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EXCLUSIVE COCHRANE SUMMARY

The use of exit interviews to reduce staff turnover

  • 5 Comments

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.

Introduction

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.

Method

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
  • Outcome:
    • 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

Results

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.

Conclusions

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.

  • 5 Comments

Readers' comments (5)

  • Might it not be more beneficial to study working conditions and reasons for the inability of the NHS to retain staff. I spent a very rewarding career in a model European university hospital which leaves the NHS in the shade as far as staff are treated and which has much to do with attitude and respect for staff and providing them with a motivating learning environment where each member of their interdisciplinary teams is made to feel they are making a valuable contribution.

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  • Wow! That's a novel idea!!
    Respect for staff??!
    Motivated learning environment?!
    Valuable contribution?! I dont think HR managers in the NHS even know what this means! They're too busy drinking Costa coffee in our hospital, and the HR women preening themselves with false eye lashes, make-up, short skirts and jewellery (expensive suits and watches for the blokes) and punishing the frontline clinical staff.
    The HR teams at the hospital I work for are useless bullies.
    When a punitive culture exists, staff will not stay. That's why so many of us are leaving to do something else. This is all we talk about in the staffroom, and winning the lottery to get out of this situation... how very sad :(

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  • Diazemuls, it is reassuring to hear staff leave or have plans to do so. Who would wish to put themselves in situations where there is suppression of those who speak out against poor care and who risk having their career and life ruined through some small and often subjectively perceived misdemeanour. I never understand those who remain clinging to a toxic environment which has the potential to give rise to serious damage to their reputation and health and with all the possibly resulting further consequences such as the impact on their personal and family life, etc.

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  • I would've loved to receive an exit interview by my previous trust. The organisational change the trust went through was quite detrimental and my work environment became more and more stressful and less enjoyable to work in. I wouldn't even want to go back to do bank work there.

    More research in exit interviews would be useful as I believe they're just as important as initial interviews for new employees.

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  • My old trust tried to get out of giving me an exit interview when I retired, but I insisted on being given the relevant paperwork. It was by no means certain that I would retire when I did (I was one of the few left who still had MHO status and could go at 55), but I'd been pushed into it by them essentially removing my job and not finding anything else for me.

    I thought the main reason I was not offered the exit paperwork as a matter of course was that I would tell them a few home truths about how badly the organisation was run, which I did when someone eventually provided me with it - after several requests I note.

    I was subsequently contacted by a manager of my acquaintance, asking to speak to me about some of "the issues" I had raised. When they would only do this face to face or over the phone rather than in writing or by e-mail I refused, telling them that their refusal to put anything in any form where their words would be undeniable told me all I needed to know about how seriously they took what I said. It is relevant, I think, that around that time Private Eye had run a couple of pieces about my service which were very critical of management and it was strongly suspected by some managers that I was the source (I wasn't but I had a damn' good idea who was).

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