Determining the relative salience of recognised push variables on health professional decisions to leave the UK National Health Service (NHS) using the method of paired comparisons.
Determining the relative salience of recognised push variables on health professional decisions to leave the UK National Health Service (NHS) using the method of paired comparisons.
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DOI：
10.1136/bmjopen-2022-070016
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发表时间：
2023-09-12
期刊：
影响因子：
2.9
通讯作者：
Coster, Joanne
中科院分区：
文献类型：
--
作者：
Weyman, Andrew;O'Hara, Rachel;Nolan, Peter;Glendinning, Richard;Roy, Deborah;Coster, Joanne
关键词：
据称，COVID-19大流行的主要和次要影响对英国国民医疗服务体系（NHS）内的医疗专业人员的保留产生了不利影响。本研究旨在通过衡量广泛引用的推（离开）影响的相对重要性来确定干预的优先事项。在2021年夏季/秋季，英国范围内的机会样本（n=1958）NHS卫生专业人员完成了在线配对比较练习，以确定与工作相关的压力，工作量强度，时间压力，人员配备水平，工作时间，工作-家庭生活平衡，对努力和薪酬的认可作为卫生专业人员离开NHS就业的原因的相对突出性。该研究被认为是自2019冠状病毒病大流行以来首次对促使员工离开NHS的因素进行大规模系统评估。所有职业都把与工作有关的压力、工作量强度和人员配置水平放在首位。薪酬通常位于各自等级的中点附近;对努力和工作时间的认可排名最低。然而，差异是明显的排名顺序和相对权重的推动变量之间的卫生专业和保健提供功能。救护车护理人员是一个离群值，特别是在人员配置水平（F统计4.47，p=0.004）和工作-家庭生活平衡的首要地位方面。相对于人员配备水平，其他推动变量施加更强的影响，护理人员比护士或医生（f4.29，p=0.006）。研究结果是相关的未来NHS卫生专业保留干预策略。除了护理人员/救护车服务，在不同的卫生专业家庭和组织类型的休假变量的排名表现出强烈的一致性，在有序的水平。然而，人口统计学差异的权重和排名，归因于推动因素的专业家庭和组织类型，表明，除了路标普遍（所有工作人员）的干预优先事项，定制的解决方案，为不同的专业和职能可能是必要的。
The primary and secondary impacts from the COVID-19 pandemic are claimed to have had a detrimental impact on health professional retention within the UK National Health Service (NHS). This study set out to identify priorities for intervention by scaling the relative importance of widely cited push (leave) influences. During Summer/Autumn 2021, a UK-wide opportunity sample (n=1958) of NHS health professionals completed an online paired-comparisons exercise to determine the relative salience of work-related stress, workload intensity, time pressure, staffing levels, working hours, work–homelife balance, recognition of effort and pay as reasons why health professionals leave NHS employment. The study is believed to be the first large-scale systematic assessment of factors driving staff exits from the NHS since the COVID-19 pandemic. All professions gave primacy to work-related stress, workload intensity and staffing levels. Pay was typically located around the midpoint of the respective scales; recognition of effort and working hours were ranked lowest. However, differences were apparent in the rank order and relative weighting of push variables between health professions and care delivery functions. Ambulance paramedics present as an outlier, notably with respect to staffing level (F-stat 4.47, p=0.004) and the primacy of work–homelife balance. Relative to staffing level, other push variables exert a stronger influence on paramedics than nurses or doctors (f 4.29, p=0.006). Findings are relevant to future NHS health professional retention intervention strategy. Excepting paramedics/ambulance services, rankings of leave variables across the different health professional families and organisation types exhibit strong alignment at the ordinal level. However, demographic differences in the weightings and rankings, ascribed to push factors by professional family and organisation type, suggests that, in addition to signposting universal (all-staff) priorities for intervention, bespoke solutions for different professions and functions may be needed.
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2.1
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