Impact of Quality of Work Life on Turnover Intention: A Study on Private Health Care Units in Odisha

Abstract

The stakeholders of the health care systems are endeavouring to render effective, efficient, and equitable care in an environment that is enduring transitions in business, clinical, and operating models. In this scenario, the performance of the health care organisations is largely dependent on the knowledge, skills and motivation of the employees. However, health care organisations worldwide, including India are facing an acute shortage of skilled health care employees, which is further intensified by high employee turnover rates. Therefore, it has become crucial for organisations to explore the perceptions of health care employees regarding the factors that influence and shape their decision to quit, for developing effective strategies to reduce turnover and retain the workforce essential to achieve health care outcomes.
Seminal works in developed countries have advocated that the turnover and turnover intention is mostly influenced by the extent to which the employees are satisfied with the facets of their work life. However, the past studies emphasising on the quality of work life (QWL) to address the turnover of health care employees are scarce in India. Thus, this research examines the impact of QWL on the turnover intention of the employees in the private health care units of India. Specifically, the study focuses on gauging the perception of health care employees on the job dimensions, human resource (HR) interventions, QWL, employee commitment, and turnover intention to build logical relationships among these variables.
A survey was conducted among the health care employees (nurses, pharmacists, laboratory technicians, and radiology technicians) working in the private health care units (nursing homes, non-corporate hospitals, and corporate hospitals) situated in the major cities of Odisha (an Indian state), namely Bhubaneswar, Cuttack, Berhampur, Sambalpur and Rourkela. A structured questionnaire comprising of one hundred thirty three items was distributed to eight hundred employees by adopting the method of convenience sampling. In the process of opinion survey, six hundred nine useful responses were retrieved owing to a response rate of seventy six percent. The responses obtained were subjected to analysis by using SPSS 20 and AMOS 20. The preliminary analysis of data was conducted by using the descriptive statistics, correlation and regression analysis. Then, the hypothesised research model was validated by using statistical tools such as exploratory factor analysis and structural equation modelling.
The findings reveal that the job dimensions have a significant association with QWL of health care employees. Further, the perceived QWL of employees is significantly and positively influenced by the operational HR interventions in the health care units. Subsequently, QWL was substantially linked with the commitment levels of the employees in health care organisations. Conversely, QWL and employee commitment were inversely related to the turnover intention of the employees. Besides, employee commitment partially mediated the relationship between QWL and turnover intention. The results also divulged that the job dimensions did not have a noticeably direct influence on employee commitment and turnover intention and both the relationship was fully mediated by QWL. Likewise, HR interventions did not have a substantial direct effect on employee commitment but had a direct and significant relationship with turnover intention. Moreover, QWL acted as a full mediator between the relationship of HR interventions and employee commitment and as a partial mediator between HR interventions and turnover intention.
Thus, this research provides a holistic framework that may act as a blueprint for health care organisations to assess and improve QWL, commitment levels, as well as reduce employee turnover. Further, the study may also provide substantial evidence to the health care managers for improving structures and planning appropriate remedial measures to build employee-friendly workplaces as well as ensure a meaningful and value driven working lives for the employees. Finally, this work supports the crusade to enhance the QWL of the employees as the top priority of the health care decision makers of the country.