Quality of care and the efficiency of healthcare institutions depend on the motivation and performance of healthcare professionals (HPs). However, along with the rest of the world there is a considerable international mobility of HPs within the EU (Glinos,2014). Due to a one-way flow of HPs from Lithuania to the more developed EU-economies, the country is facing increasing threats to sustainable quality of care due to labor shortages and accelerating age of the remaining labor, as the majority of leaving HPs are younger individuals. The research project investigates the problem of how to effectively manage and retain HPs in Lithuanian healthcare institutions. While doing so we aim to identify organizational factors that increase motivation, well-being, and performance as well as decrease emigration intentions of HPs across life-span.

To answer the research questions, we collected qualitative and quantitative data from a large sample of medical professionals (doctors, nurses, residents) and medical students in diverse hospitals in Lithuania. Research findings were presented at AOM, Dutch HRM, International HRM and other conferences and are displayed in publications referenced in this summary. We found that 39 % of students, 21 % of residents, 12 % of nurses, and 6 % of physicians were decided to emigrate and emigration decisions were linked to individual (age, gender, family situation), organizational (teamwork climate, financial needs dissatisfaction), and societal factors (perceived social worth) (Goštautaitė, Bučiūnienė, Milašauskienė, Bareikis, Bertašiūtė, 2018). Next, HRM system increases work engagement and patient orientation of HPs due to the increases of basic need (autonomy, relatedness, and competence) satisfaction and this indirect effect is contingent upon employees’ age (Goštautaitė, Bučiūnienė, Milašauskienė, paper under review in IJHRM). We further show that HRM reduces junior doctors’ intentions to emigrate and the subsequent job search abroad even after other important emigration factors (i.e., age, gender, national identity, financial dissatisfaction, number of children, provision of medical equipment) are controlled for (Goštautaitė, Bučiūnienė, Mayrhofer, paper under preparation). HRM influences job search abroad via the perceived opportunities in home country. HRM practices have a stronger negative effect on burnout for the younger HPs (they burnout was significantly higher) than for their older counterparts (Bučiūnienė, Goštautaitė, Milašauskienė & Granskas, 2018). Finally, calling (for a medical profession) not only becomes stronger with increasing age (and progressing medical career) but also prevents burnout, an effect that is mediated by increased social worth (especially among senior professionals) (Goštautaitė, Bučiūnienė, Duffy & Kim, paper under review in Career Development International).

Together, this project contributes to a better understanding of organizational factors in a hospital that not only decrease the willingness to leave own country for work abroad but also lead to motivation, well-being, and performance of age-diverse HPs. Our research acknowledges “the very different effects that HRM activities may have on different categories of personnel” (Benschop, 2001, p. 1166) and answers calls for “a more nuanced understanding of international careers in their relevant geographical, historical, institutional and organizational settings” (Al Ariss & Crowley‐Henry, 2013, p.18). We contribute to theoretical grounding and empirical evidence of explanatory mechanism by which the interactions of HRM and employee age affect work outcomes. We also provide insights on how to reduce self-initiated expatriation of HPs through organizational practices. We formulate implications for policy-making and recommendations that help healthcare institutions to develop HRM and adapt organizational factors aiming at maintaining high performance, motivation, and retention of increasingly age diverse HPs.