Cost of nursing turnover in a Teaching Hospital

This is a descriptive-exploratory study, classified as case study, conducted in a teaching hospital in the southeastern, Brazil, in the period from May to November 2013. The population was composed by the nursing staff, using Nursing Turnover Cost Calculation Methodology.

RESULTS

The total cost of turnover was R$314.605,62, and ranged from R$2.221,42 to R$3.073,23 per employee. The costs of pre-hire totaled R$101.004,60 (32,1%), and the hiring process consumed R$92.743,60 (91.8%) The costs of post-hire totaled R$213.601,02 (67,9%), for the sub process decreased productivity, R$199.982,40 (93.6%).

CONCLUSION

The study identified the importance of managing the cost of staff turnover and the financial impact of the cost of the employee termination, which represented three times the average salary of the nursing staff.

Descriptors:
Nursing, Team; Personnel Turnover; Personnel Administration, Hospital; Costs and Cost Analysis

	May		June		July		August		Total		M (SD)
Category^* * H- Hired; T- Terminated; Tx- Tax; DTS- Diagnostic and Therapeutic Service; NA- Not Answered.	H	T	H	T	H	T	H	T	H	T	H	T
Nurse	-	2	-	1	2	1	3	-	5	4	2.5 (0.5)	1.3 (0.6)
Technician	10	8	10	1	9	5	4	4	33	18	8.3 (2.9)	4.5 (2.9)
Assistant	6	3	8	10	6	2	18	1	38	16	9.5 (5.7)	4 (4.1)
Total	16	13	18	12	17	8	25	5	76	38	19 (3.2)	9.5 (3.7)
N° of employees	1,411		1,479		1,492		1,492		5,050		1,469
Turnover rate (%)	1.03		0.98		0.84		1.06		1.11		0.98
Unit
ICU	8	3	6	9	6	1	15	1	35	14	8.8 (4.3)	3.5 (3.8)
Specialized	6	10	11	2	9	7	8	4	34	24	8.5 (2.1)	5.8 (3.5)
DTS	-	-	-	1	1	-	-	-
NA	2	-	1	-	1	-	2				1.5 (0.6)	-
Total	16	13	18	12	17	8	25	5	76	38

Pre-hire cost	May	June	July	August	Total	%
Recruitment
Application registration	182.21	171.90	367.86	158.14	880.11	54.7
Application selection	221.12	108.80	59.67	161.45	551.04	34.2
Telephone Contact	67.68	36.63	20.09	54.36	178.76	11.1
Total cost	471.01	317.33	447.61	373.95	1.609.90	1.6
Recruitment/employee cost	8.88	6.34	4.18	8.12	6.28
*Vaccancies*
Measure extra working hour	32,771.58	18,098.81	13,694.90	14,316.83	78,882.12	85.1
Measure temp. contract	3.465.37	3.465.37	3.465.37	3.465.37	13,861.48	14.9
Total cost	36,236.95	21,564.18	17,160.27	17,782.20	92,743.60	91.8
Vaccancies/employee cost	2,787.45	1,797.01	2,145.03	3,55.44	2,572.20
*Selection and hire*
Telephone contact	155.98	70.9	60.27	92.17	379.32	5.7
Perform tests	334.90	459.29	334.9	334.9	1.463.99	22.1
Perform group dynamic	415.36	138.45	138.45	138.45	830.71	12.5
Perform Interview	518.99	286.98	522.88	348.27	1.677.12	25.2
Prepare documentation	886.98	484.75	350.66	577.57	2.299.96	34.6
Total cost	2,312.21	1,440.37	1,407.16	1,491.36	6,651.10	6.6
Contract cost/employee	42.81	49.66	82.77	46.60	51.16
*Total pre hire cost*	39,020.17	23,321.88	19,015.04	19,647.51	101,004.60	32.1

Post-hire cost	May	June	July	August	Total	%
Orientation and training
Perform integration PCE	664.29	664.29	687.19	675.76	2.691.53	79.8
Perform integration HR	170.77	170.77	170.77	170.77	683.08	30.2
*Total cost*	835.06	835.06	857.96	846.53	3.374.61	1.6
Training/employee cost	21.91	21.91	21.94	22.04	21.83
*Decreased productivity of newly-hired professional.*
No productivity	16,962.68	18,239.36	17,072.92	18,951.60	71,226.56	35.6
Perform orientation	28,474.57	21,712.72	35,276.22	43,292.33	128,755.84	64.4
Total cost	45,437.25	39,952.08	52,349.14	62,243.93	199,982.40	93.6
No productivity cost/Employee	3,495.17	2,350.12	3,489.94	2,706.25	2,856.89
*Decreased productivity of terminated professionals*
No productivity	3,661.62	2,376.97	2,662.78	1,046.25	9,747.62	4.6
No productivity cost/Employee	305.13	216.08	532.55	209.25	295.38
*Termination*
Perform termination interview	169.82	156.75	104.50	65.31	496.39	0.2
Termination/employee Cost	13.06	13.06	13.06	13.06	46.93
*Total cost post-hire*	50,103.75	43,320.86	55,974.38	64,411.27	213,601.02	67.9

	May	June	July	August	Total	%
Pre-hire costs
Recruitment	471.01	317.33	447.61	373.95	1.609.90	0.5
Vaccancies	36,236.95	21,564.18	17,160.27	17,782.20	92,743.60	29.5
Selection and hiring	2,312.21	1,440.37	1,407.16	1,491.36	6,651.10	2.1
Total cost	39,020.17	23,321.88	19,015.04	19,647.51	101,004.60	32.1
Turnover cost	1,393.57	777.39	760.60	654.91	886.00
*Post-hire costs*
Orientation and training	835.06	835.06	857.96	846.53	3,374.60	1.1
Decreased productivity of newly hired professional	45,437.25	39,952.08	52,349.14	62,243.93	199,982.40	63.6
Decreased productivity of terminated professionals	3,661.62	2,376.97	2,662.78	1,046.25	9,747.62	3.1
Termination	169.82	156.75	104.50	65.31	496.39	0.1
Total cost	50,103.75	43,320.86	55,974.38	64,411.27	213,601.02	67.9
Turnover cost	1,698.92	1.416.19	2.204.65	2.147.04	1.844.09
Pre/post hire costs	89,123.92	66,642.74	74,989.42	84,058.78	314,605.62
Turnover/Employee cost	3,073.23	2,221.42	2.999.57	2.801.95	2.759.69
Termination/employee cost	6,855.68	5,553.56	9.373.67	16,811.75	8,279.09

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author:Paula Buck de Oliveira Ruiz. Praça do Arpoador, 320. CEP 13104052 - Campinas, SP, Brazil. pbuckinha@yahoo.com.br

Brasil

Brasil

Cost of nursing turnover in a Teaching Hospital* * Extracted from the master's dissertation "Custo da rotatividade da equipe de enfermagem em hospital de ensino", Programa de Pós-Graduação em Enfermagem, Faculdade de Medicina de São José do Rio Preto, 2014

Costo de la rotatividad del equipo de enfermería en Hospital de Enseñanza

Abstract

OBJECTIVE

METHOD

RESULTS

CONCLUSION

Cost of nursing turnover in a Teaching Hospital^* * Extracted from the master's dissertation "Custo da rotatividade da equipe de enfermagem em hospital de ensino", Programa de Pós-Graduação em Enfermagem, Faculdade de Medicina de São José do Rio Preto, 2014