PROJECT REPORT ON ATTRITION & RETENTION PRACTICES IN HOSPITALS

SUBMITTED TO: Prof. Bandhanpreet Kaur

SUBMITTED BY: Navpreet Kaur MBA 4TH sem Roll no. -9113

ACKNOWLEDGEMENT

I would like to thank MAX hospital for providing me an opportunity to grow and enhance my knowledge and skills. I also take this opportunity to thank Miss. Shavinder kaur, HR Department, MAX hospital, Mohali for her guidance and help in procurement of the required information for my project and the jobs I was assigned. It was the extreme cooperation of the staff members that I was able to learn a lot about the practical aspects and got an opportunity to work for the regular affairs and get a real time experience. The completion of the project was a not an individual but indeed a joint effort of all the staff members.

Executive Summary of the Project

The aim of this study is to investigate and determine the current human resource practices on retention of core employees (nurses) in hospitals in Punjab. It will examine the relation between HR practices and retention further identifies the elements of HR practices, which strongly influence the core employees to stay. Results from this study will assist in the development of an effective HRM retention program for hospitals. Employee retention is very effective tool for every organization. It may improve employers chances of selecting employees who will become committed to their organization and also improve their ability to retain highly skilled and motivated employees. Retention is one of the challenges facing many business organizations today. For many organizations, strategic staffing has become a concern because the ability to hold on to highly talented core employees can be crucial to future survival. The empharical study examines the current human resource management practices (HRM) of hospitals in retention of their core employees. In particular, research identifies the core elements of HRM practices, which strongly influence the decision for core employee to stay.

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Particulars Introduction to MAX hospital Introduction to attrition Attrition in hospitals Introduction to retention Research Methodology Objectives of the study Interpretation and analysis of data. Conclusion Questionnaire Bibliography

Page no. 6 25 42 48 57 59 63 80 82 84

INTRODUCTION TO MAX

JOURNEY OF MAX

MAX INDIA OVERVIEW:

Founded in 1985, Max India Ltd. is a Public Limited company listed on the NSE and BSE of India with over 30,000 shareholders. Max India Limited is a multi-business corporate entity driven by the spirit of enterprise with a focus on people and service oriented businesses. Prominent shareholders of the company are Mr Analjit Singh and a leading private equity firm, Warburg Pincus. The balance shareholding is held by the public and Institutional Investors. The companys vision is "to be one of Indias most admired corporates for Service Excellence." Towards this end, it has established businesses that are today recognized as being at the fore front of service excellence, in each of the industry sectors where it operates. Performance, Trust and Service Excellence are enshrined in Max India Group s Vision, Mission and Values. Max India Group Mission: 1. Establish niche service businesses in Life Insurance, 2. Healthcare and clinical research 3. Life Insurance and Healthcare convergence 4. Rank amongst top three players in each niche 5. Partner with best-in-class world leaders 6

6. Create trust and service excellence in all Business

Protecting Life through its life insurance subsidiary Max New York Life, a joint venture between Max India and New York Life, a Fortune 100 company Caring for Life through its healthcare company, Max Healthcare Institute Limited, a subsidiary of Max India Limited Enhancing Life through its health insurance company, Max Bupa Health Insurance, a joint venture between Max India and Bupa Finance Plc., UK which is set to launch after statutory approvals Improving Life through its clinical research business, Max Neeman, a fully owned subsidiary of Max India. Create trust and service excellence in all Business In addition to these "life-centred" businesses, Max India manufactures speciality products for the packaging industry through its division - Max Speciality Products. MSP too, has a strong service excellence orientation that strives on building long lasting partnerships with marquee customers.

DETAILS OF SUBSIDIARIES:
Max New York Life Insurance Company MNYL is a joint venture between Max India Ltd. and New York Life Fortune 100 Company. MNYL, incorporated in 2000, is one of Indias leading private life insurance companies. The Company offers both individual and group life insurance solutions. It has established a wide distribution network across India. Through its wide network of highly competent life insurance agent advisors and flexible product solutions, MNYL is creating a partnership for life with its customers in India to help them meet their life stage needs. Max Healthcare Max Healthcare is the countrys leading comprehensive provider of standardized, seamless and international class healthcare services. It is committed to the highest standards of medical and service excellence, patient care, scientific and medical education. Max Healthcare operates eight facilities in Delhi & NCR, offering services in over 30 medical disciplines. Max Healthcare has an out-patient facility, Max Medcentre and a Speciality centre focused on Eye and Dental care at Panchsheel Park,

secondary care hospitals at Pitampura, Noida and Gurgaon and state of the art tertiary care facilities at Saket, Patparganj in South & East Delhi respectively. The tertiary care hospitals at Saket include Max Super Speciality Hospital (East Block), which is a centre of excellence for Cardiac Care, Minimal Access, Metabolic & Bariatric Surgery and Cancer Care and Max Super Speciality Hospital (West Block), a super speciality facility in Orthopaedics & Joint Replacement, Neurosciences, Paediatrics, Obstetrics & Gynaecology, Aesthetic & Reconstructive Plastic Surgery and Internal Medicine. In addition, it offers services in the disciplines of Urology, ENT, Gastroenterelogy, Nephrology, Dermatology, Mental Health & Behavioural Sciences amongst others. Max Healthcare has consolidated its position in Delhi & NCR this year with the launch of its 9th Facility - Max Super Speciality Hospital in Shalimar Bagh - in November 2011. Max Healthcare extended its footprint in North India by inaugurating 2 new Super-Speciality Facilities in Mohali & Bathinda (in PPP with Govt. of Punjab) in September 2011. Another Facility at Dehradun is on the anvil. Max Healthcare has a base of over 1600 leading doctors, 4300 employees and 13,00,000 patients with number of beds growing to over 1900 in the next two years. Max Neeman MNMI is a Clinical Research services provider offering services across the value chain of new drug development to a growing list of Pharmaceutical, Biotech and Clinical Research clients, in India and abroad. MNMI continues to focus on developing alliances with mid sized pharma and biotech companies to transition their drug development work to India. It has an employee base of 200 and five Regional offices in India & one business development office in USA.

Max Speciality Products MSP specializes in manufacturing of wide range of sophisticated barrier and packaging films. The BOPP division of MSP has an installed capacity of 29,000 tons per annum. MSPs leather finishing foil business division manufactures a range of leather finishing and laminating foils Max Bupa Health Insurance Limited (MBHI), Max Bupa Health Insurance Limited (MBHI),a joint venture between Max India and UK-based Bupa Group. It is on course to start operations in the next 12 months. The Company has put in place its top management team headed by its CEO, Dr. Damien Marmion.

MAX HEALTH CARE

Caring for you... for life

Max Healthcare is India's first truly integrated healthcare system, offering three levels of clinical service (primary, secondary, tertiary) within one system. We believe in the concept of total patient care and deliver care by combining medical and service excellence. Max Healthcare is committed to quality care that not only addresses the illness but also concentrates on the overall wellness of the patients. Salient Features: 1. A team of highly qualified and trained doctors, nurses and patient care personnel to provide the highest standards of care 2. Latest medical equipment and hospital information system 3. Over 1500 leading doctors, 280 corporate clients and a patient base in excess of 8,00,000 4. Clean and comfortable facilities at all locations 5. Fully computerised health records 9

6. 24 hour - Chemist, Ambulance, Patient Diagnostic and Emergency Services 7. Regular educational and health camps to help educate patients on various health issues, so that they make informed choices 8. A complete preventive healthcare programme - MAX 360 and one of its kind 'Platinum preventive health programme' 9. Comprehensive Healthcare System 10. Max Healthcare model visualizes setting up of a world-class healthcare model offering the best medical assistance delivered seamlessly through state-of-theart medical facilities.

Max Healthcare Vision To deliver world class healthcare with a service focus, by creating an institution committed to the highest standards of medical and service excellence, patient care, scientific knowledge and medical education. Excellence in Patient Care:
'Patient Centred Care' is the core of everything we do. Widely acknowledged nationally and internationally for its quality patient care, Max has successfully implemented the "Medical Excellence Model" through its clinical team of expert physicians and nurses who work together in an integrated manner, assessing patient needs, ordering tests, planning treatments, scheduling surgeries, monitoring progress and planning for early discharge to home. The pillars of this model include : Clinical governance Credentialing and clinical privileging of physicians & nurses Use of standardized, evidenced based protocols Patient and Staff Safety Infection control A culture of audit and continuous professional development

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Service Excellence : Our team strives to provide the best medical treatment along with excellent 'in room' hospitality and catering services in a hygienic and air conditioned environment to make the patients experience convenient and comfortable. A well-equipped OPD lounge and cafeteria services are available in all our hospitals to provide world class facilities for the patients. Continuous Improvement : We have a comprehensive performance measurement system for key processes - medical and services. Several process indicators, tracked uniformly across all hospitals, are regularly reviewed against preset targets to identify opportunities for improvement. Apart from this, a Medical Quality Dashboard is placed for monitoring adverse events and clinical outcomes. We have recently developed an innovative, first of its kind "Scorecard" for key Clinical Departments that tracks business, service and clinical outcomes on an integrated platform.

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MHC Trust Building Framework:

Patient Centered Care:

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Committed to provide patient centred care, our team shares values that prioritise patients needs first and provides medical care appropriate for the patient and consistent with the capacity and scope of the organization's mission and services.

Patient Rights
Max Healthcare has defined a set of patient and family rights to provide considerate, respectful care at all times and under all circumstances, with recognition of their personal dignity and autonomy regardless of race, gender, ethnicity, religious beliefs or age. Health Care Right Respectful Treatment Right Privacy Right Confidentiality Right Explanation of Care Self Determination Costs Informed Consent Research Projects Medical Records Safe and Secure Environment Hospital rules and Regulations Concerns, Complaints or Grievances Freedom from Abuse Ethical Consideration

Patient's Responsibilities:
Should provide accurate and complete information concerning present complaints, past medical history, hospitalizations, medications and other matters relating to the patient's health. 13

 Should follow the treatment plan advised by the Physician including the instructions of nurses and other health professionals as they carry out the Physician's orders. Should treat hospital staff and other patients with dignity and respect and not to conduct any activity that will disrupt the work of the hospital. Should respect the privacy of others and the property of the hospital Should not bring alcohol, unauthorized drugs or weapons into the hospital. Should respect that the hospital is a non smoking zone Should follow visiting hours of the hospital Should leave valuables at home and bring only those items necessary during hospital stay Should assure that the financial obligations of Patient's care are fulfilled as per the hospital policy Should be responsible for their own actions if they refuse treatment or their physician's advice

Patient Satisfaction:
Feedback is sought from all patients through a patient satisfaction questionnaire, which is then analyzed. Analyzing the feedback about the patients experience through our 'Total Customer Experience Questionnaire' is our 'moment of truth', which helps us improving the way we care. The current patient satisfaction levels with our medical care and services ranges between 80%-95%

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Quality Improvement Structures:

Awards, Accreditations and Distinctions:

Max Healthcare has achieved several distinctions and awards ISO: Five of the Max hospitals have received the ISO certification. National Accreditation Board for Hospitals and Health Care Organizations (NABH): NABH is an autonomous body established in 2005 under the Quality Council of India for setting benchmarks in Indian healthcare industry. In 2006-07, the tertiary care hospitals of Max Healthcare, Max Devki Devi Heart and Vascular Institute (MDDHVI) and Max Super-Specialty Hospital (MSSH) became the first two hospitals of North India to receive the prestigious NABH accreditation. National Accreditation Board for Laboratories (NABL): In 2006-07, Max Healthcare acquired the NABL accreditation for its laboratory at MSSH. NABH standards for Blood Bank Accreditation: Our Blood Bank in Saket is among the first few in the country to receive this Accreditation in Feb 2009, which is aimed specifically to accredit excellence and safety in management of Blood Banks. Our Blood Bank at Max Balaji Hospital PPG also received NABH accreditation recently.

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Average Length Of Stay: The average length of stay (ALOS) is calculated by adding up the lengths of stay of all admitted patients in the hospital and dividing this by total number of discharges. Our clinical teams emphasize on early discharge, and attempts are made to reduce the lengths of stay, wherever possible. With available technology, minimally invasive procedures, day care treatments, and focus on lower complication rates, there is an opportunity to keep the average length of stay at the lower side. Admission and discharge criteria for critical care patients, guiding the decisions about stay in ICUs are beneficial for the patients as well as for the organization. It is important to mention that all patients can not have a low length of stay, as their hospitalization may be longer, based on severity of illness, and recovery depends on many inherent factors. The data presented below, is an average of short as well as longer stays. This can also change depending on case mix and type of illnesses being treated at each hospital. Monitoring and focusing on the length of stay is an important way of reviewing efficiencies and helps in planning activities.

Patient Safety The hospital environment, one of the most complex environments in the world, is dependent on people, equipment and technology. There are several processes that come together or follow one after another, during the patients stay in the hospital. This inherent complexity, also poses safety problems. The organization strives to provide a culture of safety, transparency and accountability towards patient care. To prioritise the safety and quality of care for each of its patients, Max Healthcare has implemented internationally recommended protocols, and provides extensive training on an ongoing manner to minimize the risks of adverse events. Clinical Audits and corrective and preventive actions for continuous improvement drive the philosophy of the organization. Coordinating Critical Patient Safety improvements Each hospital has enthusiastic leaders working relentlessly to identify opportunities for improving all aspects of patient safety. The goals were selected based on the World Health Organization's recommendations, as well as on internally identified areas for improvement. Culture of safety The organization has successfully established a culture of safety. Staffs participate in identifying and reporting adverse events during care. To learn and strengthen safe practices projects like Root Cause Analysis, Audits and Six Sigma projects drive improvements. This culture of teamwork, accountability and transparency decreases the adverse events at Max.

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Prevention of Infections
Patients are at particular risk of developing infections. At Max Healthcare, we have instituted best practices to minimize the risk of patients developing infections. Standard operating procedures and protocols are implemented as part of our infection prevention program. All staffs undergo intensive trainings on the protocols. Hand Hygiene Cleaning, disinfection and sterilization Use of Gloves/gowns/shoe covers/masks and caps (personal protective wear) Bio Medical Waste Handling Monitoring and evaluation

CHAIRMENS MESSAGE

I am pleased to introduce you to the world of the Max India Group. We reinvented ourselves as a Group in 2000. From being a manufacturing business, we transformed ourselves into a service sector enterprise and entered into what I call 'The Business of Life'. Today, we stand as a multi-business corporate, driven by the spirit of enterprise and focus on people and service oriented businesses. We 'Protect Life' through our Life Insurance subsidiary Max New York Life, a joint venture between Max India and New York Life, a Fortune 100 company; 'Care for Life' through our Healthcare company, Max Healthcare, a subsidiary of Max India Limited; 'Enhance Life' through our Health Insurance company, Max Bupa Health Insurance, a joint venture between Max India and Bupa Finance Plc., UK which is set to launch in 2009; and 'Improve Life' through our Clinical Research business, Max Neeman, a fully owned subsidiary of Max India Limited. From its past, Max India continues its interest in Speciality Products manufacturing for the packaging industry. As a Group today, we have manpower strength of over 80,000 people and we serve over 3 million customers. We are actively involved in social service through our Max India Foundation. Committed to fostering an inclusive society, Max India Foundation spearheads the CSR initiatives of all Group companies and also partners with several reputable NGOs. Max Healthcare is an active partner of Max India Foundation in its activities. 19

Max Healthcare commenced operations in 2001 and is India's first provider of comprehensive, seamlessly integrated, world-class healthcare services. It is primarily focused on the National Capital Region (NCR) of Delhi, and is well known on its way to become the region's key healthcare provider in the private sector. We are also expanding our reach in North India and will open a hospital in Dehradun in 2009. Our vision is to deliver world-class healthcare with a service focus by creating an institution committed to the highest standards of medical & service excellence, patient care, scientific knowledge and medical education. We have set ourselves the mission of creating unparalleled standards of medical & service outcomes. Our aim is to be a care provider of first choice, be the principal choice for physicians, and be committed to follow ethical practices. 'Caring for you... for life' is what Max Healthcare is here for.

OUR PASSION:

Our passion To deliver International Class healthcare with a total service focus, by creating an institution committed to the highest standards of medical & service excellence, patient care, scientific knowledge and medical education. The Logo Story The cross is the accepted symbol for Healthcare the world over. The hands that you see within it are inspired by Michaelangelo's famous painting on the roof of the Sistine Chapel showing the birth of Adam. In this work, which has endured for centuries, God 20

bestows the gift of life on mankind through his touch, a truly fitting symbol for a group that endeavours to enhance the quality of life through healing and care. The healthcare green that we have finally chosen is fresh, close to nature and symbolic of life. We hope to use this colour to differentiate all our healthcare properties. ANALJIT SINGH

MAX HOSPITALS
Max Healthcare strives to be an admired healthcare company committed to: providing world-class patient care through medical and service excellence enhancement of knowledge of clinicians and our employees continual improvement complying with statutory regulations Max Medcentre, Panchsheel Park; Max Speciality Clinic, Panchsheel Park; Max Super Speciality Hospital, Patparganj; Max Hospital, Pitampura; Max Hospital, Noida and Max Super Speciality Hospital (A unit of Devki Devi Foundation), Saket have been awarded the prestigious ISO 9001:2000 certification. Max Speciality Centre - Panchsheel Park Max Hospital Gurgaon

Max Super Speciality Hospital, Shalimar Bagh

Max Super Speciality Hospital, Mohali

Max Super Speciality Hospital, Bathinda

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CARE PROGRAMMES:
Max Care Programmes are developed to ensure that you are completely relaxed when it comes to your health. Our programmes include, a. Healthy Neighbourhood Programme - Max Healthy Neighbourhood Programme is here to create a healthy environment through regular health check-up, camps, special offers and health related talks in your colonies. b. Max Happy Family - Max Happy Family (MHF) plan allows you to choose an Out Patient (OP) plan based on the needs and size of your family. c. Home Care Programme - Max Home Care Programme is an integrated, best-inclass medical services programme delivered at home d. NURTURE - Max Antenatal Programme is a beautifully designed programme to make the expectant moms feel confident about pregnancy, childbirth and early parenthood. The programme will help them to effectively cope with the changes in their personal, professional, social life and make the everyday life activities easy during pregnancy and postpartum. The programme focuses at making pregnancy a fun filled and a memorable journey. Expect Life, Life Expect. e. School Programme - Recognising that children's thoughts, behaviours and needs are different from those of adults Max organizes different comprehensive programmes specifically meant for school children. f. Corporate Programme - Max Healthcare Corporate Programmes help and support professional individuals to improve their performance and problem solving abilities leading to a better relationship with their organisation.

MEDICAL EDUCATION &RESEARCH

Max Institute of Medical Excellence (MIME) has established to meet Max Healthcare's vision for providing the highest quality of patient care, to establish a center of excellence in training and education. GOALS: A central education and training resource that will meet and enhance the training needs of all medical staff working in Max Healthcare, as well as of the external healthcare community. To provide leadership in all areas of healthcare education for Doctors, nurses & Paramedics; Clinical skills enhancement, continuing education, training, management education, patient education and community education. 22

To enhance the reputation of Max Healthcare as a place to learn and to work. To ensure All MHC healthcare professionals have the skills and knowledge they need to deliver the best possible patient care. To support the future expansion of clinical services. To enhance research and development activities within Max.

MISSIONS: To identify the core skills and competencies required to deliver high quality care. To develop the core skills and confidence of all Max professionals Conduct advanced courses for medical, nursing and paramedical personnel Develop leaders/mentors/teachers from existing talent. Establish a state of the art Clinical Skills Lab Provide outreach training to the various Max Hospitals/external community To provide systematic, fair and convenient access for education and training. To embrace modern technology in delivering education across the Organization, networking with education providers and exploiting the opportunities of e-learning and the 'virtual' classroom. Negotiate with accredited Universities for recognition of the various courses as applicable

MANAGEMENT TEAM: Dr. Talat Halim Director:- Emergency and Trauma Services and Post Graduate Medical Education. Max Healthcare Institute Limited OUR DEPARTMENTS: Max Healthcare's network is designed to serve the entire gamut of medical needs of the nation and beyond, through a network of specialised healthcare facilities across Delhi, Noida and Gurgaon. The aim is to provide the patient with easily accessible, comprehensive and consistent quality healthcare, with a special focus on patient care. Hence we have a number of specialised centres of excellence to help us achieve this task. o Department of Cardiac Surgery 23

o Max Cancer Centre o Department of Minimal Access Surgery o Department of Bariatric and Metabolic Surgery o Max Institute of Neurosciences o Max Institute of Orthopaedics & Joint Replacement Surgery o Max Institute of Obstetrics and Gynaecology o Max Institute of Paediatrics o Max Institute of Aesthetic & Reconstructive Surgery o Max Eye Care o Max Dental Care o Department of Endocrinology, Diabetes and Obesity o Department of ENT o Department of Mental Health & Behavioural Sciences o Department of Physiotherapy and Rehabilitation o Department of Nuclear Medicine o Department of Lab Medicine & Transfusion Services o Department of Nutrition & Dietetics o Allied Specialities o Department of cardiology

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ATTRITION INTRODUCTION

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ATTRITION INTRODUCTION:
DEFINITION: Attrition is a Human Resources Management term that describes the rate at which a workforce is gradually reduced due to employees leaving a firm through normal means such as retirement, resignation and death. Contrary to forced labor reductions (firing, mass layoffs). Reduction or decrease in numbers, size, or strength Wearing down or weakening of resistance, especially as a result of continuous pressure or harassment Gradual reduction in work force without firing of personnel, as when workers resign or retire and are not replaced. If employees are to be products, their shelf-lives are getting shorter

In the best of worlds, employees would love their jobs, like their coworkers, work hard for their employers, get paid well for their work, have ample chances for advancement, and flexible schedules so they could attend to personal or family needs when necessary. And never leave. But then there's the real world. And in the real world, employees, do leave, either because they want more money, hate the working conditions, hate their coworkers, want a change, or because their spouse gets a dream job in another state. So, what does that entire turnover cost? And what employees are likely to have the highest turnover? Who is likely to stay the longest? Defining Attrition: "A reduction in the number of employees through retirement, resignation or death" Defining Attrition rate: "the rate of shrinkage in size or number" Attrition is beginning to significantly affect offshore ROI. Just as businesses faced a scarcity of talented IT resources during the dotcom era, organizations in offshore countries such as India are experiencing similar pains. Skilled employees are hopping from job to job and taking with them the customer knowledge and technical expertise that any company needs. Their salaries are increasing, along with their perks, benefits, and bonuses. Defining the attrition problem: Global outsourcing and the astounding amount of foreign direct investment pouring into China, Russia, and India have created tremendous opportunities and competition for talented IT professionals in those countries. The downside of this increased competition is a rising rate of attrition, particularly in India. 27

FACTORS AFFECTING ATTRITION AND STRATEGIES OF RETENTION

Why Do People leave Jobs? There are various factors that affect an individuals decision to leave a job. While an employees leaving the job is considered attrition by one organization, it is looked at as talent acquisition by the new organization and to the individual it means a career move, economic growth and enhanced quality of life/convenience or closeness to family etc. Hence, what is a problem for one may be an opportunity for another. This short note examines the key reasons for attrition and explores what enhances retention as well as outlines some of the factors that can control attrition. It also touches up those factors that are beyond ones control.

Factors Affecting Attrition and Retention

There are various reasons why people leave their current job. These reasons may vary from individual to individual and when data are collected from a large number of individuals leaving or who have left an organization, some consistencies may be observed-providing more insights as to why people leave in large numbers. If these are controllable-one attempts to control. If these are not within the control of the organization, the organization should prepare itself for managing attrition. Managing attrition does not mean reducing attrition only. It could also mean bringing down the negative affects of attrition and increasing the positive affects of attrition. To increase the positive effects of attrition and reduce the negative affects, appropriate retention and capacity utilization or talent utilization tactics should be used. In one of the organizations, attrition has been used as brand building opportunity. Thus an organization may say that we provide talent for other companies or they may say that if you join us your brand value goes up and you get good jobs etc.

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Today when a person leaves it causes a lot of disturbances in the organization. If it is a small organization the disturbance is even greater. Hence it is important to understand and manage attrition. There can be various reasons for people leaving their current jobs. Some of these include:

FACTORSAFFE AFFEFACTORS FACTORSAFFECTING AFFECTING FACTORS ATTRITIONAND ANDSTRATEGIES STRATEGIESOF OF ATTRITION RETENTION RETENTION
INDIVIDUAL ORGANISATIONAL Why Do People leave Jobs? Why Do People leave Jobs? OTHERS

Thereare arevarious variousfactors factorsthat thataffect affectan anindividuals individuals There decisionto toleave leavea ajob. job.While Whilean anemployees employeesleaving leaving Role Related decision Ambitions/Career the job considered attrition by one organization, Culture the job isis considered attrition by one organization, itit isis aspirations looked at as talent acquisition by the new organization Growth and looked at as talent acquisition by the new organization Parental/Family No it challenge and to the individual means a career careermove, paths mobility and to the individual it means a career move, No learning economic growth and enhanced quality of Pay packets economic growth and enhanced quality of Personality factors Style of boss life/convenience or or closeness closeness to family family etc. etc. Hence, Hence, life/convenience to Role clarity whatisisa aproblem problemfor forone onemay may bean anopportunity opportunityfor for what be Role stress another. another.
Lack of independence

Peer pressure Environment

Thisshort shortnote noteexamines examinesthe thekey keyreasons reasonsfor forattrition attrition This and explores explores what what enhances enhances retention retention as as well well as as and outlines some of the factors that can control attrition. Ambitions or outlines Career Aspirations : It is but natural in a growing society and growing some of the factors that can control attrition. ItIt also touches up those factors that are beyond ones economy that employees at all build their career. There are economic also touches up levels those aspire factorstothat are beyond ones control. aspirations, professional control. aspirations, family aspirations and all kinds of aspirations and ambitions that affect a persons desire to move. It is rare not to have such career Factors Affecting Attrition and Retention aspirations. In Factors the past, organizations grew at Retention a pace and stability and individuals Affecting Attrition and mostly saw their career in the current organization and stuck to the same. Now a days There are various various reasons why people leave their their either organizations dont grow at reasons the pace why at which the leave individual career aspirations There are people current job. These reasons may vary from individual to grow or othercurrent organizations grow at amay pace that matches the to individual causing job. These reasons vary from individual individual and when data are collected from a large individuals to individual move. When treat all are the collected world as from a large space for growth and andyou when data a large number of individuals leaving or who have left an with the rest of building a career, it is futile for any organization to who all the timeleft compete number of individuals leaving or have an organization, some consistencies consistencies may be be observedthe world and try to provide careers for all the employees atobservedthe same pace at which the organization, some may providing more insightsas asto toin why people leave in It is better to entire world or the best more of the insights organizations thepeople world leave is moving. providing why in largenumbers. numbers. these arecontrollable-one controllable-one attempts appreciate the large growth and mobility andare movement of the mind and take attrition as a IfIfthese attempts to control. If these are not within the control of the to control. If these are not within the control of the organization, the organization should prepare itself for 29 should organization, the organization prepare itself for managing attrition. managing attrition. Managingattrition attritiondoes doesnot notmean meanreducing reducingattrition attrition Managing

affectsof ofattrition attritionand andincreasing increasingthe thepositive positiveaffects affects affects of attrition.To To increase the positive effects of attrition of attrition. increase the positive effects of attrition andreduce reducethe thenegative negativeaffects, affects,appropriate appropriateretention retention and and capacity capacity utilization utilization or or talent talent utilization utilization tactics tactics and shouldbe beused. used.In Inone oneof ofthe theorganizations, organizations,attrition attrition should natural phenomenon than to be agitated about it and have sleepless nights. However, if hasbeen beenused usedas asbrand brandbuilding buildingopportunity. opportunity.Thus Thusan an has the organizationorganization can do something to create new opportunities, that meet the growing maysay say thatwe we provide talentfor forother other organization may that provide talent aspirations of competent people, it should certainly be attempted. companiesor orthey theymay may saythat that you join usyour your However, such companies say ififyou join us attempts requirebrand correct diagnosis of and the situation. value goes up you get good jobs etc. brand value goes up and you get good jobs etc. Comparisons and Equity Considerations: Comparisons Today when person leaves leaves causes awith a lot lotpeers of or classmates Today when a a person itit causes of from the same disturbances college, batch, organization, first job, city, etc. there are in age thegroup, organization. small disturbances in the organization. IfIf itit isis a a small numerous dimensions on which similarities can greater. be picked upit and compared. organization thedisturbance disturbance even Hence organization the isiseven greater. Hence it Individuals today are flooded with such comparisons. Business magazines, is important to understand and manage attrition. There is important to understand and manage attrition. There compensation surveys by consultants and MNC companies have only aggravated this can be various reasons for people leaving their current can be various reasons for people leaving their current situation and enhanced jobs. comparisons. Organizations in their zeal to compete with one jobs. another in the market places commission such compensation surveys and further fuel Some of these include: Some of these include: the situation instead of controlling it. Unfortunately some of these organizations have to CTING ATTRITION CTING ATTRITION suffer the consequence of what they have created in their hay days. Parental and family mobility; Some times the desire to be with the closed ones also pushes the person to move. Although we have largely moved away from the joint family concept, there are still strong affiliations and affections. Need for being close with the family, spouse, children, parents etc. at different stages of ones life to fulfill different types of affiliation needs prompt a few people to leave their jobs and move from one city to another. Personality factors: Some people have a high need for variety. They get bored and fatigued easily. They need to change their job or what they are doing at periodic intervals. Other wise they are restless and create morale problems with others working with them. They waste others time discussing organizational politics and polluting the atmosphere. Some people are constantly searching and seeking. They are highly ambitious and restless. They are highly achievement driven and want to achieve new heights in the shortest time. They have either been socialized so or fulfill their own power or other motives. Some may have a different motivation or value profile which may not be matched by the current job or the company and hence the decision to leave.

Job related factors: The job related factors that cause the decision to leave are many these include the following: 1. Inability to use ones competencies 2. Lack of challenge 3. Boss and his styles 30

4. 5. 6. 7. 8. 9.

Lack of scope for growth in terms of position salary, status and other factors Role clarity Job Stress or role stress or role stagnation Lack of independence or freedom and autonomy Lack of learning opportunities Lack of excitement and innovation, novelty etc. in the job

These factors may be intrinsic and job related or extrinsic and job related or job chemistry related. Intrinsic factors are the factors related to the characteristic of the job. These are in plenty in BPOs where the work conditions (night work, work at odd hours, the nature of clients to deal with, etc) pose difficulties. Extrinsic factors are factors like role clarity, independence and autonomy, bad boss, wrong chemistry of the team, work conditions that can be changed easily, lack of respect shown to the individuals, etc. A large number of the extrinsic factors can be controlled. Economic Factors: this deal with the aspirations in relation to salary and perks, housing, quality of living, need for savings etc. In addition to these there could be many other factors that affect decisions: Mobility of partner Fatigue Family reasons like having to look after old parents Closeness to kith and kin ROI in education

Factors affecting Individual decision to leave: The factors can be classified as the following: 1. 2. 3. 4. 5. Individual related factors Role or job related factors Organization related factors Professional factors Societal factors including Peer pressure factors and socio-economic environment related factors

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Some of the Potential methods of managing retention and employee engagement or skill utilization include the following: First Find the Source of Attrition- where and why? Any method of controlling attrition or increasing retention should be based on a good understanding of the factors leading to attrition. The factors may be some times very simple and could be reveled by an examination of the statistical data. The statistical data could answer simple questions like the following: Where is the attrition occurring? Is it more in males than females? What levels? Is there anything in common among those who leave? Is it related to some disciplines or people from a particular region or linguistic group? Is it more among candidates from certain colleges or institutions? Age groups? Etc. Simple demographic analysis among those who leave could reveal some insights. For example: in one oil Exploration Company such an analysis reveled that attrition is limited to those from the Drilling division and financial services division. Those who left the drilling division were found to be older in age and those who left Finance department younger in age. Those who left the Drilling department left with VRS and got good jobs elsewhere because experienced people are in demand. Those who left the finance department left because the demand for young CAs and financial managers had gone up in the outside environment. In both cases there were push as well as pull factors operating simultaneously. UPS found that they had a lot of attrition amongst its drivers who pick up and deliver the parcel services. They were a very critical part of the organization as they were most familiar with the routes and clients. They then discovered that the drivers job included loading and unloading which they hated. It then became easy for UPS to hire loaders and save the drivers from this work. It reduced the attrition rate remarkably. In one study by the author of an engineering services company the attrition was found to be more among certain section of engineers who faced the stress due to changing technologies and requirements of the company. Until the study was conducted it was assumed that people left because they did not like the style of their manager. The survey revealed that on the contrary employees stayed longer because of the task centered but developmental style of their manager. 32

In another study of a software services company the root cause for attrition was found to be the differential wage structure of the permanent employees as compared to the temporary employees. Temporary employees were paid on an hourly rate at double the amount of hourly rate calculated for permanent employees by dividing the cost to the company by 2000 hours. However they were not properly informed of the amounts spent by the company through various benefits and the outsourcing fee that was paid to the agency. Later the company had to undertake a program to change the CTC structure and also to educate the permanent employees. Once the source/cause of attrition is identified, solving the problem becomes relatively easy. At least the organization can then determine if any internal interventions will help reduce attrition. Some of the possible interventions that could help in enhancing retention are as follows: Compensation, Financial restructuring and New Incentive schemes- including Salary and perks restructuring, ESOPs, PLPs, etc. ILFS introduced a new Performance Linked pay in mid nineties to manage retention at all levels. In this system all employees received a performance linked pay at the end of the year depending on the company performance (financial), departmental performance and individual performance. Combining all the three performance parameters it was possible to get as much as a years salary or more as PLP depending on the financial performance of the company. Introducing small recognition schemes may go a long way. Loyalty pay is a good mechanism of retaining the employee. In the loyalty pay the individual gets his share of the performance linked pay or enhanced incentive pay proportionate to his stay. For example in the ILFS case only a part of the PLP was given at the end of the first year and the remaining part is given proportionately at the end of the second and third years. Organizations use most of the time compensation surveys and hike up the salaries. The tendency to use Golden handcuffs with deferred compensation, investment options etc. are useful. However in a competitive world often they artificially hike up the salaries as the recruiters also work out mechanisms of buying out such handcuffed people at any cost. Hot skills premium is paid by some companies for those who have crucial skills in short supply. They premium can be removed as the skill availability increases or the need goes down.

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ESS and OC interventions: Organizational climate and employee satisfaction surveys help in indicating the factors affecting attrition and help organizations take corrective action. In the case of one manufacturing company a climate survey revealed the lack of schooling facilities, commuting facilities to a nearby town; schooling facilities could improve the tenure of its employees. In another study the technological innovations were found to create tension and resulting is decisions to leave in fresh and junior levels of management. Such climate schemes may indicate small things like organizational communications, social get togethers and celebrations could inculcate a sense of identity and belonging ness and enhance the we feeling and thereby retention. Climate surveys also indicate those aspects of the personnel policies that need to be revamped for enhancing retention. In one company such a survey indicated that too much of differentiation and discrimination between the workmen and officers in terms of the canteen food, leave facilities and other work conditions reduced the resentment to management an enhanced commitment to the company. The attrition was more psychological than physical in this company. Psychological attrition and retirement are particular problems in Indian PSUs. In the development sector CARE India is one such agency that undertakes periodic organizational climate surveys to keep in touch with the large number of employees engaged in development work and use it to restructure its processes and HR polices and retain people. It is interesting to have such a program in an organization where the jobs are contractual. In a development organization it is considered all the more essential to have motivated staff all the time. HRD Audit also gives insights in to the factors that may enhance retention. In one HRD audit it of an electronics company located in Bangalore where the salaries for found technicians was 20 % to 30% more than the market salaries, intention to leave the company were related to lack of career plans of the company. The company did not have any career plans as even the strategic plan was being determined by the Head Office in Europe and year to year targets came through the MD of the company. On the basis of the audit, the MD of the company was able to present his case to the Head office and get a strategic plan prepared and also institute career planning mechanisms. Audits and surveys by them selves are not solutions to the issue. Some times they could raise the hopes of an individual. In any case they are at best diagnostic tools and unless they are followed up in terms visible actions they may also set some amount of cynicism in motion.

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Celebrations and Social and cultural Networks: In some of the surveys and audits with which TVRLS is associated it has been found that employees get a sense of belongingness if the organization encourages some form of social networks, cultural programs, team celebrations. These can be done with very little investments. By encouraging employees to have picnics, social gatherings, celebrations and festivals etc. we encourage some amount of social networking and sense of belonging ness. Tata and Birla group of companies are known for doing these in their own ways. Some of these organizations have created a sense of belongingness through their clubs, cultural forums and group celebrations and activities. When the person and is family feel at home with a company and have developed a social network retention goes up. Loyalty to colleagues can be thus made a significant retention force. New forums and methods need to be thought of to suit the requirements and chemistry of a given group. Thus in one case there may be an investment club, in another Golf Club, and a third cooperative society a fourth a charitable group to assist local community and so on.

Assimilation and Integration Studies have linked the retention capacity of a firm to the induction and assimilation process. The new Economy industry and the need to be competitive require that the person needs to be indicted into the company even before he/she joins it . If the new employee joining at the top level joins the organization with full understanding of the culture, and the role he is supposed to handle a lot of employee turn over can be contained. According to studies in the US while firms go to great lengths to hire new employees, only 20% of them stay two years. Nearly 70% of the newly hired seniors leave within two years .There is only a 50% chance that when some one takes up a new job he will be with the company for more than two years. In a 3 month period in the year 2000 alone 350 CEOs in the US let their jobs. According to a HBR article (2000, issue 78) 80% of a pool of executives changed their jobs within two years. Another study reports that 47% of executives appointed as presidents left within four years. In a study of 359 positions listed in resumes it was found that 68% left their previous jobs within twelve months. (Smart, 1999) Bradford Smart (1999) estimates that the cost of mis-hires are perhaps.. 40 times base cost at top levels. When you consider recruiting, actual compensation expenditures, severance, and additional cost of lost productivity, the time it takes for some one to become productive, business mistakes and missed opportunities etc. Research by 35

Sibson & Co in four high turn over four high turn over industries found that replacement costs have reduced the earnings and stock process by an average of 38%. The estimated cost of replacement has to be multiplied at least three fold for every top leader who does not make it failed or left the origination) Effects of losing a leader ripple through out the organization. Loss affects the organization's competitive position due to leadership vacuum Triggers turnover at other levels Creates loss of developmental and intellectual resources Disrupts and weakens customer relationships Employee turnover has a significant effect on companies bottom-line by inhibiting their ability to keep current customers, acquire new ones, increase productivity, and pursue growth opportunities People dont quit companies. They quit bosses. Numerous studies have indicated the correlation between job satisfaction and direct supervisors and managers. According to new study 41% of high value employees who intend to leave their jobs are dissatisfied with their managers or supervisors. Gallup of 2 million employees form 700 companies indicated that strong links between employee tenure and employee-supervisor relationships. When a new leader joins the team they join three types: Functional team they lead Executive team they collaborate with including the senior leaders Project related cross functional teams When leader turnover is high the working alliances across the organization are not in place long enough to embed any changes that are introduced The purpose of induction and assimilation therefore is to ensure that leaders will adapt and become full contributors in the new organization faster, better and with fewer destabilizing effects to the individual and the organization. A successful assimilation is one in which both the individual and the organization are transformed for the better and are able to leverage each others strengths to achieve mutually beneficial goals. The individual and the organization need to treat together for this purpose. Assimilation of new leaders occurs in four stages: It begins with point of hire and completes when the individual is a full contributor and no longer an outsider. The 36

assimilation journey is a continuous negotiation between the two extremes and they need To be balanced. The balance needs to be between:

Being patient and becoming productive Setting ones own pace versus following organizations pace Trusting intuition versus making data based decisions Pleasing various stake holders versus meeting ones own priorities Implementing change versus respecting the culture of the organization Demonstrating competence versus seeking advice when one needs it Building relationships based on trust versus testing assumptions about others Intervening appropriately versus waiting until you have all information Drawing on the past versus not letting the past bind you Acting with authority versus staying in learning ode Not leading ego versus staying with confidence Making your position clear versus seeking feedback Affiliating with people versus maintaining boundaries

The HR Departments as well as the top management and other line manager have a responsibility to ensure that the managers indicted at the top levels assimilate the culture, role and other things of the company fast and manages the contradictions mentioned above. This will only ensure that the retention is higher and top management recruited newly into the firm give their best and high ROI. Assimilation is both fluid and dynamic. It can be influenced by different factors at different points of time of the organizational life cycle. New leaders are most likely to leave when they lack support they need to their best work. Attrition is usually the result of not being able to contribute what they were hired to make. They are most likely to stay if they feel a deep commitment and affiliation to an organization. Effective assimilation strategy: Acknowledges difficulties of entry into a new organizations Legitimizes and individuals adjustment period

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Builds in multifaceted supporting mechanisms an institutional level (peer support, tips on bridging organizational knowledge, and learning gaps) to asset the new leader through the process

Assimilation savvy organizations should: Focus on assimilation as a tool for retention and leaderships strategy Have a formal system and program of assimilation Use coaches for assimilation Use HR for assimilation process People join an industry that is perceived as leader but stay only if they meet intellectual and emotional needs. Coaching services: With increased competition and scope for career enhancement the world of executives is becoming a busy world. It is a world of work pressures, competition. Organizations pay more and put pressures on employees to perform as they need to get their ROI on CTC. The young manager is busy proving to his company that he can make a difference and serves what he is being paid. There is no time for family and self. This is resulting in increased stress and frustration. The world is becoming some times and for some people most of the time lonely world. In such a situation making available mentors, coaches and guides will go a long way in helping the individuals get the right type of counseling and advice. Such advise with a group of mentors and experienced counselors could go a long way in helping employee get realistic picture of what he is likely to get or dont get from the change he makes. Employee Engagement: The best way to retain is to provide work motivation. Challenge, job satisfaction, treating the employee with significance, being sensitive to his needs, making the organization predictable with systems and practices that are not bent or changed to accommodate any individual at any time etc. may help retention. Using task forces could be constituted to examine the sources of attrition. When employees are adequately engaged and care is taken to see that they enjoy their job ad their families are taken good care of and adequate social and financial security is provided retention goes up on its own. There is no substitute for an engaging company with a secure and protective atmosphere. The engagement should come from challenge. There are many examples of HR practices that have been found to engage employees. Providing periodic training, learning opportunties, freedom and autonomy at the work place, recognition of contributions, supportive boss, recognition of contributions etc. will make a lot of difference in enhancing retention rates. 38

Market Driven Approach: Prudential introduced a building management capability program which integrates recruitment, retention and training efforts. The program is anchored by a sophisticated planning model that enables business managers to develop highly targeted retention programs that create cost-effective contingency plans for filling potential gaps in skills. Prudential has begun to assess how long the organization would like the employees to stay on board. They decide those whom the company wants to have indefinitely, those who should be there for a shorter period and those on whom retention investments dont make any sense. Then they use a number of mechanisms depending on the categories of employees. They tailor the programs for the retention requirements rather than employing them across the board (Cappelli, 2000) Job Design and OB Customization: This method involves assessment of which tasks to be included in what jobs. For example the united parcel service mentioned earlier redesigned the job of drivers by separating the loading job from that of the drivers. Though it increased the turnover of the loaders it decreased the turn over of drivers which are considered an important role. The loaders could be replaced with ease. Designing the jobs for specified periods of time is another way of managing retention. If a person is appointed for a period of three years and the organization is prepared for the same and the employee is also prepared part of the issues resolved. CARE India and many other international NGOs use this approach. In customization programs the employees are given scope to define their job after an assessment of their skills and interests. Key employees might undertake a formal self-assessment of their work and non-work goals and how those goals could best be achieved in the context of company; operations. The assessments would form the basis for individual employment agreements, which might be created using cafeteria-style programs similar to those in allocating employee benefits (Cappelli, 2000 p 107). Change of Styles through 360 Degree Feedback and Internal Customer satisfaction Surveys: Some times the style of manager may be responsible for employees in certain departments to leave. With supportive managers and Head of departments employees think several times before they leave. Some managers may not realize that their coercive style, excessive task centeredness, and the way they assign tasks including the clarity with which they give instructions, respect etc to employees have tremendous impact on their staying with the company. By recognizing the roles they play and the styles they exhibit and seeing the impact they are making senior managers can at least reduce the push factors for attrition. There are several cases of 39

Senior Managers realizing the impact of their style in the 360 degree Feedback programs conducted by TVRLS. Other Methods: Start with recruitment. Dont recruit those people who will be the most difficult to retain. Pay attention to this aspect from recruitment stage itself. Adapt to Attrition. Attrition is the order of the day. Market forces are too strong. Focus on what you can change. Dont focus on what you cant change and lose your sleep. Some times you dont have to recruit all high powered staff. In the olden days some of the business houses did not go to business schools where the graduates are expensive and are job-hoppers. These included a highly rated business schools. They recruited from the less popular business schools and found them to contribute a lot and stay loyal. Simplify and standardize jobs and use multi-skilling to help meet any contingencies. Focus on retaining intellectual capital even when employees leave. Think of appropriate mechanisms and build organizational memories and knowledge systems to retain talent and intellectual capital. Teamwork task forces and standardized systems help. IT support helps. Electronic records of employee knowledge helps in many cases. Cooperate with competitors. Form clubs and associations. Work with local schools and communities and develop a large source of skill base by giving projects and grants to local colleges.

Associated costs with high Attrition: Talent cost It includes the cost of lost knowledge, skills and contacts that the person who is leaving is taking with them out of your door. Recruitment cost o The cost of advertisements; agency costs; employee referral costs; internet posting costs. o Calculate the cost of the manager who has to understand what work remains, and how to cover that work until a replacement is found. 40

o Cost of the various candidate pre-employment tests to help assess candidates' skills, abilities, aptitude, attitude, values and behaviors. Training cost o It includes the cost of orientation in terms of the new person's salary and the cost of the person who conducts the orientation. o It also consists of the training. o Calculate the cost of various training materials needed including company product manuals, computer or other technology equipment used in the delivery of the training. Motivational cost It refers to the cost arises because of motivating the other employees to retain them in the organization in terms of increasing their salary and time. Lost Productivity Costs As the new employee is learning the new job, the company policies and practices, etc. they are not fully productive. Calculating employee attrition: The high attrition rate in the industry has always been the greatest concern, and a subject of much analysis and debate. Organisations use different methodologies for calculating their turnover rate. It is a known fact that turnover calculation is a grey area which does not always depict the true picture. While a few techniques are common, there are no proven theories. Furthermore, the approach to this calculation might vary from organisation to organisation. Disclosure of the figure not only has a direct impact on the business, but also affects employee morale and productivity. Significantly, it might also trigger off a chain reaction-a high attrition rate will lead to more people leaving the organisation, while a lower rate will act as a retention strategy. It is not surprising that most industry observers are skeptical when organizations disclose their employee turnover. A high attrition reflects poorly on an organizations ability to hold on to its people. Unfortunately, attrition is viewed as a management flaw, when in fact; it could well be a recruitment error. In some cases it can be simply seen as an organizations competitor appreciating its quality of hires and the output, post-training-almost a backhanded compliment! Ideally, attrition should be calculated on a monthly basis for companies that have over 50 employees for the first five years of its business. Subsequently, a quarterly index should be applied till a company's 10th anniversary. Post this, annual attrition figures 41

should be measured and accounted for. This is optimal within the services industry as companies tend to have different challenges at different stages of their business lifecycle, and also maturity achieves stability around a company's 10th anniversary.

Formula for Attrition: While different organizations follow different formulae for calculating attrition depending on their size and nature of services, some of the commonly used formulae to calculate attrition are as follows: 1.) Attrition Rate = (No of employees resigned/Average manpower)*100 where, Average Manpower = (Opening Manpower + Closing manpower)/2 (opening/closing manpower could be either the calendar year beginning or financial year beginning whichever followed) 2.) Attrition = employees left * 100 / (opening balance in a month + number of employees joined in a month + number of employees left + no of employees at the end of the month Calculating employee turnover is not a matter of simple mathematical method. It is necessary to take into account the root of the problem, by going back to the hiring stage. Most organizations in practice do not evolve robust measurements for calculating cost of a bad hire or labor turnover. The detail of information required and the measurement metrics are not common formulae, but have to be designed dependent on the nature of business and function. As a result most organizations do not intend to mislead by disclosing statistics which may not be true, it is just that perhaps they believe those to be true. Organizations will however know what their real attrition figures are as this has a huge impact on business. Like with most data, attrition too can be interpreted in different ways and it is up to each organization how and what they wish to share. Organisations are generally much concerned about regretted voluntary attrition. These are people who leave at their own will and those whom the organisation would have loved to retain. Similarly, organizations measure managed attrition. These are people made redundant, laid off or exited. Though managed attrition is non-regretted by the organisation, the trend of managed attrition if on the higher side may show the organisation in poor light and does have an impact on the organizations health. Attrition does not only reflect the hiring policies of an organisation, but also induction and retention strategies, training methodologies, work culture and many other factors. It costs the company valuable time, money and often credibility (especially where employees develop relationships with customers). Some companies just look at the employee turnover in terms of the cost involved in the hiring and training of the individuals. While others look at the opportunity lost and cost. Organisations aim to reduce voluntary attrition of productive employees and encourage unproductive staff to leave its fold. It makes way for career progression, new thinking and innovation. 42

The Brighter Side of Attrition: Some employee turnover positively benefits organizations. This happens whenever a poor performer is replaced by a more effective employee, and can happen when a senior retirement allows the promotion or acquisition of welcome 'fresh blood'. Moderate levels of staff turnover can also help to reduce staff costs in organizations where business levels are unpredictable month on month. In such situations when business is slack it is straightforward to hold off filling recently created vacancies for some weeks. A poor performer is replaced by a more effective employee A senior retirement allows the promotion or acquisition of welcome 'fresh blood'. When business is slack it is straight forward to hold off filling recently created vacancies for some weeks.

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ATTRITION IN HOSPITALS

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ATTRITION IN HOSPITALS:

As the Indian healthcare industry experiences the exponential growth ,hospital organizations are shifting their focus from 'survival' to excellence. Especially, in the metropolitans one can see that hospitals are striving to be leaders in the market rather than just survivors. As a result, need for excellent manpower is now indispensable. Hence, with lucrative offers at each employee's disposal, attrition is bound to happen. In addition to this, there is a big demand and supply gap in the healthcare manpower available. In its 2009 report, a leading business magazine mentioned that by 2012 there will be shortage of 5,00,000 doctors and 10,00,000 nurses alone in India, whereas Indian medical education capacity is 31,000 per year.

No wonder that the cost of manpower resources is increasing by each day. Companies are literally bidding for good talent and attracting them with tempting salaries and designations. Undoubtedly, for any HR in the healthcare industry, retaining its employees is the need of the hour.

A Matter of Concern: Healthcare is witnessing the same exponential growth that IT and BPO industry faced some years back. Needless to say, the sector has also inherited the problem of attrition that still plagues the IT and BPO industry. "Attrition is pretty high in the industry these days. For instance, the attrition rate in Max Healthcare is 34-36 per cent. I would not call it critical but definitely important enough to be addressed," shares Surajit Banerjee, Director HR, Max Healthcare, Delhi. 45

With attrition, the organisation loses key skills, knowledge and business relationships. Shares Somnath Chakravorty, CEO, GM Modi Hospital, Delhi, "Whenever a well-trained and well-adapted employee leaves any organisation, it creates a void that is tough to fill."

To find a substitute is always a key challenge in this case. He adds that recruiting and training programmes for employees is an expensive affair. The company has to invest a lot while recruiting an employee. But the situation gets worse when attrition happens at a key skill position, as there is already a scarcity of such resources in the market. So how does one deal with such a situation? "Though it is a challenging phase, one has to be prepared well in advance. Either one hires a well-trained person on a higher salary or hire someone at the lower salary," Banerjee suggests.

Attrition amongst Nurses: Attrition rates among nurses were the highest because of their high demand in foreign countries. There has been a faster rate of nurses leaving the country, over the last couple of years, for jobs in the UK or the US. India churns out the highest number of trained nurses in the world and mature nursing professionals are opting out of the system and following growth opportunities. According to the healthcare industry analysts, the list of countries choosing from India's pool of trained nurses is growing from the traditional 'Gulf Region' or West Asia, to the UK, the US and even Africa.

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Ankush Gupta, Senior Manager-HR, Hinduja Hospital, says, "The attrition rates have increased in the last decade. We have always been the exporter of medical and nursing talent worldwide and now the extra thrust on healthcare development in Middle East and African region will further fuel it." There is definitely a shortage of nurses in the country, particularly 'specialised nurses'. The demand from other countries is recognition of the skills of Indian nurses. However, there are not too many courses for specialised training to deal with emergency situations.

According to industry estimates, the current day requirement is for about 10.3 lakh nurses. At present, there are roughly nine lakh nurses registered with various nursing councils in India. Thousands have already migrated to greener pastures overseas. There are thousands more waiting in the pipeline, signed up with commercial chains that facilitate migration of nurses. In fact, there is a boom in the number of agencies helping nurses find jobs overseas. An Indian nurse can expect to earn anything between $40,000 and $60,000 for a staff job in these countries. A nursing supervisor can earn around $80,000. And with overtime, they can add another 20,000 to 30,000 dollars to their salary. Not surprisingly, nurses are flocking to foreign countries.

The high attrition levels are also because there is limited upside to nursing as a career. While doctors are paid well in private hospitals, than in a Government institution, the case is reversed for nurses, who are better looked after in public hospitals. The present shortage may not yet be crippling large hospitals in big cities, but is mainly felt in small towns or rural areas. Because of the acute shortage, many hospitals are today hiring unregistered nurses to cope with their basic needs. Also, poaching of staff from other hospitals has become rampant. The constant churn in nursing staff inevitably means a huge monetary drain for hospitals which have to constantly plough in more funds for training. 47

Multiple Reasons: Though many HR experts believe that people leave mostly for money; a significant factor is that most people leave because of their bosses. To put it simply, they do not gel well with their bosses. "Time and again most studies have proved that employees never leave the company, they leave their bosses. An inefficient boss creates poor work culture, which is one of the frequent reasons for quitting," shares Banerjee. In addition, attrition also happens when people hate their working conditions, do not like their team-mates or perhaps do not like what they are doing. There are also cases when people leave their job for family reasons or when they wish to migrate. For example, girls often leave their jobs when they get married and shift to another city. It is common to hear 'the organisational work culture is not good so, I can't work.' Well, it is the organisational culture which determines who stays and who goes. The culture of an organisation is determined by the quality of the relationship between bosses and their sub-ordinates.

Employers often fail to understand the importance of providing opportunities for development of their employees or their career growth. "Hospitals have limitations in providing a robust career progression plan. Also, salaries peak out within the system because various reasons like collaterals at the same level of hierarchy etc," opines Gupta. The cumulative average growth rate that an employee gets does not help him/her to meet the ends and then they start looking out.

A conducive working atmosphere, good culture, training and career growth with adequate salary are some provisions that control attrition. Banerjee asserts that communication is given a lot of importance at Max Healthcare. Moreover a lot of medical services-mainly OPD-is provided to employees (to an extent, free). He adds that people who leave Max Healthcare want to join back.

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Banerjee points that she has also seen a trend of employees leaving for other organisation just to experience another work place.

Also, many people leave because they come with certain aspirations to a hospital and when these aspirations fail, employees quit.

The maximum attrition takes place at middle level management as these are the people who hit the growth ceiling in a very short span of time and find that further growth in the system would be very slow. Also, when the new facilities find it difficult to get talent who has exposure to hospital industry, they attract them with better offers.

For an organisation, the key lies in understanding and fulfilling those aspirations. Chakravorty adds that the organisation is viewed as a place where employees meet their aspirations of growth and development, values of trust, teamwork and transparency. If a company respects them and their skills, realise their potential and provide them with a healthy environment to learn and grow with flexible compensation, employees take that as a strong reason to stay on. To tackle the problem of growth, Chokravorty points out that the growth career path should also be spelt out clearly and employees must be made aware of those processes and growth path that they can expect. He adds that processes should be clearly defined. If there is a discrepancy, then the individual should be able to question it. He opines that there should be a focus on areas like training, career development and believes in equipping workforce better on the professional front.

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RETENTION INTRODUCTION

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RETENTION:
Definition: Retention is the process of ensuring that your members or volunteers remain active with your organization. Retention is not a particularly formal process. Instead, it focuses on maintaining a welcome environment, member morale, and organizational progress. HISTORY: The term employee retention first began to appear with regularity on the business scene in the 1970s and early 80s. Until then, during the early and mid-1900s, the essence of the relationship between employer and employee had been (by and large) a statement of the status quo: You come work for me, do a good job, and, so long as economic conditions allow, I will continue to employ you. It was not unusual for people who entered the job market as late as the 1950s and 60s to remain with one employer for a very long timesometimes for the duration of their working life. If they changed jobs, it was usually a major career and life decision, and someone who made many and frequent job changes was seen as somewhat out of the ordinary. As a natural result of this status quo employer-employee relationship, an employee leaving his or her job voluntarily was seen as an aberration, something that shouldnt really have happened. After all, the essence of status quo is just that little or nothing should change in the relationshipand leaving was a pretty big change! What is Employee Retention Today? According to The HR Priorities Survey from ORC Worldwide an HR consulting and data services firm, nearly 62 percent of respondents to their survey opined that talent management will be the most pressing strategic issue they face in year. The findings of the survey also indicated that 33 percent of talent management programs include workforce acquisition, assessment, development, and retention as areas that will consume most of the survey respondents' time this year 2007 (see Anonymous, 2007). Retention has emerged as the focus of much time and attention in recent years, particularly as part of talent management programs, and so much is known about it that the HR practitioner who tries to integrate it into a talent program may grow bewildered by the huge volume of research about it Employee retention is more than just keeping employees on the job. It is also about sustaining employees, primarily by enhancing their job satisfaction. Job satisfaction, in turn, can increase productivity and keep employees energized and motivated to give their best. Job satisfaction can equate to employees who stick with their current employer and strive to perform at or above expectations and standards.Employee retention is commonly considered to mean the ability to maintain a stable workforce. It is often linked to morale and to organizational productivity. Retention is thus the opposite of turnover , a well-known concept. In addition the perception of having a job for life in a public sector role no longer exists. The trend for the younger generation of workers is to shift from job to job and this is becoming a norm of society. Companies that can recruit the best talent and retain them will have an edge in the long run. 51

Today talented persons are like frogs in a wheelbarrow, which can jump at any point of time when they sense opportunities

Need & Importance of Employee Retention

Let us understand why retaining a valuable employee is essential for an organization. Hiring is not an easy process: The HR Professional shortlists few individuals from a large pool of talent, conducts preliminary interviews and eventually forwards it to the respective line managers who further grill them to judge whether they are fit for the organization or not. Recruiting the right candidate is a time consuming process. An organization invests time and money in grooming an individual and make him ready to work and understand the corporate culture: A new joinee is completely raw and the management really has to work hard to train him for his overall development. It is a complete wastage of time and money when an individual leaves an organization all of a sudden. The HR has to start the recruitment process all over again for the same vacancy; a mere duplication of work. Finding a right employee for an organization is a tedious job and all efforts simply go waste when the employee leaves. When an individual resigns from his present organization, it is more likely that he would join the competitors: In such cases, employees tend to take all the strategies, policies from the current organization to the new one. Individuals take all the important data, information and statistics to their new organization and in some cases even leak the secrets of the previous organization. To avoid such cases, it is essential that the new joinee is made to sign a document which stops him from passing on any information even if he leaves the organization. Strict policy should be made which prevents the employees to join the competitors. This is an effective way to retain the employees. The employees working for a longer period of time are more familiar with the companys policies, guidelines and thus they adjust better: They perform better than individuals who change jobs frequently. Employees who spend a considerable time in an organization know the organization in and out and thus are in a position to contribute effectively. Every individual needs time to adjust with others: One needs time to know his team members well, be friendly with them and eventually trust them. Organizations are always benefited when the employees are compatible with each other and discuss things among themselves to come out with something beneficial for all. When a new individual replaces an existing employee, adjustment problems crop up. Individuals find it really difficult to establish a comfort level with the other person. After striking a rapport with an existing employee, it is a challenge for the employees to adjust with 52

someone new and most importantly trust him. It is a human tendency to compare a new joinee with the previous employees and always find faults in him. It has been observed that individuals sticking to an organization for a longer span are more loyal towards the management and the organization: They enjoy all kinds of benefits from the organization and as a result are more attached to it. They hardly badmouth their organization and always think in favour of the management. For them the organization comes first and all other things later. It is essential for the organization to retain the valuable employees showing potential: Every organization needs hardworking and talented employees who can really come out with something creative and different. No organization can survive if all the top performers quit. It is essential for the organization to retain those employees who really work hard and are indispensable for the system. The management must understand the difference between a valuable employee and an employee who doesnt contribute much to the organization. Sincere efforts must be made to encourage the employees so that they stay happy in the current organization and do not look for a change.

TWENTY RETENTION TOOLS FOR CURBING ATTRITION

In today's scenario ATTRITION has become the most dangerous alarm to all HR employees' ears and Organization is facing troubles to fight it out. Suggested Retention Tools for curbing attrition to a great extent are submitted herewith. These need not be brainstormed and implementation strategy should be worked out immediately. 1. OFFER COMPENSATION ATTRACTIVE AND COMPETITIVE: Fair compensation alone does not guarantee employee loyalty, but offering below-market salaries makes it much more likely that employees will look for greener pastures. Use of Industry Surveys and other data tools to stay informed on wage trends. To benefit both company and employees, tie increased one time performance pay to meeting specific goals aligned with business objectives. Collect data from exit interviews to document trends from your departing employees, and then use this data to make a business case for increasing salaries across the board. Go for Employee Engagement Surveys / ESS, to find out what perks, benefits and forms of compensation other than money will help keep them motivated.

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Let employees decide their own compensation package / reimbursements once the quantum is fixed.

2. BENEFITS NEED TO BE QUANTIFIED AND QUALITATIVE: Although benefits are not a key reason why employees stick with a company, the benefits you offer can't be markedly worse than those offered by your competitors and like minded industries. Group Medi-claim Insurance Scheme and Personal Health Care (Regular medical check-ups) Corporate Credit Cards and Discount Coupons Cellular Phone / Laptop and other latest technology on-board Interest free loans for higher educations Performance based quarterly incentives Flexi-time and Flexible Salary Benefits Wedding Day and Birthday Gift

3. TRAIN YOUR FRONT-LINE, MANAGERS AND ADMINISTRATORS: It can't be said repeatedly that people stay or leave because of their bosses and not the companies. Make sure your managers aren't driving technologists away. Harp upon the competencies and substantially invest in human capital irrespective of ROI. Improve managers' leadership, communication and interpersonal skills through coaching, training and feedback. Rate these key skills in their evaluations, and tie compensation to performance. Create a safe environment and process for employees to bring up concerns with their managers. In Whirlpool Appliances , there are highly selective leadership development mentor programs. Managers selected to participate as mentors go through a rigorous selection process and are then monitored closely to ensure that only managers who consistently produce results remain in the program.

4. ROLES AND RESPONSIBILITIES NEEDS TO BE DOVETAILED: Make sure your employees know what is expected of them every day, every month and every year, what types of decisions they are allowed to make on their own, and to whom they are supposed to report.

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Provide clear vision, brawny and consistent communication, teamwork and respect for human capital' efforts. Share the company vision/mission clearly and regularly. Collaborate, communicate and listen. Contented employees achieve amazing things.

6. OFFER RETENTION BONUS: Employee longevity typically is rewarded with an annual raise and mandatory vacation time after three, five or ten years. But why not offer other seniority-based rewards such as a paid membership in the employee's professional association after one year, a paid membership to a local gymnasium and clubs after two years, and full reimbursement for the cost of the employee's formal dress. Build a high degree of recognition value into every reward you offer. Reduce entitlements and link as many rewards as possible to performance. Troubleshoot your reward system to make sure that what it is rewarding is what you really want to happen. Give employees a choice of rewards. Increase the longevity of your rewards

7. RETENTION STRATEGIES IMPLEMENTATION NEEDS TO HAVE A PROCESS OWNER: Measure your turnover rate and identify a process owner responsible for containing it. If customer returns, in-house rejections and nonconfirming products can have a process owner as a countermeasure why not a process owner for implementation of retention strategies? Think better, think bigger, think brighter, think broader, think bolder, think positive and set higher audacious goals. The ability of the employee to speak his or her mind freely within the organization is another key factor in employee retention. If so, employees offer ideas, feel free to criticize and commit to continuous improvement. If not, they bite their tongues or find themselves constantly "in trouble" - until they leave. 8. GO IN FOR EMPLOYEE ENGAGEMENT PRACTICES: You won't know what's wrong... or what's right unless you practice. To check the pulse of your organization, conduct employee satisfaction surveys on a regular basis. Go in for its analysis and implementation. One idea: Ask employees what they want more of and what they want less of Capture Voice of Employees 55

Value addition in terms of ASKPT (Attitude, Skills, Knowledge, Practices, and Trust) has to be the end product. Stay Interviews and its implementation, call back your employees and ensure ombudsmen concept.

9. TEAMWORK AND CROSS FUNCTIONAL TEAMS: It takes effort to build an effective team, but the result is greater productivity, better use of resources, improved customer service and increased morale. Give great emphasis on cross functional approach as it endorses acceptance and accountability. Make sure everyone understands the department's purpose, mission or goal. Encourage discussion, participation and the sharing of ideas. Rotate leadership responsibilities depending on your employees' abilities and the needs of the team. Involve employees in decisions; ask them to help make decisions through consensus and collaboration. Encourage team members to show appreciation to their colleagues for superior performance or achievement.

10. PAPERLESS ORGANIZATION: If your high performers and technologists spend nearly as much time filling out paperwork, it's time for a change. Convert paperwork to an electronic format; and hire non- tech administrative staff to take over as much of the paperwork burden as is allowed under legal or regulatory restrictions Intranet facility Centralized servers for data storage

11. FUN IS MUST: Celebrate successes and recognize when milestones are reached. Buffet lunches, birthday parties, employee picnics and creative contests will help remind people why an organization is a great place to work. The companies organizes cultural program as and when possible but most of the times, once in a quarter, in which all the employees are given an opportunity to display their talents in dramatics, singing, acting, dancing and sports programs such as Cricket, football, etc 12. MISSION STATEMENT FOR EACH FUNCTIONAL AREA : Everyone wants to feel that they are working toward a meaningful, worthwhile goal. Work with your 56

human capital to develop a departmental mission statement aligned with company's vision, Make sure employees understand how their contribution is important. A place where people work with a smile on their faces and dreams in their eyes A place where your views can be freely voiced and are received with an open mind A place where you know whenever you need help, there is a family of 2000 members waiting to help you out.

13. ASSIGNMENTS FOR JOB ENRICHMENT: Identify your employees' talents and then encourage them to stretch their abilities into new areas. You have to have a great mentor or mentors. A variety of challenging assignments helps keep the organization stimulating. Lay emphasis on stretch Key Result Areas. Employees today want more than just a job. They want to contribute to the big picture and help the company sustain it through the tough times. Provide challenging and meaningful work assignments that stimulate them. When employees feel bored, their motivation declines and they lose focus on how their work fits into the big picture. Delegate meaningful work whenever possible so employees can learn something new and feel challenged. Additionally, provide regular development and learning opportunities.

14. TRANSPARENCY IN COMMUNICATION: Employees are more loyal to a company when they believe management or those at the helm of affairs keep them informed about key issues Communication is the first step toward creating the kind of environment that people care about, and if they care, they just may stay, keep your people in the loop about what's happening with the company. At any time, all of your employees should have a pretty good idea of how business has been carried out. They should be aware of what issues the company is attempting to address.

15. ENCOURAGE HIGHER LEARNING: Create opportunities for your key performers and technologists to grow and learn. Encourage every employee to learn at least one new thing every week, and you'll create a work force that is excited, motivated and committed.

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To keep morale high, coach and facilitate every day. The "I tell/you do" method of management simply does not work for motivating and retaining people. Instead, become a coach to your people and encourage them to try things their own way. Allow for mistakes to happen, as mistakes are often our greatest learning opportunities. Most people are grateful for constructive feedback. It shows that you're paying attention to their progress

16. FLEXIBILITY AND PRAGMATISM: Employees will be loyal to organizations that make their lives more convenient by offering on-site childcare centers, on-site hair styling and dry cleaning, flexible work hours, part-time positions, job-sharing or involving spouses in CSR activities and promote ownership culture. Employees of school-age children might appreciate the option to work nine months a year and have the summers off to be with their children.

17. DEVELOP AN EFFECTIVE INDUCTION PROGRAM: Implement a formal orientation program that's at least three weeks long and includes a thorough overview of every area of your department and an introduction to other departments. Infosys has a 23 days Induction Program with ISB Bangalore * Sona Group has tied up with MDI Gurgaon for one month Induction Program

18. WORKPLACE AMBIENC: No one wants to work with equipment that's old or constantly breaking down. Provide employees with the highest quality supplies you can afford. Cheap, leaky pens may seem like a small thing, but they can add to employees' overall stress level. A career-oriented, valued employee must experience growth opportunities within your organization.

19. NEVER, NEVER, EVER THREATEN AN EMPLOYEE'S JOB OR INCOME: Even if you know layoffs loom if you fail to meet targets, it is a mistake to foreshadow this information with employees. It makes them nervous; no matter how you explain the information, even if you're absolutely correct, your employees will update their resumes Demonstrate a vibrant workplace that retains and promotes talents and at the same time encourages development of non-performers to perform better and dissuade pink slips

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20. VALUE YOUR EMPLOYEES: Recognize outstanding achievements promptly and publicly, but also take time to commend on the many small contributions your staff makes every day to the organization's vision, mission and growth. A commonplace complaint we hear during an exit interview is that the employee never felt senior managers knew he existed. Take time to meet with new employees to learn about their talents, abilities and skills. Meet with each employee periodically.

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RESEARCH METHODOLOGY

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Research Methodology
Research inculcates scientific and inductive thinking and it promotes the development of logical habits of thinking and organization. The role of research in several fields of applied economics, whether related to business or to the economy as a whole, has greatly increased in modern times. Research in common parlance refers to a search for knowledge. It can also be defined as a scientific and systematic search for pertinent information on a specific topic. Research methodology is a way to systematically solve research problem. It may be understood as a science of studying how research is done scientifically. In it we study the various steps that are generally adopted by a researcher in studying his research problem along with the logic behind them. It is necessary for the researcher to know not only need to know how to develop certain indices or tests, how to calculate, how to apply particular research techniques, but they also need to know which of these methods or techniques, are relevant and which are not, and what would they indicate and why. The research frame for the study is detailed below. It is necessary to explain the methodology for the research work done. The purpose of research is to discover answers to question through some specific procedure. The aim of research is to find out the truth which is hidden or which has not been discovered as yet. While conducting this research I have mainly used primary data and some sources of secondary data also.

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OBJECTIVES OF THE PROJECT

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OBJECTIVES OF THE PROJECT:

To find out factors causing attrition. To study the HR practices on retention of core employees.

To evaluate whether retention practices influence the behavior of the existing employees.

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RESEARCH METHODOLOGY:
The main purpose of this chapter is to present the method and procedure used in execution and conduction of this study. In order to facilitate the presentation this chapter is divided into following section: Selection Method Sample size Collection of data o Primary sources o Secondary sources Analysis of data Diagrammatic presentation

Selection of method:

A survey method was adopted to carry out the research in which data was collected by means of a questionnaire.

Sample Size:
A random sample of 50 respondents has been drawn.

Data Collection:
There are two sources of data collections: o Primary Sources o Secondary Sources

a) Primary Sources are: The data collection had been done by interviewing respondents through a questionnaire.

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b). Secondary sources are: Following are the sources which were helpful in research. Policies of the hospital towards various nurses. Hospital website. Various articles on attrition & retention. Newspapers. Magazines.

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ANALYSIS AND INTERPRETATION OF DATA

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Diagrammatic presentation: Results were interpreted and discussion was done. The tabulated data was then represented diagrammatically in the forms of pie diagrams.

ANALYSIS AND INTERPRETATION OF DATA

Analysis and Interpretation is one of the most important steps of Research process. No research is successful without analysis and interpretation, because from analysis only we can come to know the actual figures. 1. Do you enjoy healthy and progressive environment at work place. Yes / No Sr. no. response Percentage 1 Yes 100% 2 No 0

Interpretation: 100% respondents believe that they enjoy healthy and progressive environment at work place.

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2. Are you satisfied with your management? Yes / No Sr. no. response 1 Yes 2 No

Percentage 94% 6%

Interpretation: Maximum percentage i.e 94% respondents are satisfied with the management.

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3. Are you satisfied with the management policy of your hospital? Yes / No Sr. no. response Percentage 1 Yes 96% 2 No 4%

Interpretation: 96% respondents are satisfied with the management policy of hospital nad rest 4% are not satisfied.

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4. Is there an absence of coordinal relationship between employees? Yes / No Sr. no. response Percentage 1 Yes 66% 2 No 34%

Interpretation: Maximum percentage of 64% believe that there is lack of coordinal relationship between employees. Where 36% believe that there is a good relation between employees.

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5. Are you surely satisfied with your pay? Yes / No Sr. no. response 1 Yes 2 No

Percentage 56% 44%

Interpretation: 56% respondents are satisfied with their pay and rest are not satisfied.

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6. Is the job of a nurse is tough? Yes / No Sr. no. 1 2

response Yes No

percentage 86% 14%

Interpretation: 84% respondents consider the work of a nurse is tough whereas, 14% consider it easy.

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7. Is there a good relation between you and your leader? Yes / No Sr. no. response 1 Yes 2 No

Percentage 72% 28%

Interpretation: 72% respondents is having a good relation between them and

their leaders.

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8.Are you provided with extra facilities(hostel,medical,leaves etc)? Yes / No Sr. no. Response Percentage 1 Yes 68% 2 No 32%

Interpretation: 68%(maximum) said that are provided with extra facilities(hostel,medical,leaves etc)

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9.Are you satisfied with the training facilities? Yes / No Sr. no. Response 1 Yes 2 No

Percentage 84% 16%

Interpretation: 84% respondents are satisfied with the training facilities. 75

10. Do you see high career growth and development in your hospital? Yes / No Sr. no. Response Percentage 1 Yes 64% 2 No 36%

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Interpretation: 64% respondents said they see high career growth and development in their hospital

11. Attrition rate among nurses is high because of their high demand in foreign countries? Yes / No Sr. no. Response Percentage 1 Yes 98% 2 No 2%

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Interpretation: 98% respondents are agree with the statement that Attrition rate among nurses is high because of their high demand in foreign countries.

12. Do you get recognized by your efforts in the organization? Yes / No Sr. no. Response Percentage 1 Yes 56% 2 No 44%

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Interpretation: 56% respondents said that they get recognized by their efforts in the organization

13. Do the management motivates you by co-operation & trust? Yes / No Sr. no Response Respondent 1 Yes 74% 2 No 26%

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Interpretation: 74% respondents believes that the management motivates them by co-operation & trust

14. Are you provided with external rewards? Yes / No Sr. no Response 1 Yes 2 No 80

Percentage 58% 42%

Interpretation: 58% respondents said that they are provided with external Rewards. Rest 42% said that they are not provided with the external rewards.

15. Is there any unique retention strategy which is followed in your hospital? Yes / No Sr. no. Response Percentage 81

1 2

Yes No

6% 94%

Interpretation: 94% respondents said that there is not any unique retention strategy which is followed in their hospital

16. If yes, do specify_______not any response_______

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CONCLUSION

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CONCLUSION Nurses are the cradle of providing patient care, next only to doctors. However, now the hospitals are facing lots of problem in retaining the nurses and shortage of qualified nurses can hinder the smooth flow of work in the hospital. The present study Attrition and Retention of nurses in hospitals was done to identify the factors contributing to nurses retention, to assess the retention strategies and challenges and to analyze the factors for reducing attrition. It was conducted in MAX Hospital,Mohali.

The survey has found out that there are various reasons for Employee Attrition 1.Higher Pay Package in another hospital 2.Good working hospitals 3.Opportunities for growth in new hospital 4.Change of Place problem 5.A better Boss in new hospital 6.Brand Image of the new hospital Employee attrition costs a lot to the hospital. There are various costs which are borne by the company at the start when the employee is under training period. Costs such as 1.Conveyance Cost 2.Cost of lodging of the new employee 3.Trainers cost 4.Cost of venue where training will be conducted 5.Materials to be supplied during training process

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QUESTIONAIRE

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RESEARCH QUESTIONAIRE

Name : Year of experience :

Department :

1. Do you enjoy healthy and progressive environment at work place : Yes / No 2. Are you satisfied with your management : Yes / No 3. Are you satisfied with the assessment policy of your hospital: Yes /No 4. Is there an Absence of cordial relationship between employees: Yes /No 5. Are you surely satisfied with your pay : Yes / No 6. Is the job a nurse is tough: Yes / No 7. is there a good relation between you and your supervisor: Yes / No 8. Are you provided with the extra facilities (hostel, medical, leaves etc ;) : Yes / No 9. Are you satisfied with the training facilities : Yes / No
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10. Do you see high career growth and development in your hospital : Yes / No 11. Attrition rate among nurses is high because of their high demand in foreign countries : Yes / No 12. Do you get recognized your efforts in the organization : Yes / No 13. Do the management motivates you by co-operation & trust : Yes / No 14. Are you provided with external rewards : Yes / No

15. Is there any unique retention strategy which is followed in your hospital : Yes / No 16.If yes, do specify----------------------------------------------------88

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BIBLOGRAPHY

1. Challenges of attrition and retention(by Anil Sharma). 2. http://www.retentionconnection.com

3. http://mdbgroup.com/retention1.html 4. http://www.employeeretentionstrategies.com/ 5. http://www.hrmagazine.co.uk/ 6. http://www.shrmindia.org/hr-magazine 7. War of attrition (Ana Lobo) 8. Retention(by Peter Gaber)

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