| Research background:The mobility of medical staff is increasing with the continuous deepening trend of the medical and health system reform and the proliferation of flow mechanism and channels.It continuously troubled the hospital managers for the loss of medical personnel.Along with the reform of personnel system of public hospitals,it shakes the medical staff stability in private hospitals for the performance wage reform of public hospitals.How to reduce the medical staff loss and keep the health human resource relatively stabling,is becoming an important task for human resources management in hospitals.The private hospital is an important part of China’s medical system.However,the poor stability and high mobility of medical staff in private hospitals is continuously deteriorating,partly because of the private hospital management system,cultural background and management system.It brings serious influence to the stability and development of the hospital personnel for excessive loss of staff,such as employees dissatisfied with the work,thought is not stable,and then more medical staff turnover.It is important that staff turnover is professional and technical clinical experienced,even if the same number of new staff is added,they don’t get the same quality and efficiency so soon.It impacted on medical services,medical quality and safety,to reduce the trust and satisfaction of patients,thereby reducing the competitiveness of the hospital,the long-term development of the hospital.In addition,frequent turnover,recruitment,hiring,trial,wasted a lot of time and energy for hospital manager.Thus the turnover of staff must have the attention of managers.The hospital managers urgently need to think and solve the problems,to find out the main reasons of staff turnover of private hospitals,taking effective intervention measures to stabilize the medical staff,reducing the turnover rate.The hospital is a private joint-stock hospital operated by a medical group unified management in Nanjing.From 2010 to 2013 the number of medical staff frequent turnover,especially in 2013,a larger number of backbone nurses quit,and many department leaders feel that it is hard to keep the personnel stability.At the same time,the Hr should pay more attention to the treatment and the recruitment,which is difficult.According to the investigation,in 2012,the treatment of the public tertiary hospitals in the same area increased after the performance salary reform at the same time,It requirements for medical staff were increasing for the expansion of public hospital wards and beds,and even increase the establishment examination opportunities and places for the talent.The private hospitals were greatly threatened.In order to stabilize the medical and nursing personnel,the hospital tries to stabilize the qualified personnel by improving the treatment of medical staff.The human resources department of the hospital nursing department in 2014 jointly formulated and implemented the "nursing post management measures",in order to improve the treatment,So as to study nurse turnover especially the increase of backbone nurses.In 2014,The remuneration of doctors is not improved,the salary imbalance between the doctors and nurses resulted in increased resignation rate of doctors.In order to balance the doctor’s income level,in January 2015,the hospital formulated and implemented the "physician performance appraisal approach",which improved the doctor’s performance bonus,so as to observe whether the doctor’s resignation rate has improved.Objectives:This study describes the tertiary private hospital in Nanjing city during 2010-2015 staff turnover situation and distribution situation,investigation and analysis of the hospital medical staff turnover,and observe the salary change influence on doctors and nurses turnover rate,discussion and put forward the stability of the hospital medical staff team of countermeasures for human resource management especially provide the basis for medical staff management.Methods:1.Select the Nanjing City three levels of a comprehensive private hospital in 2010-2015 turnover in the 501 employees of the hospital as the research object,through the transfer of human resources staff in the archives of the exit interview form,the disclosure of information and database monthly employee turnover,collected from the hospital staff turnover,and analyze the distribution of posts,education,title,age,school age and other factors,and set up the database with Epidata3.1,further analysis of turnover in staff turnover status and reasons for leaving,as a descriptive study.The objective analysis of relevant data by the statistical software SPSS 17.0,statistical description of the percentage,rate,distribution of objective analysis of salary,staffing,family reasons and personal development factors of turnover in different years and in different populations.2.Develop and implement the salary reform programs.The hospital first considered from the pay side intervention,through changing the salary observed on the medical staff turnover rate.In 2014,the hospital human resources department of joint nursing department formulated and implemented the "nursing post management approach",according to nurses at different hillock level to improve the nurse pay,observe the medical staff turnover rate changes.The content of the method is:according to the nurse’s title and the degree of seriousness of the post,divided into five post class,according to the post level to give different standard post grade salary;another according to the hospital time to give nursing age wages.In 2015,the joint operation Department of the hospital human resources department formulated and implemented the "physician performance appraisal program" to improve the performance bonuses of doctors and nurses.The content of the program is:according to the principle of balance of payments,improve the total proportion of doctor bonuses,thereby enhancing the performance pay of doctors.Doctors and nurses are divided into proportion when they are allocated,and doctors’ and nurses’ bonuses are increased.Results:1.Since January 2010 to December 2015,the hospital for a variety of reasons,a total of 501 employees leave voluntarily,including a total of doctors and nurses,accounting for the total number of turnover of up to 366 of the total of up to 73%.Annual turnover rate of medical staff were 5.47%,6.11%,7.32%,7.98%,13.62%,9.14%.In year 2014 to reach the highest,significantly reduced in year 2015.The top three reasons of turnover are staffing,salary and family.2.The reasons for the resignation of nurses for family reasons,staffing and salary.Each year the nursing staff turnover rate:5.50%,6.67%,6.10%,8.72%,12.50%,9.68%,2010 to 2014,the turnover rate of nurses is increasing,and the 1-3 year old nurse turnover rate was the highest in 2015 and decreased significantly;the lower the turnover rate of nurses in higher;nurses except student nurses,the title is low the turnover rate is higher;after 2014 the nursing staff post salary increase,the nursing staff turnover rate is not reduced,but reached the highest,but the distribution of turnover nurses changed significantly,because the salary of nurse turnover significantly reduced the proportion,more because of family reasons and staffing.3.The reasons for leaving doctors mainly for staffing,salary and career development.Each year the rate of doctor turnover:5.43%,5.50%,8.65%,7.12%,14.81%,8.49%,in 2010-2014 the doctor turnover rate increased year by year,and the primary professional doctor turnover rate has been higher.2014 nurses post grade wages increased,nurses fixed wages increased by 0-2000 Y.Doctors did not adjust the wage synchronization,coupled with the imbalance of nurses led to a significant increase in physician turnover rate,reaching the highest calendar year.And doctors because of career development and postgraduate leave more than nurses.4.The year after the implementation of the performance appraisal program for doctors,doctors pay a substantial increase in the performance of nurses also increased wages,doctor bonuses increased by 940-2100 ranging from 2015.On 2010-2013 and 2014,2014 and 2015,doctors and nurses turnover rate test was statistically significant.Doctors turnover rate decreased by 6 percentage points,the nurse turnover rate decreased by 3 percentage points,while the cause of the distribution of turnover has changed.Conclusion:l.The medical staff turnover in a higher proportion annual in the hospital,the staff turnover rate at a high level,as the main departure crowd,the hospital is also the focus of the crowd,the hospital should formulate corresponding measures to reduce the turnover rate of medical staff,first consider the salary to change.2.The turnover reasons of nurses,the main factors are family,staffing and salary.For 2014,improve the nurse post salary is not directly reduce the turnover rate of nurses,but the turnover for salary significantly reduced the proportion of nurses.In 2014 the causes of nurse turnover rate is still high and the relaxation of public hospital staffing recruitment related,this year 16 people admitted to the local public hospitals two.Visible public hospital protection mechanism is still the flow of talent barriers.Meanwhile,nurses pay more attention to the family,which is limited to the nurse’s career space,in line with professional characteristics.3.The main factors of reason for leaving doctor are staffing,salary and occupation development,the implementation of the year 2014 nursing post salary has led to unbalanced treatment of doctors and nurses,doctors as the main income crowd,wages can’t be timely reflected,the enthusiasm of the hit,the turnover rate increased significantly,it showed that the stability of the doctor not only depends on the salary,and job related to the balance between.The results suggest that policymakers should consider not only improving absolute values but also considering the rationality of different employee categories when making salary plans.In addition,doctors and nurses pay more attention to career development space and self promotion,which is also an important mechanism for private hospitals need to consider stable personnel.4.Improve the salary of doctors and nurses to reduce the turnover rate,so that the cause of the distribution of the occurrence of a significant change,may also dilute the medical staff on staffing and family concerns.Staff turnover rate had significant difference,that there is a direct relationship between the medical staff turnover reason with salary;but not all because of the salary problem,occupation development,family reasons and postgraduate studies are more concerned about the medical staff.To remind researchers to consider other factors,to further study the reasons for the resignation of medical staff and formulate countermeasures to provide a basis for research. |
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