Summary of themes.
This chapter analyses employees as human assets by investigating various retention theories. It is imperative that employers do not treat employees like “cogs in the wheel” but rather understand what factors would retain these individuals. The working environment in any organisation is important, as it has to be conducive to attaining a competent and successful workforce. The chapter focuses on a research study conducted evaluating what makes employees remain in an organisation. From the findings a conceptual retention model was developed which would assist employers in retaining staff and ensuring they are treated as human assets. The retention model was based on both a quantitative and qualitative analysis, and many themes and theories have been included in this model.
- Human resources
- culture in workplace
Many great leaders, have always reiterated that our human resources in any organisation are our largest assets. Richard Branson advocates for shaping employees to their best version as the people you employ are a product of you. He further adds: “If you take care of your employees they take care of your business”. In many industries we suddenly, see the inability to retain staff especially in the health sector. In this sector we require highly skilled labour and it’s imperative once we have invested time and money on these individuals we actually should be retaining them.
It is quite obvious that not every employee is cut from the same cloth, or has the same motivation to remain in a job. Staff turnover can have serious financial implications for an organisation, such as the loss of clients, low morale, the added costs of the recruiting process and then training new employees. It is not only the cost incurred by a company that emphasises the need for retaining employees but also the prevention of these talented, skilled employees from being head-hunted . Implementing an effective retention strategy can significantly reduce the high costs of increased turnover, prevent the loss of company knowledge, protect the intellectual property of the organisation, diminish the interruption of customer service and maintain the good will of the company, which in turn will regain the efficiency and effectiveness of the services .
While a wide range of retention strategies have been introduced in various settings to reduce unnecessary staff turnover and increase their length of stay, only a few of these have been rigorously evaluated. Little evidence demonstrating the effectiveness of any specific strategy is currently available . Traditional retention strategies are no longer effective for retaining professionals, people have access to more information due to the 4th industrial revolution. They able to learn more and most are looking for value in an organisation. This chapter focuses on retention strategies such as career anchors, job characteristics, job satisfaction, organisational commitment and intention to quit. Once employers can understand what retains employees, they are able to implement these strategies to ensure human resources are regarded as an asset.
2. Literature review
2.1 Theoretical models
After reviewing and analysing scholarly articles and theoretical frameworks, 5 key theoretical concepts were identified that relate to the problem of retaining employees, namely the job characteristic model  and job satisfaction , career anchors , organisational commitment  and intention to quit . Further, it can be inferred from the theories and other studies that the job characteristics model, job satisfaction and career anchors can be seen as predictor variables that can be used as proxies of retention. Organisational commitment and intention to quit are often used as the proxies of retention .
Job characteristics could be one of the main factors that influence retention . The model predicts that if employees have jobs higher in task variety, task significance and task identity, it gives meaning to work . Autonomy, which is responsible for work outcomes, and feedback can create a greater experience of meaning and knowledge of results . The combination of these job characteristics can then result in high intrinsic motivation, high job performance and job satisfaction and low absenteeism and turnover, thus retaining employees in the organisation . It can be denoted that by identifying these individual characteristics we can ensure we understand what motivates employees in a work place. One would also want to create a work environment which is conducive to employees.
A career anchor is one’s self-concept, and consists of one’s talents and abilities, including skills and competencies, basic values, perceptions of motives and needs as they pertain to an individual’s career and functions . Once the self-concept has been formed, it functions as a stabilising force, an anchor. The career anchor as defined here is the element in a person’s self-concept that he/she would not relinquish, even if he/she was faced with difficult career choices [5, 9]. Eight possible career anchor constructs were identified . Most people’s self-concepts revolved around these given categories, reflecting basic values, motives and needs: autonomy/independence, security/stability, technical-functional competence, general managerial competence, entrepreneurial creativity, service or dedication to a cause, pure challenge and lifestyle .
Organisational commitment means that an employee takes pride in the organisation for which they work, identifies with the mission and objectives of the organisation, and works to achieve the goals . An employee who is committed intends to remain in the long term and is loyal to that organisation, defending the company whenever the occasion arises. Any employer wants a committed individual, they would want an employee who treats the business as their own, and hence creating an environment which enhances organisational commitment will ensure that business is a success .
The intention to quit can be defined as an employee’s plan to quit their present job and look for another job in the near future. Previous research has demonstrated that the intention to quit is one of the strongest predictors and an immediate precursor of employee turnover .
3.1 Research design and sampling
An exploratory study of professionals in the pathology sector was conducted. The study was conducted in three phases. In the first phase, psychometric instruments were used to assess the characteristics of interest. 116 professionals from 3 different locations completed the questionnaires. The relationship between the independent and dependent variables were calculated. The second and third phases were qualitative in nature and consisted of interviews with the mentioned professionals (in total 15) and their managers (in total 3). All the questionnaires and interviews were directed at identifying antecedents to retention.
The two main research questions which needed to be answered were based on retention of these human assets:
Are traditional retention factors responsible for the retention of professionals in private healthcare sector?
What will retain professionals in the health sector?
3.2 Quantitative analysis
Firstly, descriptive statistics were calculated, as to describe the respondents and their standing on the constructs. Secondly, correlations analysis was calculated. This was performed to analyse the overlap between individual predictors and the proxies to retention. Lastly, linear regression was conducted to find the relationship between groups of variables and proxies to retention. The combination of significant correlation coefficients and significant betas were used to derive the retention model.
3.3 Qualitative analysis
The purpose of phase two was to determine what would make professional staff leave and what would encourage them to stay. The structured interview responses were captured and content analysis were used to assess what they deemed as antecedents to their own retention. For the third phase, the same procedure was adopted, as structured interview questions were put to three of the managers, asking them about their experiences regarding retaining professional personnel. The data was then coded and themes were derived from the collated data.
In total, 188 respondents answered the questionnaires, 53 (22.8%) were male and 135 (71.8%) were female. The majority of respondents (48.9%) were in the age group 30–39 years. The geographic spread included (56.4%) of the respondents from Gauteng, (22.9%) from the Eastern Cape and (20.7%) from KwaZulu-Natal. There were 116 (61.7%) professional staff and the remainder were the non-professionals.
4.1 Intention to quit data
Career anchors which showed significant (p < .05) correlations with the intention to quit for professional staff were technical (r = .209; p = .024), managerial (r = .264; p = .004), challenge (r = .244; p = .008) and lifestyle (r = .232; p = .012). The correlation with career anchors, autonomy, security, entrepreneur and service was not statistically significant. When conducting a regression analysis using career anchors as independent variables and intention to quit as dependent variable (R = .489, R2 = .239, p = .182), it was evident that only challenge from the job agents contributes uniquely and significantly (standardised beta = .417, p < .001) to the variance in intention to quit for professionals. It should be noted that intention to quit is the opposite of retention. As such, the results show that the more technical the job, the more likely employees are to stay, similarly, with managerial and lifestyle. However, when it comes to challenge, which is positively correlated with a negative construct intention to quit, the more challenge the professionals need, the more likely they are to leave.
When considering the job characteristics and intention to quit, the results revealed that one of the job characteristics correlated significantly with the intention to quit. At first glance, it seems that skill variety, task identity, task significance, autonomy nor feedback relate to intention to quit. However, when conducting a regression analysis using job characteristics as independent variables and intention to quit as dependent variable (R = .289, R2 = .083, p = .024), it was evident that feedback from the job agents contributes uniquely and significantly (standardised beta = .279, p = .023) to the variance in intention to quit for professionals.
When analysing predictor variable satisfaction to intention to quit, only one category of satisfaction correlated to intention to quit for the professional staff, namely job satisfaction (r = .20; p = .032). The correlation between the other types of satisfaction (pay, security, social, supervisory and growth) were not statistically significant. Also, when entering all the satisfaction variables into a regression analysis (R = .270, R2 = .073, p = .022), it showed that that job satisfaction contributed uniquely and significantly (standardised beta = .196, p = .045) to the variance in intention to quit for the professional.
4.2 Organisational commitment data
Career anchors, job characteristics and satisfaction were compared to organisational commitment for the professionals.
When taking into consideration the effects career anchors has to organisational commitment it was evident that security showed a moderate correlation (r = .195, p = .035). The correlation with career anchors technical, managerial, challenge, lifestyle, autonomy, entrepreneur and service was not statistically significant. This shows that, as far as the participating professional staff were concerned, the more security they had, the more committed they were to the organisation.
After analysing the predictor variable job characteristics to organisational commitment, the results revealed that one of the job characteristics correlated significantly with the organisational commitment for the professional staff. At first glance, it seems that skill variety, task identity, task significance, autonomy nor feedback relate to organisation commitment. However, when conducting a regression analysis using job characteristics as independent variables and intention to quit as dependent variable (R = .333, R2 = .111, p = .053) it was evident that feedback from other contributes uniquely and significantly (standardised beta = .252, p = .012) to the variance in intention to quit for the professionals.
When considering satisfaction to organisational commitment, none of the elements of satisfaction correlated with organisational commitment for the professional staff and showed no statistical significance. Furthermore, when entering all the satisfaction variables into a regression analysis (R = .149, R2 = .022, p = .032), this also showed that none of the elements of satisfaction contributed uniquely and significantly to the variance in intention to quit for the professional.
Figure 1 illustrates the correlation between the predictor variables with intention to quit and organisational commitment for the professional staff, using both the correlations and beta significance. The correlations depicted in the figure reflect the elements that should be included in a retention program, and are not reflective of a positive correlation, but rather just relationships.
In this figure, a solid line represents highly significant correlations (p < .01) and a dotted line, a significant correlation (p < .05). The absence of a line represents the absence of a significant correlation.
4.3 Qualitative results
Ten themes were gathered from the responses of the professionals. The first question asked whether retention of professionals is a problem in their respective organisations. The following responses were noted: Of the total respondents, (87%) agreed, (7%) responded no, and (7%) said sometimes. Table 1 summarises the numbers and names of themes and the percentage endorsements across texts. From the Table, it can be noted theme 7, which was ‘well established and reputable organisation’, had the highest percentage (67) and theme five, which was ‘growth and intellectual stimulation’, had the lowest percentage (23).
|Percentage endorsements across text||Theme|
|60||Theme seven: Well-established and reputable organisation (67%)|
|50||Theme two: Management and leadership style (59%)|
|40||Theme one: Financial gain and remuneration (40%)|
|30||Theme three: Working environment and culture (31%)|
Theme six: Research, publications, conferences (31%)
Theme nine: Involvement with patients (31%)
|20||Theme ten: Recognition and acknowledgement (29%)|
Theme four: Organisational learning and training and development (25%)
Theme five: Growth and intellectual stimulation (25%)
Theme eight: Team building and coaching (23%)
The main inference drawn from the findings was that two different retention strategies will be required for professionals and non-professionals, as different factors have been proven to be responsible for the retention of professionals and non-professionals. Moreover, ten themes emerged which has been proved to be pertinent in retaining professionals. From the quantitative and qualitative data, a conceptual model was developed, which would be useful to retain professionals in private pathology.
5.1 Proposed retention model
The retention model can be interpreted by looking at the key which defines what the solid and dotted lines represent. The model has incorporated the elements of the predictor variables, which were the job characteristics, career anchors and satisfaction together with the proxies for retention which were intention to quit and organisational commitment. These formed the quantitative outputs of the model. The qualitative outputs included the ten themes that emerged, and they are ranked from the most popular to the least popular theme (Figure 2).
5.2 Predictor variable: career anchor
The most interesting finding was the positive correlation of ‘challenge’ with the negative construct of intention to quit, which could indicate that the greater the challenge the professionals had, the more likely they were to quit the organisation. They preferred doing the mundane technical functions but did not want a very challenging work environment where they would need to overcome hazards and difficult problems in the workplace. This was confirmed by the interviews with the professionals, when the professionals felt staff did not enjoy a challenging work environment.
When further reflecting on the ‘managerial’ aspect of the model, the professionals wanted the job functions and the responsibility of being a general manager. This career anchor shows that professionals want to be managers, as they like problem solving and dealing with other people .
The ‘technical’ career anchor included in the model showed that the professional staff enjoyed doing something they were good at and would work to become an expert at that. This type prefers to specialise in their skill in medical science, and they tend to pursue excellence and enjoy being in their area of expertise .
The next career anchor included in the model is ‘lifestyle’, which showed that the professionals were focused first on lifestyle and their whole pattern of living. They preferred to maintain a work/life balance .
The last career anchor which showed a link to organisational commitment was ‘security’. This shows that the participating professionals wanted a secure job in which they would be financially stable and professionally in the right career .
5.3 Predictor variable: job characteristics
Based on the findings, the main job characteristic for professionals was ‘feedback’. This includes feedback from the job itself, feedback from agents and feedback from others. The job characteristic feedback refers to the degree to which people learn how effective they are being at work . ‘Feedback’ refers not only to supervisory feedback, but also to feedback from peers and agents and to the opportunity of observing the results of their work.
5.4 Predictor variable: satisfaction
‘Job satisfaction’ can incorporate all the elements of satisfaction, which are security, pay and growth, supervisory and social satisfaction. If employees were satisfied, they would be committed and would probably remain in the organisation. Satisfiers should therefore be incorporated into a retention strategy .
5.5 Retention themes
The next part of the model consists of the ten themes derived from the qualitative section. The most effective theme was seen to be that of a ‘well-established and reputable organisation’. It was noted that employees wanted to be part of an organisation that had good financial standing, and was commendable and credible, and actually valued their employees.
The next theme that was found to be relatively important was the ‘leadership style’. It was shown that the professionals wanted clear direction when it came to objectives and goals, which was in line with organisational strategy. They wanted a leader who was genuine and who could guide them in the organisation, give them constructive feedback on their performance and offer ways of improving.
The next theme was that of ‘financial remuneration’, and it can be concluded that the participating professionals felt they had studied for a long time, they had scarce skills, and they had a stressful job. They felt they deserved a job that remunerated them well.
‘Work environment and culture’ was seen as another factor that could help retain staff, as the employees felt they needed an encouraging working environment characterised by a good work ethic and a positive work culture.
The next three themes were extremely interesting: ‘Research and conferences’, ‘involvement with patients’ and ‘recognition and acknowledgement’. The theme of involvement in research can be seen as an important one for the professionals in pathology, as they felt they should not be treated like cogs in a wheel, but should rather be exposed to scientific matters like new diseases and new drugs that have been clinically trialled and tested. It can be concluded the participating professionals wanted to be seen as ‘experts’ in their field, and they wanted to be more in touch with the doctors, who are clinically involved with the patients. They also wanted to do ward rounds, to see interesting case studies. They would also like to present papers and attend medical conferences where knowledge sharing in the field of science takes place. The professionals also wanted to be recognised and acknowledged for their involvement in the important work that they do for mankind and the inconvenient hours they work.
The last three themes were ‘training and learning’, ‘growth and intellectual stimulation’ and ‘team building’. Organisational learning and training are imperative in the medical science industry . The participating professionals felt it was important for them to grow in an organisation, whether in their career or simply personal intellectual growth. The professionals felt the need for a culture of continuous learning and intellectual stimulation, as they had to keep up with the latest research and the HPCSA continued professional development. Team building activities were seen as necessary, as this would also contribute to a positive working environment.
It is important to note that the application of the retention model in the case of the professionals should be utilised by combining all the factors in the model to ensure effective retention. No one aspect is more important than another, but rather it is important to look at an integration of all the factors mentioned.
As gathered from literature, it is important for any business to be successful, one needs to treat the employees like an asset to the organisation. In order to do this, it is imperative that we evaluate the factors that would retain competent staff. The findings have been derived from valid and concise research methods. The research suggests that similar factors are not responsible for the retention of professionals and non-professionals in healthcare, and further information needs to be integrated to establish the reasons employee will be satisfied in a job and remain there. Furthermore, a conceptual model was developed from the findings of this research which can be used as a management tool to retain professionals in the health sector.
The contribution of this research is twofold. Firstly, it has proven that incorrect retention strategies have been used for a long time, and it’s imperative each organisation gets their retention policy correct. Secondly, a conceptual model was developed that contributes to theory as well as practice as the model takes into account the relationships and variables of factors that affect retention in the health sector. This model can be adapted to other sectors as well.
Based on the outcomes of the research and information contained therein, it can be stated that not all employees in the health sector are cut from the same cloth, and yes, we have been wasting our time implementing incorrect retention strategies for professionals by assuming everyone can be retained by the same strategy. By understanding how employees think and feel, it shows that employers regard them as an important asset in their organisation.