title: Turnover in health care: the mediating effects of employee engagement.
abstract: OBJECTIVE
  This study aimed to understand the interaction between interpersonal respect, diversity climate, mission fulfilment and engagement to better predict turnover in health care.
  
  
  BACKGROUND
  Registered nurse turnover has averaged 14% and current nursing shortages are expected to spread. Few studies have studied employee engagement as a mediator between organisational context and turnover.
  
  
  METHODS
  Study participants were employees working within 185 departments across ten hospitals within a large healthcare organisation in the USA. Although a total of 5443 employees work in these departments, employee opinion survey responses were aggregated by department before being linked to turnover rates gathered from company records.
  
  
  RESULTS
  Engagement fully mediated the relationship between respect and turnover and the relationship between mission fulfilment and turnover. Diversity climate was not related to turnover.
  
  
  CONCLUSIONS
  Turnover in health care poses a significant threat to the mission of creating a healing environment for patients and these results demonstrate that workplace respect and connection to the mission affect turnover by decreasing engagement.
  
  
  CONCLUSIONS
  The findings demonstrated that to increase engagement, and improve turnover rates in health care, it would be beneficial for organisations, and nurse management to focus on improving mission fulfilment and interpersonal relationships.
authors.affiliation: Denison Consulting, Ann Arbor, MI, USA.
authors.forename: Stevie A
authors.initials: SA
authors.lastname: Collini
authors.forename: Ashley M
authors.initials: AM
authors.lastname: Guidroz
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Perez
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009718:Nurse Administrators / Q000592:standards*; D015279:Organizational Culture; D010563:Personnel Turnover / Q000706:statistics & numerical data*
keywords: engagement; health care; mediation analysis; organisational context; turnover