Managing High Turnover Rates In Acute Care Ward

The acute care ward faces a problem of high employee turnover offset by unfavorable working conditions and limited opportunities for growth within the organization. This unstable workforce has also created a substantial economic burden for the organization, which has to hire agency staff in addition to losing highly valued employees. This paper will employ systems thinking to provide appropriate complexity science approaches to these problems.

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Employing Systems Thinking in Managing High Turnover Rates In Acute Care Ward

There is a need to promote future adaptability and resilience to the disorderly and unstable environment created by high employee turnover (Zastocki 1999). Managers in the organization need to learn to manage uncertainty in the middle zone by encouraging innovation and experimentation (Zastocki 1999).  Political decisions often rely old ineffective ideas and short term solutions, such as hiring agency staff, which will never be useful if the fundamental problem is still active (Zastocki 1999).  Unless the issue is tackled from its root, then it is likely to attack the organization from even more vulnerable routes and ultimately affect the quality of patient care offered in the acute care ward.

Understanding why and how problems arise within the organization is critical to determining how complexity theory can be applied to decision making and what form of innovation needs to be applied to current strategies to make them more effective (Zastocki 1999).  In the case of the acute care ward, the inability to provide opportunities for career advancement has led to high turnover rates in middle-level staff members. When these staff members quit, the organization has to hire new, less experienced staff, which creates a communication gap between senior-level management and new staff. New staff members have to put in extra work hours and effort, which increases fatigue, reduces morale, and ultimately exacerbates the already high turnover rate. As a long term solution, the organization’s management could establish smaller divisions within each department. This form of distributed control within the organization will provide opportunities for upward and lateral mobility in middle-level management (Zastocki 1999).  Furthermore, the modified structure will increase diversity information and connections within the organization and provide better stability for the organization in case of future uncertainty (Zastocki 1999).  

However, providing these opportunities may not offer an immediate solution to the organization challenge. The shortage of staff members means that there are very few experienced nurses to fill new positions created by distributed control. Cause and effect relationships may not always be clear. It is beneficial to have an idea of what the ideal situation would be and monitor how well new strategies aid in the organization’s progress towards it (Zastocki 1999). Distributed control should facilitate the attainment of this ideal situation. This is because, the presence of opportunities for growth should lower turnover rates in middle-level management, which should improve communication and harmony in the workplace and ultimately foster retention of new staff members in the long run.

In anticipation of the benefits of distributed control, the organization could initiate robust recruitment of new middle level to junior staff members and offset current staff shortages by hiring agency staff. Accelerating investment on short term solutions such as hiring agency staff to work in tandem with staff members might reduce fatigue in existing staff members and improve morale. Once newly recruited staff members join the workforce, this investment can be terminated. The balancing feedback provided by short term strategies should be effective in ensuring the organization remains on its feet before long term solutions take effect (O’Connor and McDermott 1997).


Understanding the interconnection between different points in a system is critical to the development of effective solutions. The high turnover rates in the acute care ward seem to arise from stagnation within the workforce. While investment in short term patches is essential to provide temporary relief, complexity science approaches such as distributed control should create opportunities for growth, information exchange, foster diversity and innovation within the organization and ultimately prevent future turbulence.

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