ALKA HOSPITAL

Introduction
The history of private hospital in Nepal dates back to late 80's. After the people's popular movement 1990, there was mushrooming of private hospitals or nursing homes. Nearing to peoples popular Movement 2062 (April 2006), there was sprouting yet another hospital called ALKA Hospital in the heart of the Lalitpur District ALKA Hospital is located at Jawalakhel, Lalitpur, Nepal. ALKA Hospital had its footprints in the form of ALKA Pharmacy, which was established in 2052BS (1995) with an aim of supplying and quality medicine in its close vicinity. But within 2 years ALKA hospital expands its service with endless effort of the staffs and its give birth to ALKA Polyclinic 2057 BS, (2000 AD) along with its pharmacy. After that hospital never look backward. Continuous dedication and day night effort of staff gave grant success to ALKA Polyclinic result turn into ALKA Hospital in 2062 BS with the great motto Quality Health Care. ALKA Hospital continued to serve people in all fields. The excellent rapid and affordable services provided by the hospital with its well equipped technology drags them to be more conscious and responsible. Hospital more focused at existing service and put ting on great effort to remain up to date with advance technology. ALKA hospital is a 100 bedded hospital with super specialty diagnostic and curative facilities like emergency services, maternity services, ambulance services, general and specialty operating theaters, advanced laboratory, R-ray, ECG, ECHO etc. The hospital provides tertiary level of care across wide range of medical specialties. Beside this, the hospital is committed to provide world class medical treatment with care, compassion and empathy. One of the salient features of the hospital is peace and friendly Environment in wards and cabin. According to the wish of patients, the hospital provides different beds with reasonable charges. With the aim 'To provide quality health workers to the country's health system', ALKA at present is conducting Proficiency Certificate Level in Nursing Education. The hospital has its own

institute named ALKA Institute of Medical Sciences (AIMS). The hospital is planning to conduct Bachelor in Nursing and several other courses related to health science.

Background of the study

There are various reasons due to which employee leave organization like better opportunities, increase compensation, broader than current job, better facilities, organization image etc these are voluntary turnover. Voluntary turnovers are those caused by the interest of the employee (e.g. to take job in other organization for better salary) while involuntary turnovers are the decision of management to quit employees from work (e.g. dismissal for gross misconduct weak performance of employee, high absentiseem, inappropriate behavior etc). Either turnover occur volunteer or non volunteer organization incurs direct as well as indirect expenses which directly affect on organization performance. Voluntary turnovers are further distinguished between functional and dysfunctional turnovers. Functional turnovers are the resignation of substandard performers and dysfunctional turnovers are refers to the exit of effective performers.21 They also classified dysfunctional turnover, which is the most concern of management due to its negative impact on the organizations general performance, into avoidable turnover (caused by lower compensation, poor working condition, etc) and unavoidable turnovers (like family moves, serious illness, death, etc) over which the organization has little or no influence. Therefore, management should gives special attention to avoidable turnover over which it has control and improves the situation and then staffs retention. The following chart adapted from Loquercio et al gives a clear picture of staff turnover ladder.

Turnover
Involuntary

voluntary

Functional

Dysfunctional

Avoidable

Unavoidable

Fig no 1: Source, Loquercio, et al, Understanding and Addressing Staffs Turnover in Humanitarian agencies

Thus to retain employee in organization, organization have to offer some benefits like increment in incentive plan, pay holidays, sick leave, bonus, employee empowerment according to their capability, flexible working hour, performance based reward etc. these factors helps to cut the new recruit cost, advertising cost, human resource fee as well as helps to decrease employee turnover rate. By reducing employee turnover organization can improve their performance, productivity as well as profit. A recent study of turnover by Boxall et al (2003) in New Zealand confirmed the view that motivation for job change is multidimensional and that no one factor will explain it. However, over time there have been a number of factors that appear to be consistently linked to turnover. An early review article of studies on turnover by Mobley et al (1979) revealed that age, tenure, overall satisfaction, job content, intentions to remain on the job, and commitment were all negatively related to turnover (i.e. the higher the variable, the lower the turnover). In 1995, a meta-analysis of some 800 turnover studies was conducted by Hom and Griffeth, which was recently updated (Griffeth et al, 2000). Their analysis confirmed some well-established findings on the causes of turnover. These include: job satisfaction, organizational commitment, comparison of alternatives and intention to quit. These variables are examined in more detail
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below, as are a number of other factors where the evidence on the link to turnover is less conclusive. Purpose of the study Only well equipped organization is not enough to improve organization performance, to be a high productivity organization need human resources as well. To increase employee commitment toward organization, organization needs to satisfy their employees through various factors like benefits and policy of the organization. To control employee turnover HR play an import role so while formulating new policy they need to concern about employee as well not only organization benefits. Without employee organization have no any value as well as they cant sustain in market. With the benefits and facilities organization has to attract employee toward the organization. Similarly in ALKA hospital, they are facing high employee turnover. The only way to sustain their employee in organization are providing benefits to employee, reward them as they deserve, provide opportunities to modify their capabilities, induction and training which helps to decrease the employee turnover. Hence the purpose of the study will be: To analyze the impact of employee turnover on the organization performance. To analyze the contribution of HRM practices in reducing employee turnover. To examine the effect of employee turnover on the organization which could be helpful for HRM to reduce employee turnover? Analysis both internal and external environment of the organization which help to reduce employee turnover What best practices should adopt to reduce employee turnover?

Literature review People are important component of any organization. Successful organizations strive to maintain a low level of employee turnover because of its associated organizational impacts costs (Bohlander and snell, 2007). A review of human resources management literature describe the various organizational consequences associated with employee turnover. To calculate the rate of employee turnover, the US department of labor suggests that organizations simply divide the number of employees leaving the organization in any given month by the total number of employee working during that month (Bohlander and snell, 2007).

Business analyse the total turnover cost associated with an employee leaving an organization by breaking this cost down into three distinct areas(Bohlander and Snell, 2007). Bohlander and Snell (2007) categorize these costs intoseparation costs, replacement costs for the departing employee, and training costs for the nre employee(p.90)/ these three cists are than added together to dertermine the total turnover cost. Examples of separation costs would includes the administrative costs for processing any required paperwork for the resignation. Employee replacement costs would focus on job advertisement, testing procedures and interviews. Training costs would include costs associated with employee or training manuals, required educational programs and employee salary and benefits costs while the employee is in training (Bohlander and Snell, 2007) While recognizing the possibility of an optimal rate of turnover, Huselid (1995) assumes that low rates of turnover are preferable to high rates. Glebbeek and Bax (2004) refer to Huselids claim as the conventional assumption of turnover research (p. 279). Much of this negative effect stems from the direct costs of turnover, such as those involved with severance and the recruitment and training of new employees (Staw 1980, Darmon 1990, Hom and Griffeth 1995). In addition, turnover has been associated with several indirect costs. First, firms may experience operational disruption (Staw 1980, Mobley 1982) following the departure of key employees. This could be due to either the loss of the firm-specific human capital that resides in departing employees (Becker 1962) or the loss of the social capital embedded in workers relationships to each other and the organization (Leana and Van Buren 1999, Dess and Shaw 2001). A second source of indirect costs is the demoralization of employees who remain with a firm (Staw 1980, Steers and Mowday 1981, Mobley 1982). This demoralization may be due to the loss of a respected colleague or the fact that turnover may require additional work to be absorbed by remaining employees whose capacity is already stretched (Mowday et al. 1982). Despite substantial evidence regarding turnovers negative consequences for firms, several studiesincluding many of those abovenote offsetting positive effects. For example, the economic perspective on turnover suggests that turnover reflects the beneficial aspects of worker mobility, such as the improvement of matches between employees and firms over time (Jovanovic 1979). Organizational psychologists have also claimed that workers efforts may be highest when they first join an organization and may decrease over time (Staw 1980). These conflicting views concerning the effects of turnover suggest that one must not view turnover as a
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monolithic concept, but rather as a contingent phenomenon. The relevant question thus becomes not whether turnover has positive or negative effects on performance, but rather under what conditions it is more harmful or beneficial to the firm (Osterman 1987). Several studies provide support for the benefits of turnover in settings requiring exploration or innovation. Dalton and Todor (1979) and Staw (1980) note that the worker mobility implied by turnover may serve as a source of new knowledge for firms. Furthermore, an experimental study by Argote et al. (1995) finds that, although the average effect of turnover on work group performance is negative, this effect is less pronounced for complex tasks than for simple tasks. They attribute this difference in turnovers effect to the fact that the performance of complex tasks requires greater innovation (i.e., exploration) than simpler tasks requiring repetition (i.e., exploitation). We maintain that performance in retail chain settings, such as the setting considered in this study, is more accurately characterized as requiring exploitation than exploration. We refer to Marchs choice of terms to describe exploitation (e.g., refinement, production, efficiency, implementation, execution) versus exploration (e.g., search, variation, risk taking,

experimentation, discovery, innovation) (March 1991). As Winter and Szulanski (2001) also argue, companies that operate multiple units often evolve from a phase of exploration during which they experiment with different approaches, to a phase of exploitation during which they freeze the design and replicate the established approaches. As a result, the performance at mature retail chains is highly dependent on the successful execution of known activities such as processing of incoming inventory, shelving merchandise, responding to customer queries, and transacting sales on the cash registers. In this environment, we expect employee turnover to have a negative effect on firm performance due to operational disruption from employee departures, additional work that must be absorbed by remaining employees, and the loss of tacit knowledge and accumulated experience held by departing employees. While activities such as shelving merchandise may benefit from increased effort of new employees, we expect this positive effect to be outweighed by the negative effects of turnover. Staff turnover that is termination of employee and the hiring of other individuals to replace them is a complex phenomenon requiring a systematic view and an awareness of many variables within both the work and external environment. Employee turnover is an important measure of
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the health of an organization. Employee turnover in organizations has received substantial attention from both academics and managers. To check the impact of employee turnover on the organization performance the researchers used 48 months of turnover data from US stores of a major retail chain and find that on average, employee turnover is associated with decreased performance, as measured by profit margin and customer service. The particular aspect of management on which the researcher focus is process conformance the extent to which managers aim to reduce variation in store operations in accordance with a set of prescribed standards for task performance service (Zeynep Ton, Robert S. Hickman, 2007). Prior research has offered mixed conclusion based on both theoretical and empirical analysis and according to previous research that turnover has negative effects on operating performance due to the disruption of existing routines (Dalton and Todor 1979, Bluedorn 1982). Employee turnover is an important measure of the health of an organization. All libraries should implement a three step program of turnover management the collection and analysis of data on turnover patterns, the identification of those factors contributing to turnover in the library through organization of a formal exit interview program and implementations of remedial actions which address the main causes of turnover. The exit interview as an effective tools for documenting the causes of turnover in a library and for influencing management action. The exit interview must be based upon a standardized format, assure employee confidentiality, employee talented inter-viewing staff, and involve periodic assessment of effectiveness and provide for routine feedback to management. (James, Neal 1989). Most research on turnover focuses on voluntary and avoidable separations because they are more subject to control by management (price, 1977). Turnover can be seen as providing some benefits, helps keep salary costs down, creates opportunities for upward mobility, encourage staffing flexibility and organizational restructuring, brings employee with new ideas and experiences into the organization and reduces the frustration created by dead-end jobs. The negative consequences tend to be more visible and the costs greater than anticipated. The fiscal impact sometimes describe as the positional replacement costs, can be summarized in several categories, costs incurred when an individual leaves, costs of advertising the position and recruiting and selecting a replacement, cost of new employee orientation and training costs of equipment and costs of lost production and productivity (Flamholts, 1973). Many organizations employ a post turnover survey as a substitute for or as a complement to the conventional exit interview. The use of questionnaires
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enables the organization to sample consistently rather than depend on evidence produce by the sporadic statements of individuals employees (your-man, 1965). The exit interview is thus a central component of effective turnover management and the exit interview is thus a central component of effective turnover management and the exit interview provides for the establishment of good working relations with former employees and furnishes useful management data. It must be based upon a standardized format, assure employee confidentiality, employ talented interviewing staff, involve periodic assessment of effectiveness and provide for routine feedback to management (James G.Neal.1989). The vast majority of research on the relationship between the provision of training and turnover has adopted the human capital theory. The increasing availability of training data has greatly aided research on the effects of training (soreze, 2008) this study is important because by directing this inquiry into important area of the effectiveness of workplace education and training in terms of employees turnover, the findings derived from the study will be expected to be useful in understanding the effect of training on employee turnover and in developing management retention strategies in the focus organization as well as other organization operates in the same sector in general. (Sorese, 2008). A quantitative approach using survey or secondary data develop a causal link between variables with only few empirical research studies have been able to take a closer look at the nature of company training and its effects (loewenstein and Spletzer 1998, Barron et al 1999, cited in Soreze, 2008). The research purpose combine explanatory but according to the research descriptive researcg is concern with identifying the phenomena whose variance wish to describe ( Ghauri et al 2002, cited in Soreze, 2008) thus the use of descriptive study as one purpose is to identify and describe the variability in different factors that seem to affect the training effectiveness in term of reducing employ turnover (Saunders et al, 2003). In simple term, the standard human capital model predicts a negative relationship between firm specific training and turnover, where general training would have no effect on turnover. However, the existing empirical studies provide evidence that the relationship is not actually straight forward. The results are indeed mixed in the sense that although the majority of studies point to a significantly positive relationship (Gree et al, 1996, Forrier and Sels 2003). Some indicates that the relationship is negative (elias 1994 , loewenstein and Spletzer 1999, lynch 1991, cited in Soreze, 2008), while others suggested a non significant relationship (Krueger and Rouse 1998)
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Allen & Meyer (1990) investigated the nature of the link between turnover and the three components of attitudinal commitment: affective commitment refers to employees emotional attachment to, identification with and involvement in the organization; continuance commitment refers to commitment base on costs that employees associate with leaving the organization; and normative commitment refers to employees feelings of obligation to remain with the organization. Put simply, employees with strong affective commitment stay with an organization because they want, those with strong continuance commitment stay because they need to, and those with strong normative commitment stay because they feel they ought to. Allen and Meyers study indicated that all three components of commitment were a negative indicator of turnover. In general, most research has found affective commitment to be the most decisive variable linked to turnover. The relationship between satisfaction and turnover has been consistently found in many turnover studies (Lum et al, 1998). Mobley et al 1979 indicated that overall job satisfaction is negatively linked to turnover but explained little of the variability in turnover. Griffeth et al (2000) found that overall job satisfaction modestly predicted turnover. In a recent New Zealand study, Boxall et al (2003) found the main reason by far for people leaving their employer was for more interesting work elsewhere. It is generally accepted that the effect of job satisfaction on turnover is less than that of organizational commitment. Martin (2003) detected a complex relationship between turnover and training. He suggested that establishments that enhance the skills of existing workers have lower turnover rates. However, turnover is higher when workers are trained to be multi-skilled, which may imply that this type of training enhances the prospects of workers to find work elsewhere. The literature on the link between lower turnover and training has found that off-the-job training is associated with higher turnover presumably because this type of training imparts more general skills (Martin, 2003). According to strategic planning consultant Leigh Branham, SPHR, 88% of employees leave their jobs for reasons other than pay: However, 70% of managers think employees leave mainly for pay-related reasons. Branham says there are seven main reasons why employees leave a company: 1. Employees feel the job or workplace is not what they expected. 2. There is a mismatch between the job and person.
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3. There is too little coaching and feedback. 4. There are too few growth and advancement opportunities. 5. Employees feel devalued and unrecognized. 6. Employees feel stress from overwork and have a work/life imbalance. 7. There is a loss of trust and confidence in senior leaders. According to Right Management, a talent and career management consulting firm, it costs nearly three times an employees salary to replace someone, which includes recruitment, severance, lost productivity, and lost opportunities. Life Work Solutions, a provider of staff retention and consulting services, provides the following turnover facts and rates:

Over 50 % of people recruited in to an organization will leave within 2 years. One in four of new hires will leave within 6 months. Nearly 70% of organizations report that staff turnover has a negative financial impact due to the cost of recruiting, hiring, and training a replacement employee and the overtime work of current employees thats required until the organization can fill the vacant position.

Nearly 70 % of organizations report having difficulties in replacing staff. Approximately 50% of organizations experience regular problems with employee retention.

There is a growing recognition that work-environment factors affect health system performance (Graham S Lowe, 2006). Basically, the work environment factors affect the quality of work life, individual quality of work life outcomes, and organizational outcomes. The study mainly focuses on various factors such as work hours, schedules, time off, professional development and training, job quality, workload, job satisfaction, work team or unit, quality of supervision and management, organizational change, work-life balance, health and well-being, career plans and basic demographic and employment characteristics affect the work environment and work life of healthcare providers particularly nursing staff (Teresa M et el, 1996, Linda Flynn, 2007, L Dugdill and J Springett, 1994). International Nursing Council has chosen Positive Practice Environments: Quality Workplaces = Quality Patient Care as the theme of International Nurses Day 2007 (Andrea Baumann, 2007) present health systems are
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increasingly challenged faced with a growing range of health needs and financial constraints that limit services potential to strengthen health sector infrastructures and workforces. The major and global nursing workforce crisis one marked by a critical shortage of nurses. The reasons for the shortage are varied and complex (Jeanne M Daffron and Sara E Hart, 2001), but key among them are unhealthy work environments that weaken = performance or alienate nurses and, too often, drive them away from specific work settings or from the nursing profession itself. It is well known that clergy work beyond the regular 40 hour work week and do so during unscheduled times at locations other than their workplace, such as visiting the hospital when a parishioner has had a heart attack or attending ballgames of youth in the church. Weaver, Flanelly, Larson, Stapleton & Koenig (2002) compiled a helpful research reviewon mental health issues among clergy. In it, they note that on average, United Methodist clergy spend 56.2 hours per week in ministry, and 12 evenings a month away from home on church duties and that 25% of surveyed pastors work more than 60 hours per week (citing Gallup & Lindsay 1999). Work hours have also been shown to be related to increased job stress, especially related to family, in physicians (Rovik et al. 2007) and to emotional exhaustion in those doing people work (Daalen, Willemsen, Sanders, & Veldhoven 2009). These long work hours may be indicative of a strong commitment by clergy to their congregations and community. Personal dedication, investment in ones job, and commitment increase job satisfaction in clergy and religious order workers (Wittberg 1993). Anecdotal accounts can certainly verify this commitment, and it is something clergy have in common with firefighters (Lee & Olshfski 2002). Family stress certainly contributes to job satisfaction (Hang-yue et al. 2005). Marital discord and more children are related to decreased job satisfaction (Rogers & May, 2003). Relocation, which is particularly relevant to United Methodist clergy, may contribute to marital discord, especially when there are children involved. Wives feel more stress than their clergy husbands when relocating, dealing especially with their own and their childrens sense of loss and loneliness when leaving their social network (Frame & Shehan, 1994). Clergy generally express excitement about a move while spouses express concern over the financial burden, changing schools for the children, and loss of friends as well as lack of support from the clergy
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spouse. Both clergy and their wives see a need for more and better family-oriented support services from the denomination, but wives reported this in significantly higher levels (Morris & Blanton 1995). A study of physicians, who tend to work more than 40 hours per week as clergy do, also points to family issues relating to job stress (Rovik et al. 2007). Number of children was shown to relate to increased job stress, and spousal support was shown to relate to decreased job stress.

Research question
Impact of employee turnover in organization performance

Conceptual framework
On the basis of literature review following conceptual frame work is developed to conduct the study:
Dissatisfaction on job

Better job opportunities Better compensation plan Close communication Lower commitment Working environment Employee turnover Organizatio nal performance

Fig no 2: conceptual framework developed after literature review

Hypothesis
H1: There is negative relationship between employee turnover and organizational performance. H2: De-motivation, job dissatisfaction, lack of open communication and better job opportunities are positively related with employee turnover. H3: De-motivation, job dissatisfaction and better job opportunities are interrelated with each other
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H4: better job opportunities and job dissatisfaction increased employee turnover H5: Human Resources practice directly affect on employee turnover and the organization performance. H6: there is relation between job dissatisfaction and de-motivation.

Methodology
I have used both methodologies in my research paper qualitative and quantitative method. Main aim of mixing both method is combination provides a better understanding of research problems that either alone method. During the process qualitative data will be collected using semi-structured interviews in the first phase of the study through open ended questions. On the other hand quantitative data will be collected through questionnaire in the second phase of the study. Thus, the study will be conducted through a survey within ALKA hospital.

Sampling Design:
This research is descriptive in nature as the research is related to measure the impact employee turnover in organizational performance which can be studies through questionnaire. Descriptive research is concerned with the description of data and characteristics about a population. The goal is the acquisition of factual, accurate and systematic data that can be used in averages, frequencies and similar statistical calculations. Descriptive studies seldom involve

experimentation, as they are more concerned with naturally occurring phenomena than with the observation of controlled situations. Descriptive research, also known as statistical research, describes data and characteristics about the population being studied. The research is used for frequencies, averages and other statistical calculations.

Instrument:
A structured questionnaire will be used to measure the impact employee turnover on organization performance (the questionnaire is attached in annex 1).

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Sampling Method: This study is going to be conducted at ALKA hospital, so according to the convenience, random sampling method has been used for data collection. Sample Size Sampling Method Sample Unit Measuring Tool 35 Convenience Sampling Employees at ALKA hospital Questionnaire, interview

Data Collection Method: The data will be collected from the employees of ALKA hospital. The data collection process will be as follows: Explain the respondents about the objectives of the study. Get the respondents fill the questionnaire. Collect questionnaire from respondents after they fill it.

Data Analysis Method Since this study is descriptive in nature where respondents responses which will be quantitative, need to be analyzed by using statistically tools. For analyzing the finding I am using bar chart, pie chart.

Limitations
This study will try to achieve perfection in meeting its objectives. However there are some limitations as every research has some constraints. The limitations of this study are highlighted as follows: The study will be carried out in very short span of time due to time constraint

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This study will be conducted in ALKA hospital. Hence, the findings cannot be generalized to other hospital.

The responses given by the respondents may include some elements of bias. The validity and reliability of the data have not been tested.

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Research and finding

What according to you are the causes of employee turnover?

1 .Compensation package policy 2 .Job and employee skill mismatch 3 .Less recognition 4 .Less growth opportunities Total

7
12

Series1

10 8

11 8 35

6 4 2 0 1 2 3 4

According to the 35 samples of ALKA Hospital from which 7 of them say due to the compensation package policy of the organization cause the employee turnover where as 9 of them say that job and employee skill mismatch cause the employee turnover, similarly 8 of them say less growth opportunities during their working duration cause the employee turnover, similarly 11 the highest employee says that due to the less recognition of employee in the organization is one of the major causes of employee turnover in organization.

What according to you are the few ideas that a smart company use to keep their employee turnover rate low. 1 .Pay them well 2 .Treat each employee with respect regardless of their job 3 .Offer good health care plans/flexible hr 4 .Profit sharing plan Total 5 35 14
3 40% 2 20%

9 7
4 14% 1 26%

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According to 35 samples of the ALKA Hospital 9 of them says that pay them well is one best idea to retention their employee in organization which helps to reduce the employee turnover, similarly 7 of them says that treat each employee with respect regardless of their job helps to reduce the employee turnover, 14 of them says that offer good health care plans/flexible hours helps to reduce employee turnover and 5 of the them says that profit sharing plan also helps to control employee turnover in organization.

How do you estimate the turnover costs of the organization?

1 .Very high 2 .High 3 .Very low 4 .Low Total

7 20 5 3 35

25 20 15 10 5 0 1 2 3 4

According to 35 samples of ALKA Hospital 7 of them says that employee turnover cost for organization is very high, where as 20 of them says employee turnover cost for organization is high, similarly 5 of them says cost for organization is very low and 3 of them says turnover cost of the employee to the organization is low. In the case of high employee turnover what are the major direct cost include for an organization? 1 .Recruitment and selection 2 .Training 3 .Others Total 12 8
34% 23% 43%

15

35

17

According to 35 samples of ALKA Hospital 15 of them says that recruitment and selection is the major direct cost includes for an organization, where as 12 of them says training is the major direct cost includes for an organization similarly 8 of them says that others factor may be there which is the major direct cost includes for an organization. In the case of high employee turnover what are the major indirect cost include for an organization? 1 .Increase workloads 8
1 2 3

2 .Increase overtime expenses 14 for workers 3 .Reduce productivity associated with low employee morale Total 35
40%

13
37%

23%

According to 35 samples of the ALKA Hospital 23% of them says that it increase the work load of employee which may rise the conflict , similarly 37% of them says that it increase overtime expenses for workers is the major indirect cost include for an organization and 40% of them says that it reduce productivity associated with low employee morale. What are the certain causes associated with turnover in any specific job or organization? 1. work supervision 2. Working condition 3. High stress 4. close communication Total 14 8 10 3 35
2 23% 4 8% 1 40%

3 29%

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According to 35 samples of the ALKA Hospital 40% of them says that work supervision practice in organization is one major causes associated with employee turnover in any organization, similarly 23% of them says that working condition is another cause associated with employee turnover, where as 29% of them says that due to high stress in organization is major cause associated with employee turnover and 29% of them says close communication is another cause of employee turnover in organization.

What steps should have to be taken by the company to check employee turnover time to time? 1. Measure the cost of turnover 2.Career development opportunities 3.Employee orientation 4.Overall compensation package Total 35 10 4 17 4
18 16 14 12 10 8 6 4 2 0 1 2 3 4

According to 35 samples of the ALKA Hospital 4 of them says that measure the cost of turnover is major step which should have to be taken by the company to check employee turnover time to time, whereas 17 of them says that career development opportunities is major steps which should have to be taken by the company to check employee turnover time to time, similarly 10 of them says that employee orientation is major steps which should taken by the company to check employee turnover time to time and 4 of them says that over compensation package is major steps which should taken by the company to check employee turnover time to time .

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What initial steps can be taken to reduce turnover?

1.Hire qualified candidates 2.Career development opportunities 3.Employee orientation 4.Overall compensation package Total

6 7

14 12 10

10 12

8 6 4 2 Series1

35

0 1 2 3 4

According to 35 samples of ALKA Hospital 6 of them says that hire qualified candidates is initial steps which helps to reduce employee turnover, where as 7 of the says that career development opportunities is initial steps which helps to reduce employee turnover, similarly 10 of them says good employee orientation to employee is an initial steps to reduce employee turnover in organization and 11 of them says that overall compensation package is initial steps to reduce employee turnover in organization.

What are the various ways to reduce employee turnover?

1.Reward system 2.Create a career path 3.Recognize employee success 4.offer competitive pay and benefits Total

7 4 9
4 43% 3 26%

1 20% 2 11%

15

35

According to 35 samples of the ALKA Hospital 7 of them says that reward system is the way to reduce employee turnover, similarly 4 of them says that create a career path is the way to reduce employee turnover, where as 9 of them says that recognized employee success is the way to reduce employee turnover and 15 of them says offer competitive pay and benefits is the way to reduce employee turnover
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Finding
1 .Compensation package policy 2 .Job and employee skill mismatch 3 .Less recognition 4 .Less growth opportunities Total Number Mean Value SD 7 9 11 8 35 4 8.75 11.832

After survey in ALKA Hospital most of the employee suggested that organization have to recognized on their best performance which helps to motivate them which directly connect on production of the organization. Out of 35 samples 9 candidates suggested that due to mismatch with job and employee skill mismatch employee quite from their job so to control the employee turnover in organization during the hiring time organization have to hired qualified as well as related field employee. Mean value for the questionnaires is 8.74 which is close to the job and employee skill mismatch which means that to develop improve the organizational performance which low turnover ratio organization has to focus on job and employee skill mismatch. During the new recruit organization has to go through the background of the employee which helps them to know that even they are compatible to job or not. If they hire unrelated field person at such condition they has to faced employee turnover which directly affect on organization performance. The standard deviation for this questionnaire is 11.832.

1 .Pay them well 2 .Treat each employee with respect regardless of their job 3 .Offer good health care plans/flexible hr 4 .Profit sharing plan Total Number

9 7

14

5 35 4

21

Mean SD

8.75 3.9

The best way to control employee turnover which helps to increase the organization performance 14 candidates suggested that organization have to offer a good health care plans/flexible hours/vacation plan for the employee where as 9 candidates suggested that paying employee according to the market trend helps to motivate the employee to perform which affect on organizational performance. After calculating mean of this survey it is close to the pay them well. Thus, according to mean value the best way to control employee turnover which helps to increase organization performance is pay them well. If the employee are paid good compare to market trend they will be motivate to perform better in the organization which helps to improve organizational performance. The mean value is 8.75 where as the standard deviation is 3.9.

1 .Very high 2 .High 3 .Very low 4 .Low Total Number Mean SD

7 20 5 3 35 4 8.75 7.67

According to 35 employee of the ALKA Hospital 20 of them suggested that employee turnover cost for the organization high. Turnover cost for the organization is high for the organization because if one well experience staff leaves their organization they need to hire another employee to whom they need to train again and there is no any guarantee that he will perform same as first one. Very least number of samples suggested that turnover cost for the organization is low which means employee knew the value of employee in organization. Here the mean value of these factors is 8.75 which mean turnover cost for the organization will be high for the organization id they wont concern during the recruit time. The standard deviation value for this factor is 7.67.

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1 .Recruitment and selection 2 .Training 3 .Others Total Number Mean SD

15 12 8 35 3 11.67 3.51

According to 35 samples of ALKA Hospital to control the direct employee turnover cost for an organization 15 of them suggested that they need to focused on recruitment and selection and 12 of them suggested that organization need to provide training to their employee. The mean value of the questionnaire is 11.67 which are closely related to training. To control the employee turnover organizations have to run the training session for their employee which helps to improve the employee capability. If organization focused on training for the employee they can improve the organizational performance even their employee is not well qualified. Well training practice in organization means there is present of work supervision from the organization to their employee. The Standard deviation value is 3.51.

1 .Increase workloads 2 .Increase overtime expenses for workers 3 .Reduce productivity associated with low employee morale Total Number Mean SD

8 14 13

35 3 11.67 3.21

According to 35 employee of the ALKA Hospital indirect cost for organization in case of high employee turnover is 14 of them suggested that increased overtime expenses for coworkers and 13 of them suggested that high employee turnover reduced productivity associated with low employee morale toward the organization. Here the mean value of these question is 11.67 which is closely related to the reduce productivity associated with low employee morale. Some direct cost which affect on organization performance due to employee turnover is it
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reduce the productivity of the organization and decrease the moral toward the organization. the standard deviation value is 3.21.

1. work supervision 2. Working condition 3. High stress 4. close communication Total Number Mean SD

14 8 10 3 35 4 8.75 4.57

According to 35 employee of the ALKA Hospital 14 of them suggested that work supervision is one major causes associated with turnover in organization, 10 of them suggested that high stress is another major causes associated with turnover in organization, 8 of them suggested that working condition is another major causes associated with employee turnover in organization and 3 of them suggested that close communication is another major causes associated with employee turnover in organization. The mean value is 8.75 which is close to high stress. High stress is major cause for the employee turnover. If organization put lot of pressure to the employee to achieve the organization goal it may affect to the employee performance and they may leave the organization. The standard deviation value is 4.57.

1. Measure the cost of turnover 2.Develop retention strategies 3.Plan for some expected turnover 4.Recognize quality of work life Total Number Mean SD

4 17 10 4 35 4 8.75 6.18

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According to 35 employee 17 of them suggested that develop retention strategies steps have to be taken by the company to check employee turnover time to time, 10 of them suggested that plan for some expected turnover steps have to taken by the company to check employee turnover time to time, 4 of them suggested that measuring the cost of turnover and recognized quality of work life is another steps have to taken by the company to check employee turnover time to time. The mean value is 8.75 which is close to organization has to plan for some expected turnover. Organization have to keep some employee stand by which help them to recruit when they need whom they can hire when their employee quite their job. The standard deviation value is 6.18. 1.Hire qualified candidates 2.Career development opportunities 3.Employee orientation 4.Overall compensation package Total Number Mean SD 6 7 10 12 35 4 8.75 2.75

According to 35 employee 11 of them suggested that overall compensation package is an initial steps to reduce turnover, 10 of them suggested that employee orientation is an initial steps to reduce turnover, 7 of them suggested that career development opportunities is initial steps to reduce turnover, 6 of them suggested that hired qualified candidates is an initial steps to reduce turnover. The mean value is 8.75 which are close to employee orientation. Organizations have to provide orientation before they join the organization which helps them to know that what will be there key responsibilities. If employee get to know their responsibility before they join the organization they will be prepare for that. It means work supervision play important role to control employee turnover and helps to improve the quality of organization performance. The standard deviation value is 2.75.

1.Reward system 2.Create a career path 3.Recognize employee success

7 4 9
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4.offer competitive pay and benefits Total Number Mean SD

15 35 4 8.75 4.64

According to 35 employee 15 of them suggested that offer competitive pay and benefits is the ways to reduce employee turnover, 9 of them suggested that recognize employee success is the ways to reduce employee turnover, 7 of them suggested that reward system is the ways to reduce employee turnover and 4 of them suggested that create a career path is the ways to reduce employee turnover. The mean value is 8.75 is closely related to recognize employee success. Means value shows that organization need to recognize employee success which helps to motivate their employee to increase their loyalty toward the organization and give their best to increase the organization performance. The standard deviation value of 4.64.

Conclusion
As we know that employee is the key factor for organization, so to retain their employee organization need to concern with various factors like reward system, compensation package, benefits plan, recognized program etc. Thus, if employees do not exist in organization at that condition organization wont have any value even they are well equipped organization. If organizations have to maintain organizational performance they have to satisfy their employee. Through survey I get to know that if organizations have to control employee turnover they have to develop a good compensation package policy. If they have good compensation package policy comparing to the market trend at that condition employee will attract toward the organization and they gave their best performance which helps to improve the organizational performance. If employees are satisfied at that condition they gave their best and they suggest different idea which helps to innovate new product in organization. Another factor which helps to control the employee turnover is offer good health care plan/flexible hours and vacation plans for the employee. If employees are not satisfied with the organization policy they will not give their best to earn more profit through their performance. The turnover cost for organization is very high so they always need to well prepare for this so to prevent from the ultimate loss of employee they need to prepare a plan like recruitment and selection, training for the employees and others. Not only has this turnover included direct as well as indirect cost for the organization. When there is turnover in organization the workload will be increase to other staff which may increase the stress level of the employee which
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directly affect to the organizational performance. Some direct cost will be in hiring new employee where as indirect cost will be decrease productivity cost of the organization as well as decrease the morale and loyalty toward the organization. Main cause of employee turnover is less growth opportunities, less appreciation for work done and employee skill mismatch. If employee are frequently turnover at such condition organization wont be able to achieve their goal as well as unable to earn profit margin which means that the performance of the organization is also going down. Thus, to improve the

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Recommendation
The organization belongs to the health sector which require experienced as well as qualified employee. Thus it is necessary that organization concern on employee turnover ratio within the organization. They must be able to retain their employee in organization and make them feel that they are valuable for the organization. to attract the employee toward organization they need to provide benefits for them, change the organization practice as change in market trend. in findings most of employee believe that pay them well, providing benefits, praise them on their success helps to control the employee turnover which ultimately improve the performance of the organization. For organization employee are the key factor without which they can run their organization. They appreciate that supervisor guide them when they are in problem, they feel good when their supervisor talk with them. Only pay system is not only one variable which attract toward the organization. The relationships which maintain within the organization also play an important role to retain employee in organization. When employees are pressurized to perform in organization they wont give their 100% so to get their best performance organization need to make them feel valuable for the organization. If employee wont perform well at that condition the organization performance will fall. So to improve the organization performance organization need to satisfy the employee with facilities which they need Employees who are praised in organization, pay them well in organization always give their best in organization which they are responsible for. When the stress level is low at work place they enjoy to perform their responsibility and they give their best for to improve the organizational performance. When the employee find hard to cope they generally lose their work morale. The effect of this is reduced productivity of the company or organization. It is therefore in the best interest of the employers to lift employees' spirit by minimizing the problems that they experience by boosting their morale as well as helps to improve the organization performance. Some steps which can followed by organization which helps to control employee turnover as well as improve the organizational performance are as follows: Step 1 Communicate to employees and share with them the goals and objectives of the company. This will help them to understand what is expected of them and prevent any misunderstandings about
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employees' roles and responsibilities. Knowing the objectives of the company may also work to boost employees' morale as they will understand what they are working to achieve. Step 2 Give financial rewards to employees who are performing well. These can be in the form of a cash bonus, days off with pay or a salary increase. Financial rewards minimize the problem of employees resigning to look for better offers elsewhere. By offering competitive financial rewards, chances are that you will motivate them to work harder for you. Step 3 Recognize employees' efforts. Showing appreciation for an employee's good work and dedication will improve morale. This could be done in conversation or by having an employee-of the-month award. With public recognition of an employee's performance, you not only motivate that one employee, but also her co-workers. Step 4 Show employees that organization care for them and not just your business. Organization can do this by getting to know their goals, interests and career objectives; wherever possible, you can help them to achieve these interests. For example, if an employee wants to further his education, you might offer financial help or allow him the time to take classes. Step 5 Allow your employees to have flexible working schedules. This will help the employees organize and manage their time efficiently. For example, parents with younger children might want to arrange their work schedules so that they can pick up or drop off their children at school. This will prevent the problem of absenteeism or resignation as employees attend to urgent personal needs. Step 6 Introduce training programs that will help your employees learn new skills. As technology keeps changing, helping employees develop new skills can be used to increase productivity. The new skills will also boost employees' morale as they will feel more confident in their jobs. Step 7 Improve the working environment and make it comfortable enough for the workers. This can be done by creating enough working space, having comfortable chairs and having proper lighting and ventilation systems.
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ANNEEX Survey questionnaire of employee turnover

You are kindly requested to participate in the survey and complete the attached questionnaire. Your responses will be kept strictly confident and will be used only for the purpose of the present day.

1. What according to you are the causes of employee turnover? a) Compensation package policy c) Less recognition b)Job and employee skill mismatch d)Less growth opportunities

2.

What according to you are the few ideas that a smart company use to keep their employee turnover rate low.

a) Pay them well b) Treat each employee with respect regardless of their job c) Offer good health care plans/flexible hours/vacation plan d) Profit sharing plan

3. How do you estimate the turnover costs of the organization? a) Very high b)High c) Low d)Very low

4. In the case of high employee turnover what are the major direct cost include for an organization? a) Recruitment and selection b) training c) others

5.

In the case of high employee turnover what are the major indirect cost include for an organization? a) Increase workloads b) Increased overtime expenses for coworkers c) Reduce productivity associated with low employee morale

6. What are the certain causes associated with turnover in any specific job or organization? a) Work supervision b) Working conditions
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c) High stress d) close communication

7. What steps should have to be taken by the company to check employee turnover time to time? a) Measure the cost of turnover b) Develop retention strategies c) Plan for some expected turnover d) Recognize quality of work life

8. What initial steps can be taken to reduce turnover? a) Hire qualified candidates c) Employee orientation b)Career development opportunities d) Overall compensation package

9. What are the various ways to reduce employee turnover? a) Reward system b) Recognize employee success c) Create a career path d)Offer competitive pay and benefits

10. Any suggestions to the organization in order to avoid employee turnover? ..

Thank you

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