Effects of Reducing the Number of Quick Returns (< 11 h off Between Shifts) on Turnover Intention and Job Satisfaction: a Cluster-Randomized Controlled Trial Among Healthcare Workers

PURPOSE: To investigate the effects of reducing quick returns (i.e., < 11 h between shifts) on turnover intention and job satisfaction, and to explore potential moderating factors. METHODS: A cluster-randomized controlled trial was conducted at a Norwegian university hospital, where 66 units were randomly assigned to an intervention or control group. Participants, comprising healthcare workers (n = 1314; 85.2% female) contracted to ≥ 50% of full-time positions, were followed over six months. The intervention group was assigned to a work schedule with fewer quick returns, while the control group maintained its level of quick returns. Turnover intention and job satisfaction were assessed at baseline and follow-up using validated self-report measures. Linear mixed models were used to evaluate intervention effects and potential moderators. RESULTS: The intervention group halved the number of quick returns from baseline (mean = 13.2, SD = 8.7) to follow-up (mean = 6.7, SD = 6.0), while the control group showed minimal change (baseline mean = 13.2, SD = 8.7; follow-up mean = 12.0, SD = 9.3). No overall effects were found on turnover intention and job satisfaction. However, moderator analyses revealed that among workers aged 30-41 years, the intervention reduced turnover intention (p = .003, Cohen's d = -0.54), primarily observed among workers aged 30-41 years with no children at home, and improved job satisfaction (p = .003, Cohen's d = 0.54). Additionally, beneficial effects on turnover intention were found among workers with commuting times exceeding 45 min. CONCLUSIONS: Reducing quick returns improved job satisfaction and reduced turnover intention in specific subgroups. These findings highlight the importance of considering factors such as age, family status, and commuting time, when planning shift schedules in healthcare settings. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT04693182 (registered 12/31/2020).