeguard their reputation.

Preventing the High Turnover Rate in Private Health Care Organization
To reduce high turnover rates in private healthcare organizations, a comprehensive approach addressing the root reasons of turnover is necessary (Poghosyan, 2017).The following are particular strategies healthcare organizations can utilize to prevent turnover: Increasing job satisfaction is an essential factor in reducing employee turnover rates.By addressing the sources of employee discontent, businesses can increase employee satisfaction.This can be caused by a number of factors, including workload, compensation, a lack of managerial assistance, or a feeling of being underappreciated.Organizations may conduct employee surveys or focus groups to identify problem areas.Companies can fix problems by reducing workload, bolstering remuneration packages, providing opportunities for employee appreciation, and ensuring that employees feel appreciated and supported based on the outcomes (Top, 2015).Providing opportunities for career advancement and development can help employees feel valued and motivated.Examples include providing training programmes, mentoring opportunities, and career advancement possibilities.By investing in employee development, organizations can assist individuals in developing their abilities and advancing their careers.This can increase employee engagement and loyalty while decreasing the likelihood of staff turnover.In healthcare organizations, burnout is a frequent cause of staff attrition.Employers can assist workers in achieving a healthy work-life balance by offering flexible scheduling, telecommuting options, and paid time off.This can help individuals better balance their work and personal responsibilities, hence reducing the risk of burnout.In addition to providing stress management services and mental health support, businesses can also aid employees in coping with work-related stress by providing stress management services and mental health assistance.Poor communication is a common cause of employee discontentment and turnover.Businesses can improve communication by providing regular feedback to employees, holding regular team meetings, and maintaining open and transparent communication channels.In addition to encouraging two-way communication, businesses can also encourage employees to express their opinions and ideas.Through boosting communication, organizations may enhance trust and create a more positive work atmosphere.Provide competitive compensation and benefits: Providing competitive wages and benefits can help healthcare organizations attract and retain outstanding talent.Businesses are able to study compensation and benefit norms in the industry and adjust their offerings accordingly.One example is providing competitive wages, health insurance, retirement plans, and other amenities.By providing competitive pay and benefits, organizations may demonstrate appreciation for their employees and enhance their well-being.Reducing turnover rates in private healthcare organizations requires a diversified strategy that addresses the root causes of turnover.By enhancing job satisfaction, providing career development opportunities, encouraging work-life balance, enhancing communication, and providing competitive compensation and benefits, organizations can create a pleasant work environment that increases employee loyalty and decreases the risk of turnover.

Conclusion and Strategic Suggestions
Employee turnover is a big concern for private healthcare organizations, as it may have a detrimental influence not only on the quality of care provided to patients but also on the bottom line of the organization as well as the morale of the staff that is still employed there.In order to solve this problem, it is necessary to have a solid understanding of the elements that play a role in employee turnover and to proactively address those concerns.Dissatisfaction with one's work is one of the primary contributors to staff turnover in private healthcare firms, and it is one of the most important aspects.Workers in the healthcare industry who believe they are not recognized or appreciated are at an increased risk of quitting their positions.It is absolutely necessary for healthcare organizations to acknowledge the significance of job satisfaction and to take measures to enhance it.This can include giving employees with chances for growth and development, recognizing and rewarding employee achievements, and making certain that staff members have access to the tools necessary to efficiently execute their tasks.Unprofessional management is another significant element that has a role in high staff turnover rates.It is more likely that employees in the healthcare industry will quit their positions if they feel that their bosses do not support or advise them.When it comes to effectively leading their teams, healthcare organizations need to make investments in their managers by providing them with the training and resources they need.In addition, managers should be encouraged to speak often with their team, offer feedback, recognize and reward outstanding performance, and provide recognition for exceptional work.In the private healthcare industry, employee burnout is another key element that contributes to employee turnover.Due to the rigorous and high-stress nature of their professions, those who work in the healthcare industry run the risk of experiencing burnout.It is imperative that healthcare businesses acknowledge the significance of the well-being of their employees and adopt preventative measures to address burnout.This can include the provision of assistance for mental health, the promotion of a work-life balance, and the implementation of policies that lower the risk of burnout.Another significant element that contributes to staff turnover in private healthcare firms is a lack of a healthy balance between work and personal life.Employees in the healthcare industry who have the perception that they are unable to successfully combine their personal and professional commitments are more likely to resign from their positions.It is imperative that firms in the healthcare industry acknowledge the significance of maintaining a healthy work-life balance and make provisions for their employees' well-being by offering flexible schedules, paid time off, and other perks.In private healthcare businesses, compensation and benefits are key elements that contribute to staff turnover.Other factors that contribute to employee turnover include: Workers in the healthcare industry who have the impression that they are not being treated properly or given sufficient perks are more likely to resign from their positions.It is essential for healthcare firms to offer competitive salary and benefit packages in order to both entice and keep the best employees.The atmosphere of the workplace is another contributor to employee turnover that should not be overlooked.It is more probable that employees in the healthcare industry will quit their positions if they perceive the working environment to be hazardous, dirty, or unorganized.In the healthcare industry, firms have a responsibility to make their working spaces as secure, tidy, and well-organized as possible, and to provide their employees with the tools and resources they need to do their tasks successfully.Lastly, a poor fit with the company's culture is a significant factor that contributes to employee turnover.It is more likely that employees in the healthcare industry who do not feel that they fit in with the culture of the firm will quit their jobs.It is necessary for healthcare businesses to cultivate a culture that is upbeat and welcoming, one that recognizes the value of diversity and encourages a sense of belonging among staff members.In conclusion, lowering the turnover rate of employees should be one of the highest priorities for private healthcare firms.In order to address the factors that contribute to employee turnover, a comprehensive approach is required.This approach involves increasing job satisfaction, providing opportunities for growth and development, encouraging a healthy work-life balance, ensuring that compensation and benefits are fair, developing a positive work environment, and promoting a culture that values diversity and inclusion.It is possible for healthcare businesses to enhance patient care results, staff satisfaction and engagement, and turnover costs all at the same time if they can decrease their turnover rates.In general, addressing the issues that lead to employee turnover is essential for the continued growth of private healthcare organizations over the long term and for the provision of high-quality treatment to patients.

Strategic Suggestions to Prevent a High Turnover Rate among Nurses:
The following is a list of some strategic proposals that can be used to prevent a high turnover rate among nurses working for private healthcare organizations: 1. Compensation and benefits that are competitive Because of the strong demand for nurses, it is important to give compensation and benefits that are competitive in order to both recruit and keep skilled nursing staff.It is important for firms that provide healthcare services to consider benchmarking their remuneration packages against industry standards and adjusting them as needed.2. Opportunities for professional development are important for nurses, as they wish to improve professionally and go up in their careers.It can be a significant weapon for employee retention to provide possibilities for professional development and advancement in the workplace.This may take the form of mentorship opportunities, training programmes, or even ongoing education.
3. Workplaces that are conducive to growth are essential for the professional development of nurses.The culture of a healthcare institution should seek to recognize the importance of nurses and provide them with support.This includes providing a working environment that is safe and comfortable, recognizing and rewarding performance, and promoting a healthy balance between work and personal life.4. Options for flexible scheduling Nurses frequently require schedules that are flexible so that they can handle their personal and family responsibilities.To better meet the requirements of nurses, healthcare companies should seriously investigate the possibility of providing alternative work arrangements, such as part-time or telecommuting work. 5. Concerns about the amount of work that needs to be done Nurses frequently express concerns about the amount of work that needs to be done as a cause for leaving their jobs.It is the responsibility of healthcare organizations to ensure that the staffing levels are sufficient to satisfy the demands of patients and that nurses are not overworked with administrative responsibilities.This can help reduce feelings of exhaustion as well as turnover.6. Feedback from workers and employee participation: Nurses want to know they are valued and heard.
Regular chances for nurses to express input to management and engage in conversation with those in charge should be made available by healthcare organizations.This may involve employee surveys, regular check-ins, or focus groups with other staff members.7. The importance of having a feeling of purpose and meaning in one's work is something that nurse's look for as a source of motivation in their profession.The beneficial effect that nurses have on the care they provide patients and the outcomes of those care should be highlighted and celebrated by the organizations that provide healthcare.In conclusion, a multi-pronged strategy is required in order to reduce the high incidence of nurse turnover that occurs in private healthcare organizations.Healthcare organizations are required to provide employees with competitive compensation and benefits, opportunities for professional development, a positive working environment, flexible scheduling options, and solutions to workload concerns, employee feedback and engagement, and an emphasis on a sense of purpose.Healthcare companies have the ability to increase the quality of patient care, encourage growth and success, and attract and retain qualified nursing personnel when they put into action the strategic proposals presented here.