The Association of Shift Work Characteristics and Shift Work Planning Strategies with Turnover in Social and Healthcare: A Payroll Study Utilizing Shift Planning Unit - Level Data 2006-2021

Introduction: Hight turnover in the nursing workforce, associated with a global shortage of personnel, poses significant challenges to the healthcare system and quality of care. To address this, we designed an interactive tool to social and health care organizations. The tool provides feedback based on FIOH Working Time Traffic Light (WTTL) recommendations, enabling units to assess the used shift planning strategies and to implement ergonomic shift planning to improve health and wellbeing. This study aimed to investigate how longitudinal changes in the working hour characteristics and shift planning strategies in the interactive tool were associated with annual changes in turnover.

Methods: Working Hours in the Finnish Public Sector (WHFPS) cohort with longitudinal data on registry-based working hours and turnover 2006–2021 was utilized. Annual characteristics of working hours, shift planning strategies and turnover of all shift planning units with at least 10 employees and 30 annual work shifts were included. Longitudinal fixed effects (FE) time- dependent logistic regression was used to investigate whether changes in the unit-level working hour characteristics were associated with a high annual turnover (≥7.5% difference between two years). The model included all independent variables to account for their potential interrelationships. The Odds ratios (OR) with 95% confidence intervals (IC) were calculated. The cut-off levels of FIOH WTTL recommendations were used for independent variables. The final sample for external turnover consisted of 3938 independent shift planning units (36354 observations during 2006–2021). Shift schedules were mostly irregular, while 60% of the sample were working shifts and 14% of employees were men.

Results: Several long (>48 hours) free-time spells (OR 0.50, CI 0.46–0.55), single free days (OR 0.58, CI 0.60–0.76), the use of shift wishes (OR 0.91, CI 0.82–0.99), and ≥12 hour shifts (OR 0.86, CI 0.75–0.98) were less likely associated with high turnover, while lack of free weekends (OR 1.25, OR 1.10–1.44), shift work (OR 1.33, CI 1.08–1.65) and quick returns (< 11 hours, OR 1.28 (CI 1.15–1.44) were associated with increased likelihood of high turnover. However, having at least 2-night shifts in a week and having slowly rotating shift schedules (≥ 4 nights,) were linked to less likelihood of high turnover (OR 0.59, CI 0.49–0.72; OR 0.88, CI 0.79–0.98).

Conclusion: The results indicate that factors associated with frequent free-time arrangements and recovery in shift work, often linked to better worktime control and the use of 12-hour shifts, as well as slower rotating work schedules, could possibly promote staying in work in mostly irregular shift work in the social and healthcare. Support: This research is conducted as a part of the Mental Health Toolkit project. The project is a part of Finland’s Sustainable Growth Program and funded by the EU Recovery and Resilience Facility (Next Generation EU).

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Artikel online veröffentlicht:
08. Oktober 2025