Frontiers in Operations: Operational Overload: The Impact of Workload on High-Skilled Workforce Attrition
Blair (Lianlian) Liu et al.
Abstract
Problem definition: Worker attrition is critical and costly, disrupting operations across industries and leading to significant productivity losses. In healthcare, nurse attrition poses even greater challenges, which are exacerbated by persistent shortages and increasing burnout. Despite its importance, nurse attrition remains underexplored in operations management (OM) literature, particularly concerning how different workload dimensions influence voluntary attrition. This study aims to address this gap by investigating how various workload dimensions, including nurse responsibility, overtime shift, emotional toll, and cumulative workload, affect voluntary attrition among ICU nurses. Methodology/results: Utilizing high-resolution data from a large U.S. hospital system, we analyze 26 months of operational, clinical, and HR records, capturing nurses’ dimensions of workload leading up to voluntary attrition decisions. Our findings reveal a nuanced relationship; whereas greater nurse responsibility during a shift reduces the likelihood of voluntary attrition, cumulative workload over time shows a U-shaped relationship with the likelihood of voluntary attrition. Additionally, both the emotional fatigue from handling patient death events and the burnout from attending overtime shifts heighten the likelihood of voluntary attrition. One more incident of emotional fatigue increases the odds of voluntary attrition by 54.3%. One more overtime shift increases the odds of voluntary attrition by 58.5%. However, supportive coworkers can help mitigate some negative effects, highlighting the importance of collaborative environments. Managerial implications: This research makes several contributions. First, we estimate the distinct effects of workload dimensions on voluntary attrition. Second, we demonstrate how supportive coworkers act as a buffer against burnout-induced attrition. Finally, we offer actionable strategies for managers to enhance workforce retention: monitoring workloads to prevent fatigue-driven attrition, implementing flexible scheduling to allow recovery, and fostering peer support systems. By addressing a critical issue in high-stakes environments like healthcare, this study enriches OM literature and provides practical insights for organizations seeking to retain talent in knowledge-intensive fields. History: This paper has been accepted in the Manufacturing & Service Operations Management Frontiers in Operations Initiative. Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2025.0037 .
Evidence weight
Balanced mode · F 0.40 / M 0.15 / V 0.05 / R 0.40
| F · citation impact | 0.50 × 0.4 = 0.20 |
| M · momentum | 0.50 × 0.15 = 0.07 |
| V · venue signal | 0.50 × 0.05 = 0.03 |
| R · text relevance † | 0.50 × 0.4 = 0.20 |
† Text relevance is estimated at 0.50 on the detail page — for your query’s actual relevance score, open this paper from a search result.