Exit interviews should provide useful information about staff turnover but research is required to establish how these interviews should be conducted
Citation: Phillips P (2017) The use of exit interviews to reduce staff turnover. Nursing Times; 112: 14, 15.
Author: Patrick Phillips is research associate at the School of Health and Related Research, University of Sheffield, and a member of the Cochrane Nursing Care Field.
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The turnover of staff is routine in any business or organisation and it can be beneficial in preventing organisational stagnation. However, excessive turnover can result in increased operating costs and there are potentially additional negative impacts in healthcare associated with patient care and clinical outcomes.
Exit interviews are formal or informal, oral or written exchanges that take place at some point following voluntary resignation or shortly after leaving an organisation. The purpose is not only to understand why an individual leaves a post, but also to understand what impact the work environment has on those who stay.
Theoretically, exit interviews reduce turnover by facilitating improvements in organisational structures and reputation. This is important in the context of global shortages of health professionals, of which nurses make up a substantial proportion.
Ideally, someone other than the line manager should conduct the exit interview, with information being analysed and fed back into the organisation. There are many potential pitfalls in the use of exit interviews, including poor implementation by people unskilled or unprepared to conduct them. Information gathered may not be analysed or used effectively and there is also a real risk that the information gathered is inaccurate as leavers fail to be honest for a variety of reasons.
The Cochrane review summarised here (Webster and Flint, 2014) aimed to determine the effectiveness of various exit interview strategies in decreasing turnover rates among health professionals working in healthcare organisations.
Key electronic databases were searched and additional strategies used, including hand-searching and reference list checks. The method is summarised in Box 1.
Two reviewers screened all titles and abstracts independently, retrieving and assessing full texts of all potentially relevant studies. Planned data extraction was to be conducted by one author with a second person double-checking.
Box 1. Study method
- Participants: health professionals (nursing, medical, allied health professionals)
- Intervention: exit interviews conducted face to face, by telephone, self-completed survey (paper or electronic) following voluntary resignation
- Comparator: with another form of exit interview or with no intervention
- Primary: turnover defined as the proportion of employees who leave the organisation
- Secondary: organisational change, cost, absenteeism, organisational job satisfaction
- Study type: Controlled trials not restricted to randomised trials
A total of 2,780 citations were identified, of which 19 were potentially relevant. Following a review of abstracts, eight full-text papers were retrieved; none met the inclusion criteria. However, it is of relevance to this summary, written primarily for nurses, that six of the eight papers focused specifically on “exiting” nurses. Most papers were described as surveys.
There is no evidence currently available on the effectiveness of exit interviews in reducing turnover among health professionals. This suggests a need for rigorous comparative studies to support decision making about the ongoing use of exit interviews as an intervention to reduce staff turnover. Such studies should clearly define the intervention and address the potential complexities, in terms of differences in outcome related to:
- Method of delivery: paper based, face to face or telephone;
- Responsibility for conducting the interview: line manager or independent person;
- The healthcare setting: for example, acute or community care.
Using alternative outcome measures, such as absence or organisational culture, should also be considered.
Implications for practice
It seems reasonable that exit interviews might provide useful information which, if used constructively, will reduce turnover of staff and aid retention of highly qualified and expensively trained nurses. Unfortunately the exact nature of the interview – the how, when, where and by whom – is not known and, ultimately, in the absence of evidence of effectiveness, the value of continuing this practice with the intention of reducing staff turnover is uncertain.
Webster J, Flint A (2014) Exit interviews to reduce turnover amongst healthcare professionals. Cochrane Database of Systematic Reviews; Issue 8: CD006620. DOI: 10.1002/14651858.CD006620.pub4