ESTUDIO COMPARATIVO DE CTPH Y DBUSE DE LOS PACIENTES CON ICTERICIA OBSTUCTIVA DE ORIGEN MALIGNO TRAS CPRE FALLIDA.

Employee retention has become an increasingly important focus for organisations, considering tight labour markets, the costs of recruitment and turnover and the costs of training employees. Organisational investment in employee retention is critical if an organisation wants to keep its ‘right’ people; yet retention is not merely the absence of turnover. The Hudson Report (2007, p. 5) defined retention as the ability of an organisation to keep its most precious resource: ‘its people’. All organisations experience some level of employee turnover; however, retention is about keeping those employees who are critical to the sustained success and growth of the business. The growing focus on retention by organisations is noted by Evans (2008, p. 13), reporting that AHRI’s HR Pulse Survey on Retention (completed by senior managers and HR practitioners), which found that 60% of respondents admitted that they had a problem retaining staff and 80% reported that retention problems had caused impacts on organisational effectiveness and financial performance.

The cost involved in replacing a separating employee and training a replacement, plus the reduced productivity in the initial employment period, also need to be considered when examining or addressing employee separation. Midalia (2008) stated that the cost of hiring, training a new employee and knowledge management costs commonly represent 150% of a departing employee’s salary.

Asquith, Sardo and Begley (2008), undertook a Pulse Survey of AHRI’s membership base (of senior managers and HR practitioners) on retention issues and found that reasons for leaving an organisation differed slightly depending on the size of the organisation, however, lack of promotion, inadequate pay and poor work-life balance were all highly indicated regardless of the organisational size. Asquith, Sardo and Begley (2008, p. 9) found that 36% of survey respondents considered the relationship between employees and their managers as the key reason for leaving their employment. Branham (2005, p. 58) supported a Gallup study conclusion that the greatest drivers of employee engagement and retention are intangible and mostly related to the way managers treat employees. HRM can reduce turnover; but the ability to retain employees depends significantly upon the ability to manage them (Kalisprasad, 2006, p. 22). This suggests that organisations need to be cognisant of

the importance of this relationship and how to develop managerial capability and measure managers’ performance.

Linked to retention is the need for a workforce management system that addresses employee or career development opportunities and that assists with succession and capability planning. According to the Boston Consulting Group and the World Federation of Personnel Management (2008), in developing and retaining the best employees, organisations have to focus on managing talent, improving leadership development and managing work-life balance. Managing work-life balance is now essential for creating an attractive ‘HR brand’ for recruiting and retaining employees. Westacott (2007, p. 897) identified lack of job satisfaction as the major reason for employees leaving an organisation and that dissatisfaction stemmed from: employees not having a clear and coherent organisational direction; the lack of strong, open and effective leadership; a lack of a clear understanding of the requirements of the role; the lack of a clear understanding of managers’ expectations of their performance in the role; the lack of a clear understanding of how the role fits into the activities of the organisation; and the lack of the appropriate skills and competencies to perform the role effectively. In addition to this, Westacott (2007) also found other factors that influence a person’s job satisfaction and decision to leave included: the absence of a clear organisational structure where reporting lines are apparent; the lack of a reasonable number of responsibilities that an employee is capable of fulfilling in the time available; lack of variety in their role, thereby making the job boring and unfulfilling; lack of recognition; the absence of regular and timely feedback on performance; and an inability to attain a work-life balance because of long hours or excessive travel requirements (whether these are imposed by the role or by the location of the job in relation to the employee’s residence). Many of the factors listed are also identified in engagement and are contributors to job satisfaction; and therefore also bear on engagement and retention.

Westacott (2007), writing about employee retention, noted that research indicated that what employees most want is interesting work, full appreciation of work performed, and a feeling of ‘being in on things’. The motivational reasons for employee attendance were based on the nature of work, job satisfaction, job security, location, pay and benefits and career advancement possibilities. Reasons why employees leave were identified as poor relationships with their managers, inappropriate organisational culture, poor organisational communication practices, inappropriate pay and benefits, ineffective reward practices and lack of effective or appropriate recognition.

Boxall, Macky and Rasmussen (2003) noted from their cross-sectional research undertaken in New Zealand of 549 randomly selected employees that there is increasing employment stability as people get older and as they become better paid, lending support to the idea that there are identifiable development stages affecting the careers of both men and women. In terms of the reasons for employee turnover, Boxall, Macky and Rasmussen (2003) hold that motivation for job change is multidimensional: no one factor will explain it. There are a number of organisational factors that strongly affect employees’ reasons for leaving an organisation. Boxall, Macky and Rasmussen (2003) found that whilst interesting work is the strongest attractor and retainer, the strongest responses were about factors that involved how the workplace is managed. Boxall, Macky and Rasmussen (2003) found that over half of the respondents indicated that their desire to improve their work-life balance was their reason for changing employment.

Academic and practitioner literature has endeavoured to identify what makes employees leave or stay with organisations (Boxall, Macky and Rasmussen, 2003; Shacklock, 2005; Westacott, 2007, Asquith, Sardo & Begley, 2008). Towers Perrin’s (2008a) Workforce Study identified the top retention drivers relating to organisations having excellent career advancement opportunities; satisfaction with the organisation’s people decisions; the organisation's reputation for social responsibility; appropriate amount of decision-making authority to do the job well; ability to balance work and personal life; effective job training; work environment in which new ideas are encouraged; quality of work, product or service; competitive base salaries; and a belief that senior management values the workforce.

The Hudson Report (2006, p. 4) identified a number of work attributes that underpin mature-aged employees’ decisions to remain in employment, including an employee’s ability to work from home, access to financial advice, opportunities to mentor or coach others, working with new challenges, recognition, access to flexible working arrangements and a friendly work environment. Rolland (2007) identified similar attributes, but added leadership and job content as to why older employees continue in their employment. The common factors identified in this chapter relate to both older and younger people, and include the need for interesting or challenging work, flexibility, the right employment conditions, good management and communication.

According to Westacott (2007), a key strategy for employee retention requires managers to develop an effective relationship with each employee for whom they have direct responsibility. Effective performance expectation-setting is essentially driven

around the appropriateness and clarity of an employee’s current job description. Successful organisations will focus on providing their managers with the skills, tools and opportunities to build sustainable relationships with each employee, thereby using the manager-employee relationship as a key employee-retention strategy.

TalentDrain (2005, 1) undertook research, involving HR managers and practitioners, into organisational retention practices, finding that public sector organisations reported lower turnover rates. However, the larger organisations (those with over 1,000 employees) had, in 70% of cases, turnover rates in excess of 20%. Larger organisations reported that they are more likely to perceive turnover as having a negative effect and more likely to report that they are experiencing retention difficulties. However, public sector organisations are both more likely to perceive turnover as having a positive effect, and less likely to report retention difficulties (TalentDrain, 2005). The strategies organisations may develop and implement need to be considered against the organisational context. This further identifies the need for organisations to have an effective bundle of HR or employment practices, along with good management for effective attraction, engagement and retention of their workforce.