Introduction
Canadian healthcare is undergoing an unmatched crisis due to a sharp decline in the number of medical professionals, which puts additional pressure on the system. This shortage has increased workloads, staff burnouts, and alarming high turnover rates nationwide. Since joining the health facility management team, I have identified staff recruitment and retention as a top-ranking issue. Staff-patient ratio adjustment is imperative for meeting accreditation requirements, providing top-tier patient care, and guaranteeing a sustainable workforce (Protano et al., 2019).
Attaining and retaining competent and experienced healthcare professionals is a complex task requiring a multi-pronged strategy. High staff turnover is exceptionally harmful because continuity of care is significantly affected, training new hires becomes more expensive, and morale among remaining workers is also affected (Galanis et al., 2023). The loss of experienced staff may directly result in a decrease in the quality of patient care. In order to build efficient plans to retain staff, the processes that lead to turnover among healthcare workers in the facility should be understood and acknowledged. Previous studies have revealed different factors that lead healthcare professionals to leave their positions, such as job dissatisfaction resulting from excessive workloads and lack of work-life balance, burnout, and emotional exhaustion, poor management and leadership practices, lack of opportunities for professional development, and safety and violence issues in the workplace (Floriana et al., 2019). Through synthesizing the existing evidence about the factors above and evaluating the proven strategies, healthcare facilities can develop a comprehensive, evidence-based plan to tackle this critical issue, affecting the quality of patient care across the country.
Methodology
The literature review aims to look for research materials on the selected topic. To do this, searches were performed across the central academic databases, including PubMed, CINAHL, Scopus, Medline, PsycINFO, PLOS, and Cochrane. The search has been narrowed down to research articles published within the last ten years (2013 – 2023) in peer-reviewed journals focused on patients’ perspectives of therapy. I employed core words such as “staff burnout,” “worker retention,” “healthcare workers,” “Canada,” “,” and “long-term care homes.” Other sources were obtained through backward, and nurses and physicians forwarded citation searches of main articles. The review included a total of 35 empirically-based papers that fulfilled the criteria of this review. Most (22) were quantitative studies that engaged healthcare occupations through questionnaires, while 8 were qualitative interviews or focus groups. Also, we examined five other papers conforming to the systematic reviews, meta-analyses, or literature reviews group focusing on this topic regarding Canada.
Factors Contributing to Staff Turnover
Job Dissatisfaction & Work-Life Conflict
Research findings from many studies showed that the higher the turnover intention of employees was, the more prevalent job dissatisfaction was among the working staff in healthcare in Canada. The main stressors reported were the imbalance between work-life and effort-pay, which account for 35% of the cases (Stasny, 2024). Overloading of assignments, controls, lack of autonomy, inappropriate personal relationships with colleagues, and minimal staffing level are the leading causes of dissatisfaction (Stasny, 2024). Some healthcare staff complained about time and resource constraints, which they felt made it difficult for them to reach high levels of care.
Burnout
Job dissatisfaction was also brought about by burnout, a condition owing to energy loss overextended by workplace stress. Extensive studies show that burnout is an excellent determinant of turnover intentions, particularly in nursing (Shen et al., 2024). Burnout led to disengagement interrelated to it and reduced personal accomplishment.
Organizational Factors
The study highlighted authority issues and management challenges as essential players in the attrition outflow. Inadequate communication, supervisor support, inflexibility in roles, and the absence of co-governance were considered feelings of discontent (Lasching et al., 2024). Reduced chances of career promotion, professional growth, recognition of a team member’s contribution, and lack of mentors were equally likely factors that led to this future turnover intention (Cao et al., 2013). The idea that employees’ beliefs did not align with the organizational goals was a usual case.
Workplace Violence & Safety Concerns
Personal security among people was considered one more concern. This showed itself in provoking verbal harassment, physical violence from patients/families, and the absence of protective measures against injuries at the workplace, which mainly led to increased staff turnover, especially among nurses, support personnel, and housekeeping groups (Alzailai et al., 2023). Unreliable “live beams” accountability, security deficiencies, and underreporting of incidents only fueled the vicious circle of violence.
Strategies to Improve Retention
Shared Governance & Empowerment
To solve the problems of low autonomy and voice, the facility has applied a shared governance model, which involves staff in decision-making. The committees were increasing in participation, the development of nursing practice councils, and staff responses to the policies were the common factors (Sajedian et al., 2023). This was linked to the team member’s” enhanced job satisfaction and work engagement.
Work-Life Balance Initiatives
Since a work-life conflict has emerged as a driver of turnover, the effectiveness of programs to support the creation of a better balance and increase in wellness was assessed. The positive effects on employability rates included flextime, paid leave, onsite childcare, physical activity programs, and team member assistance services (Babamohamadi et al., 2023). The provision of programs that support stress management training, counseling, and mindfulness was also influential in making those better outcomes occur, according to Lavoie-Tremblay et al. (2018).
Safety & Violence Prevention
To counter workplace violence and security issues effectively, some facilities started comprehensive prevention programs with risk evaluations, de-escalation training, incident reporting systems, and additional security measures (Babamohamadi et al., 2023). The zero-tolerance policy and proper staffing were significant organizational dimensions. Implementation of these has been aimed at preventing accidents and turnover.
Leadership & Professional Development
Investing in leader training to foster the development of a caring, supporting management style at all Affiliate sites was a successful strategy for many sites (Cowden et al., 2011). Specific mentoring programs, choice of specialization, and tuition support covering additional schooling were among the factors that guaranteed the stability of the workforce (Lotfi-Bejestani et al., 2023). Another impactful point was looking beyond specific performance and awarding when necessary.
Discussion
This comprehensive literature review corroborates that multiple inter-relational factors contribute to staff turnover in the Canadian healthcare system. Both the type kinds — less sleep and poor balance outside the office work-related, as well as the more recent ones — home abuse and burnout are two of the people working in a dangerous zone. However, success is concerned with each level of the work experience – individual, interpersonal, organizational, and environmental (Lotfi-Bejestani et al., 2023). Tackling these issues from various perspectives includes flexible schedules, team member assistance programs, as well as shared governance, among others. However, some of these are well-tested and proven best practices. Nevertheless, alternative approaches like mindfulness training and traumatic stress reduction initiatives represent emergent techniques that should be considered in addition to pre-existing strategies for future evaluation (Lotfi-Bejestani et al., 2023). What needs to be put under the spotlight is that many organizations that implemented the strategies designed to improve team members’ outlook reported the firm’s culture, including team member benefits or programs.
Although the nurses dominated the research, the deficit of narrow-down research on medical doctors, help staff, and other healthcare affiliates was also noted. These elements may have a distinct impact and generate different retention planning mechanisms for these job categories about the unique role of personnel and their job environment (Sajedian et al., 2023). Both efforts should be made to conduct more research to develop practical recommendations in each case. Besides the fact that the studies, on most occasions, had a relatively short duration of follow-ups (1-2 years) or relied on conditions such as self-reported intentions rather than actual turnover, the studies also emphasized this. The long haul, look back examinations of long-term retention outcomes and cost-benefit analyses have yet to come in most instances for many of the interventions applied. Such breeds the uncertainty of prescribing specific strategies over others, as the organizational decision-makers need the evidence to make them confident and limit their agents to one protocol only.
Conclusion
Overall, this review of the literature examining the causes of the high level of staff turnover in the Canadian healthcare sphere has resulted in the conclusion that the multitude of difficulties that nurses face with the numerous administrative tasks and a heavy nursing workload together with the difficulties they may have to endure while trying to adjust to a new work environment are the factors that might contribute the most to the nurse’s intention to leave. In the last part, The multi-sided aspect of turnover is seen from the baggage of factors mentioned, i.e., burnout for individuals, concern over safety issues, and organizational leadership matters. While handling this problem will be a multi-tiered process directed towards those in the healthcare sector at various levels, implementing such initiatives as recruitment and retention of the workforce will make this possible.
The range of strategies that emerged as practical was dependent on the latest data and included, for example, an approach for shared control and team member support, including provision of work-life balance, prevention of workplace violence, provision of professional development, and implementation of supportive leadership practices. However, knowing that many of these methods are undergoing an in-depth review to determine the long-term retention outcomes and the expenses entailed gives rise to a new development in the learning field.
During Canada’s time with a severe shortage of healthcare providers, the imperativeness of having robust retention policies is ever more vital. Mitigating the early departure of staff and thus functioning efficiently to guarantee a sustainable workforce is one of the frontiers that will be critical if we are to keep high-quality patient care and get out of the current crisis. Progress towards further evidence-building on effective retention strategies that meet Canadian specifics will be facilitated, allowing healthcare settings and policymakers to make decisions that will defend this handy labor force.
References
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