MMHA 6220 Week 10 Exit Interview Analysis Example

They Said Pay, but They Described the Drive: A Thematic Analysis of Thirty-Four Exit Interviews at Bellwood Valley Home Health, With Its Limits and Four Recommendations

Student Name

Walden University

MMHA 6220: Human Resource Management in Healthcare

Instructor Name

Month Day, Year

They Said Pay, but They Described the Drive: A Thematic Analysis of Thirty-Four Exit Interviews at Bellwood Valley Home Health, With Its Limits and Four Recommendations

Method

Bellwood Valley Home Health, the invented agency followed all term, conducted 34 exit interviews in the past 18 months: 24 with home health aides, 7 with nurses and 3 with therapists. The HR generalist conducted all of them, in person or by phone, during the employee's final week. The form has eight open questions, including the main reason for leaving, what the agency could have done differently, how the employee would describe their workload and their supervisor, and whether they would return. Answers were recorded as notes rather than transcripts.

Data from people already leaving have known limits, discussed below. With that caution, the notes were analyzed in the six steps Braun and Clarke (2006) set out for thematic work, moving from rereading and coding the notes through grouping, checking and naming themes to the write-up. Coding was done by the HR manager and checked by the administrator, who coded a third of the interviews independently; disagreements were discussed and the codebook refined. Departing employees had been told at the start of each interview that their answers would be used in summary form to improve the agency, and the notes were stripped of names before coding.

Codebook

Table 1

Codebook With Definitions and Paraphrased Examples

Examples are paraphrased from the notes so that no former employee can be identified.

Themes

Table 2

Themes, Frequency and Roles

An interview can contribute to more than one theme; supervisor support was mostly positive and is not reported as a reason for leaving.

The day is shaped by the car. Drive time, mileage and schedule density clustered together, especially among aides. Aides described days with visits spread across counties, unpaid gaps between visits and mileage that did not cover costs. The theme was about the structure of the day, not any single factor.

Paperwork follows me home. Six of the seven nurses and all three therapists described completing documentation after hours, often unpaid in practice for salaried staff.

Working alone. Across all roles, departing employees described rarely seeing colleagues and having no one to ask during a hard visit. This theme appeared even among those who praised their supervisors.

Supervisor support deserves a note because of what it did not show. Most comments about direct supervisors were positive: departing employees described supervisors who answered the phone, covered visits in emergencies and listened. In the agency's case, people were not leaving their managers; they were leaving the shape of the work. That finding redirects attention from supervisor training, a common first response to turnover, toward scheduling and workload.

Stated Reasons and Surrounding Conditions

The most common answer to the main-reason question was pay, named in 20 interviews. But in 16 of those 20, the surrounding notes described drive time, schedule density or after-hours documentation. A typical pattern: an aide said she was leaving for two dollars more an hour, then described a schedule with long unpaid drives between visits. A higher hourly rate elsewhere may have been a way to name a day that felt unsustainable. National survey data on home health workers support this reading: being assigned insufficient hours and lacking consistent patient assignments were associated with greater intent to leave, alongside job satisfaction and benefits (Stone et al., 2017). Pay matters, but raising it alone may not address what departing aides described.

Limitations

The most important limitation is that people who stayed were never interviewed. The themes describe those who left, and the same conditions may be present for those who stay and may not drive anyone away; without a comparison, the analysis cannot say which conditions cause departures. Second, the interviewer was from HR, and departing employees may soften criticism of supervisors or the agency to protect references. Third, notes rather than transcripts mean that the interviewer's summaries shaped the data. Fourth, therapists are few, so their themes rest on three interviews. Braun and Clarke (2019) have also emphasized that themes are constructed by analysts rather than discovered, which means another team might have grouped these codes differently.

Recommendations

Recommendations are fewer than themes, and each is linked to one theme and one role.

For aides and the car: redesign routes so that each aide's visits are clustered geographically, and pay drive time between visits at the regular rate. Measure: average unpaid minutes between visits.

For nurses and therapists and paperwork: build 30 minutes of paid documentation time into each day's schedule. Measure: share of notes completed during scheduled hours.

For aides and isolation: start a weekly 30-minute paid huddle by video for aides in each county. Measure: attendance and aide responses in stay interviews.

For all roles and the data gap: begin stay interviews with current employees, asking what keeps them in the job and what might tempt them to quit, so that next year's analysis can compare those who stay with those who go.

References

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. https://doi.org/10.1191/1478088706qp063oa

Braun, V., & Clarke, V. (2019). Reflecting on reflexive thematic analysis. Qualitative Research in Sport, Exercise and Health, 11(4), 589-597. https://doi.org/10.1080/2159676X.2019.1628806

Stone, R., Wilhelm, J., Bishop, C. E., Bryant, N. S., Hermer, L., & Squillace, M. R. (2017). Predictors of intent to leave the job among home health workers: Analysis of the National Home Health Aide Survey. The Gerontologist, 57(5), 890-899. https://doi.org/10.1093/geront/gnw075