Volume 3, No. 10 October 2024 - (2184-2202)

p-ISSN 2980-4868 | e-ISSN 2980-4841

https://ajesh.ph/index.php/gp

The Influence of HRM, Employee Engagement, and Organizational Commitment on Employee Turnover Intention

Pinky Sutrisno Saraswati¹, Justine Tanuwijaya²*, Andreas Wahyu Gunawan³

Universitas Trisakti, Indonesia

Email : justine@trisakti.ac.id

ABSTRACT

High turnover rates are a significant challenge in the healthcare sector, where employee retention is critical to maintaining service quality and organizational performance. The purpose of this research is to determine and analyze the effect of HRM, employee engagement and organizational commitment on employee turnover intention at Tebet Hospital Jakarta, Atmajaya Hospital Jakarta, and UKI Hospital. The research method used was qualitative, which involved in-depth interviews with key respondents from the three hospitals. Primary data was collected using a structured questionnaire and analyzed using SEM-PLS (Structural Equation Modeling-Partial Least Squares). The findings show that HRM has a positive but not statistically significant influence on employee engagement, while significantly reducing turnover intention. Organizational commitment is positively and significantly related to employee engagement and decreased turnover intention. In addition, turnover intention positively affects employee performance. This research has implications highlighting the need for hospitals to develop more effective HRM strategies that encourage employee engagement and strengthen organizational commitment, ultimately reducing turnover rates.

Keywords: Employee Engagement, Organizational Commitment, Employee Turnover, Human Resource Management.

INTRODUCTION

Human resources are fundamental to achieving success. Emphasizing the attachment of human resources can improve the quality of competition, creativity, and needs (Riniwati, 2016). Human resource attachment has a great influence on the development of employees' abilities to the maximum (Dzimba & van der Poll, 2024). Organizations must be aware that maintaining and cultivating existing employee talents is a top priority and instilling organizational commitment is something that must be done (Tumbelaka & Kaligis, 2023).

Nowadays, the competition in the service industry is getting tougher, companies are constantly trying to develop different ways to continue to survive in competitive competition. In marketing research, service, service quality is one of the drivers of consumer satisfaction and creates consumer loyalty (Zahara, 2020). The rapid growth of competition in the business world has caused many companies to realize that employees are the number one asset and are the center of resources and diversity of society. A successful company depends on the stability and talent of workers who are able to create good product or service quality.

(Agarwal, 2018) revealed "employee engagement reports are the most important part of the organizational experience as this leads to performance retention and increased productivity". When employees are engaged with a company, employees have an awareness of the business. Awareness of the company's business that makes employees will give all their best abilities to the company.

Commitment is the level at which an employee is able to side with an organization and the goals and desires to stay working in the organization (Sianipar & Haryanti, 2014). Organizational commitment relates to the employee's feelings and beliefs about the organization in which he or she works as a whole. According to Jennifer and Gareth, there is a dimension of organizational commitment, namely affective commitment, which is the commitment when the employee becomes a member of an organization, happy, trusted, and feels good to be (Yusuf & Syarif, 2018). Organizational commitment has three dimensions, namely affective commitment, continuance commitment, and normative commitment (Wardianto et al., 2019). Affective commitment is related to the emotional bond of employees and how employees are involved in doing their work. Continuity commitment is related to the employee's consideration to continue because the employee will feel disadvantaged by the costs that will be burdened if he leaves the organization.

However, there is one problem related to human resource problems is turnover. Turnover is a condition for moving employees from an organization and is usually the last option (Kusumowardani & Suharnomo, 2016). Turnover is often used for employees to get or seek a better situation, but it causes losses to the organization they leave (Rahadi, 2021).

A research by the Brandon Hall Group found that turnover rates in healthcare are four times higher than in other industries in the United States. As technological advancements have driven accelerated change in the workplace, healthcare organizations are struggling to keep employees engaged. Engagement is not only important for a company's productivity, but it is also a key factor in employee turnover. Engagement gives employees a sense of belonging, allows them to build a genuine relationship with an organization, and increases their desire to stay at the company they work for (Adomako, 2023). High turnover is a challenge in various organizations in managing employees as a competitive factor. (Parinsi & Musa, 2023) states that many professional organizations are in a dilemma as a result of the competition that comes in attracting and retaining highly skilled workers because they fail to match the salaries offered by their competitors or offer more than their competitors. Therefore, the challenge for many organizations today is to come up with an efficient reward strategy to retain employees for the success of the organization (Terera & Ngirande, 2014). This also affects patient service activities because it is related to involvement in building relationships between patients and health service organizations (White-Williams et al., 2020).

Creating an organizational environment capable of retaining talented human resources is an immediate step that must be achieved to reduce employee turnover. According to (White, 2019) that organizations should focus on communication, decision-making, compensation, incentives, career development, rewards and management as 5 things that can be done to maintain human resources in an organization.

The success of an organization depends heavily on its employees. According to (Ekhsan, 2019), turnover can be achieved when employees have good job satisfaction. If the employee turnover of a company is high, it will have a bad impact on the state of its employees which can ultimately lead to a decrease in employee job satisfaction. The decline in job satisfaction is a manifestation of the attitude of employees who cannot feel the things that can make employees survive, such as compensation and incentives that are not fulfilled or the attitude from managers to employees that is less communicative.

Type B hospitals are hospitals that are able to provide medical services with broad specialists and limited subspecialists. It is planned to establish a type B hospital in each provincial capital that accommodates referral services from district hospitals. This type B hospital has a vision to become a trusted, holistic, and competitive hospital. With a mission to provide quality services by prioritizing patient safety, developing human resources professionally, and ethically.

Hospitals strive to provide health services to the maximum, so human resources are required to carry out their duties as well as improve service performance. Attachment among fellow employees is needed so that they are able to provide quality service, because if the employee gets comfort while working, the employee will try to do the work and obligations until it is completed and well above the standards made by the organization.

This phenomenon shows that human resources, especially those that ensure a high level of performance, are extremely important for the business success of an organization (Pandita & Ray, 2018). According to various studies, the results show that talent management is a significant contributor to financial performance and business continuity, regardless of the size and scale of its activities (Khilji & Pumroy, 2019).

Based on preliminary studies conducted at Tebet Hospital Jakarta, Atmajaya Hospital Jakarta, and UKI Hospital, it was found that in the initial interviews conducted by the author with twenty employees who became key respondents related to this research. And it can be seen that the average employee turnover in 2021 - 2023 is 45 employees (10.67%). In this research, initial interviews were conducted to ask for their responses regarding the HR management system implemented in the company related to employee engagement and organizational commitment. Referring to the theories and research that have been presented related to employee engagement, as well as organizational commitment to hospitals and employee turnover intention.

Based on the background above, the purpose of this research is to determine and analyze the effect of HRM, employee engagement and organizational commitment on employee turnover intention at Tebet Hospital Jakarta, Atmajaya Hospital Jakarta, and UKI Hospital. So that the benefits in this research are to contribute to hospital management in understanding the factors that influence employee turnover intention, especially in the context of human resource management (HRM), employee engagement, and organizational commitment. This research is also expected to provide valuable input to design more effective HR management strategies in increasing employee engagement and strengthening organizational commitment, which in turn can reduce turnover rates.

RESEARCH METHODS

Sum

150

100,0%

Source: Data processed The research method use is a qualitative research method. While this type of research uses a qualitative description type, where the researcher will describe or construct in-depth interviews with the research subject based on existing facts or evidence (Kriyantono & Mckenna, 2017). (Moleong, 2015) mentioned that qualitative research is research that uses a natural background with the intention of phenomena that occur and is carried out by involving various existing methods such as interviews, questionnaire assessments, and the use of documents.

The primary data collection method used in this research is a questionnaire. Questionnaire is a data collection technique that is carried out by giving a set of questions or written statements to respondents to answer (Abdussamad, 2022). In this research, the questions in the questionnaire are arranged according to the order of variables that are in accordance with the indicators, the purpose is so that the questions in the questionnaire do not deviate from the research objectives. In this research, researchers used a Likert scale for 32 to measure a person's attitude, opinion, and perception of social phenomena. The questionnaire used is a closed questionnaire in which answers have been provided (strongly agree, agree, moderately agree, disagree, and strongly disagree).

The data collected in this research came from a questionnaire with ordinal data measurements. The measurement of ordinal data (ordinal scale) will show data in accordance with a certain order or sequence. While the type of ordinal scale used is a sematic scale, which is a response to a stimulus presented in the form of a sematic category, which states a certain level of property or information.

To find out and assess the attitude and perception of respondents about customer value, service quality, and customer satisfaction affect employee loyalty. In this research, the Likert scale was used. The instruments in this research were developed from previous research instruments. This research instrument is measured by the Likert scale, which is a scale used to measure the attitudes, opinions, and perceptions of a person or group of people about certain events. The questionnaire is created through google forms and shared via WhatsApp and Instagram.

RESULTS AND DISCUSSION

Description of Research Data

In this chapter, the data collected, the results of data processing and interpretation of the results of data processing.

Table 1. Profile Response (n=150)

Profil Respond	Characteristic	Frequency	Percentage
Company Name	Tebet Hospital Jakarta UKI Hospital Atmajaya Hospital Jakarta Total	57 43 50 150	38% 28,7% 33,3% 100,0%
Gender	Man Woman Total	87 63 150	58% 42% 100%
Education Level	Diploma Sarjana Postgraduate Doctor Total	24 88 37 3 150	16% 58,7% 24,7% 2% 100,0%
Age	20-29 Years 30-39 Years 40-49 Years >50 Years Total	68 71 12 2 150	45,3% 47,3% 8% 1,3% 100,0%
Working Period	˂1 Year 1-3 Years 3-5 Years >5 Years Total	7 42 39 62 150	4,7% 28% 26% 41,3% 100,0%
Service Unit	Medical Unit Inpatient Unit Nursing Unit Administrative Unit House Keeping & Technical Unit Legal Total	45 23 24 44 13 1 150	30% 15,3% 16% 29,3% 8,7% 0,7% 100,0%

The table above shows that the number of respondents who meet the criteria and requirements to fill out the questionnaire in this research is 150 respondents. The results of data processing showed that all respondents worked in the health industry, with a total of 150 respondents and a percentage of 100%.

The table shows that the majority of respondents are men, which is 58%. Then, for women by 42% or 63 respondents. The results of data processing showed that most of the respondents had a bachelor's degree, which was 58.7% or 88 respondents. For those with the last postgraduate education is 24.7%, for the last education of Doctor is 2%, and the last education of Diploma is 16% or 24 respondents.

From the results of data processing, the majority of respondents aged between 30 and 39 years old were 47.3% or 71 respondents. Then, respondents aged 20 to 29 years old were 45.3% or 68 respondents, respondents aged 40 to 49 years were 8% or 12 respondents and for respondents over 50 years old were 1.3% or 2 respondents.

Based on the results of data processing, the majority of respondents had a working period of more than 5 years of 41.3% or 62 respondents, respondents with a working period of 1 to 3 years amounted to 28% or 42 respondents, respondents with a working period of 3 to 5 years amounted to 26% or 39 respondents, and the smallest respondents with a working period of <1 year amounted to 4.7% or 7 respondents.

Based on the results of data processing, the majority of respondents worked in the medical service unit by 30% or 45 respondents, worked in the administrative service unit by 29.3% or 44 respondents, in the inpatient service unit by 15.3% or 23 respondents, in the house keeping and technical unit by 8.7% or 13 respondents, and in the legal unit by 0.7% or 1 respondent.

Descriptive Analysis of Questionnaire Results

The descriptive analysis of the questionnaire results is intended to explain how much the respondents perceive in understanding each indicator through the questions in the questionnaire. Based on the results of the questionnaire answers from each of the respondents, descriptive analysis for each variable can then be analyzed according to the information that has been obtained in the field.

Descriptive Variables of HRM

According to Stoner, human resource management is an ongoing procedure that aims to supply a company with the right people to be placed in the right positions and positions when the organization needs it. Table 2. shows the results of responses from respondents from Tebet Hospital, UKI HOSPITAL, Atmajaya Jakarta Hospital to the indicators of each HRM construct.

Table 2. Frequency of Variable Answers of HRM

HRM
Indicator	Value					Total
	STS 1	TS 2	CS 3	S 4	SS 5
XI	5%	43%	15%	37%	0%	100%
X2	0%	5%	26%	62%	7%	100%
X3	0%	0%	22%	67%	11%	100%
X4	0%	15%	21%	64%	0%	100%
Mean	1%	16%	21%	57%	5%

Source: Primary Data

From Table 2. it can be seen that the average answer given has a tendency to score 4 (Agree), which is with a percentage of 57%. This shows that the average HRM of Tebet Jakarta Hospital, UKI Hospital, and Atmajaya Jakarta Hospital in the category is quite likely to be close to high (good). This is supported by the value of the X3 and X4 indicators where it shows that the help from fellow colleagues and support from superiors can affect employee performance in a good or positive direction. However, there are 2 indicators in X1 and X2 that have very low values because they are considered to be salaries received that are not in accordance with the burdens/responsibilities carried out and the absence of clarity of job positions in the company.

Descriptive Employee Engagement Variables

Employee Engagement is a multidimensional idea emotionally, cognitively or physically. Engagement occurs when a person is consciously alert and emotionally connected to others. Table 3. shows the results of the responses from respondents from Tebet Hospital, UKI Hospital, and Atmajaya Jakarta Hospital to the indicators of each organizational commitment construct.

Table 3. Employee Engagement Variable Answer Frequency

Employee Engagement
Indicator	Value					Total
	STS 1	TS 2	CS 3	S 4	SS 5
X5	0%	0%	0%	32%	68%	100%
X6	0%	0%	36%	53%	11%	100%
X7	0%	0%	11%	67%	22%	100%
X8	0%	0%	11%	48%	41%	100%
Mean	0%	0%	15%	50%	35%

Source: Primary Data

From Table 8, it can be seen that the average answer given has a tendency to score 4 (Agree), which is with a percentage of 50%. This shows that the average employee attachment to Tebet Hospital, UKI Hospital, and Atmajaya Hospital Jakarta is still in the category of quite tending to approach the high direction (good).

This should be paid more attention to by the company's management so that the attachment of its employees can be better or at least maintained. In the long run, companies with employees who have a bad attachment to the company will have a negative impact, including company employees who are not really focused, do not concentrate on work, do not pay attention to the responsibilities of the work they do, in the health industry in particular, patients will complain about the inability of employees to handle patients well so that the reputation of this hospital becomes bad. The company cannot run its business effectively and efficiently.

Descriptive Variables of Organizational Commitment

Organizational commitment is an employee's association with the organization or a collection of employees' emotional feelings and beliefs towards the company. Organizational commitment is an important concept in management. Table 4. shows the results of the responses from respondents from Tebet Hospital, UKI Hospital, and Atmajaya Jakarta Hospital to the indicators of each organizational commitment construct.

Table 4. The Results of the Responses from Respondents

Organizational Commitment
Indicator	Value					Total
	STS 1	TS 2	CS 3	S 4	SS 5
X9	17%	42%	23%	11%	7%	100%
X10	11%	49%	22%	18%	0%	100%
X11	6%	30%	33%	24%	7%	100%
X12	0%	25%	28%	27%	19%	100%
X13	6%	19%	20%	55%	0%	100%
Mean	8%	33%	25%	27%	7%	100%

Source: Primary Data

From Table 4, it can be seen that the average answer given has a tendency to score 2 (Disagree), which is with a percentage of 33%. This shows that the average organizational commitment of employees of Tebet Hospital, UKI Hospital, and Atmajaya Hospital Jakarta in the category is quite likely to approach the low direction. With a low level of organizational commitment to employees, it has the potential to have a negative impact on the company, including: providing negative effects in the workplace such as poor work performance, lack of good performance and employees tend to look for new jobs so as to increase the company's turnover rate. If this is not paid attention to by the company, of course, in the long run it can result in several things, such as high replacement costs, and a decrease in the effectiveness of the company's operations.

Descriptive Turnover Intention Variables

There are several definitions of turnover intention, including the employee's intention to leave the organization/company, the tendency of employee behavior to leave the company, which causes the actual turnover intention and turnover intention is the main factor that supports the action to resign from the company. Table 5. shows the results of the responses from respondents from Tebet Hospital, UKI HOSPITAL, Atmajaya Jakarta Hospital to the indicators of each turnover intention construct.

Table 5. Frequency of Turnover Intention Variable Answers

Turnover Intention
Indicator	Value					Total
	STS 1	TS 2	CS 3	S 4	SS 5
X14	11%	4%	37%	34%	13%	100%
X15	11%	4%	30%	11%	43%	100%
Mean	11%	4%	34%	23%	28%	100%

Source: Primary Data

From Table 5. , it can be seen that the average answer given has a tendency to score 3 (Neutral), which is with a percentage of 34%. This shows that the turnover intention rate of employees of Tebet Hospital, UKI HOSPITAL, Atmajaya Hospital Jakarta is in the sufficient category. However, the score of 4 (Agree) and score 5 (Strongly Agree) also has a fairly large and influential percentage, namely 23% and 28%.

This also affects the high level of turnover intention in employees, of course, it has a negative impact on the company, for example, the high level of actual employee resignation, the general division of the HR (Human Resources) department will eventually be disrupted by the recruitment and selection process of new employees which can cause high turnover costs, as well as the company's productivity decreases so that the company's profits and targets achieve also decrease.

Analyzes SEM-PLS

SEM-PLS analysis was carried out through 2 analyses, namely measurement model analysis (outer model) and structural model analysis (inner model).

Measurement Model Evaluation Results (Outer Model)

The data processing in this research uses the SEM-PLS Smart application PLS 3.0. The data that has been filled in by the respondents is made into 1 in a CSV (Comma Separated Values) type data tabulation. This data processing is to determine the shape of the model, the loading factor, significant in each latent variable. Data processing using SEM-PLS is carried out by running data repeatedly so that the validity and reliability values are met. There are 3 measurement criteria to assess the Outer model, namely Convergent Validity, Discriminant Validity, and Composite Validity.

Convergent validity with reflective indicators can be seen from the correlation, among others, indicators with their construction values. Indicators with loading factor values are said to be valid/reliable if they have a correlation value above 0.7, but nevertheless for the initial stage of research from the development of a loading value measurement scale of 0.5 to 0.6 is considered sufficient (Chin, 2022 in Ghozali, 2018). However, if the value produced is not >0.5, the indicator is declared invalid and the indicator must be removed from the model so that data must be re-processed.

Table 6. Outer Loading Value in SEM-PLS Phase 1 Data Processing

HRM	Employee Engagement	Organizational Commitment	Turnover Intention
X1	0.796
X2	0.820
X3	0.553
X4	0.717
X5		0.935
X6		0.866
X7		0.920
X8		-0.343
X9		0.682
X10			0.987
X11			0.983
X12		0.888
X13		0.810
X14		0.811
X15		0.904

Source: SEM-PLS Phase 1 data processing

From the results of SEM-PLS Phase 1 data processing in the table above, it is found that there are still invalid indicators, namely on X8 with a loading factor value of -0.343 indicators with a small loading factor value showing a small contribution so that the indicator needs to be eliminated and reprocessed data.

Table 7. Outer Loading Value in SEM-PLS Phase 2 Data Processing

HRM	Employee Engagement	Organizational Commitment	Turnover Intention
X1	0.796
X2	0.821
X3	0.554
X4	0.717
X5		0.926
X6		0.869
X7		0.910
X8
X9		0.716
X10			0.987
X11			0.983
X12		0.887
X13		0.806
X14		0.815
X15		0.905

Source: SEM-PLS Phase 2 data processing

From the results of SEM-PLS Phase 2 data processing in Figure 4.6 and Table 10. above,

It was found that all indicators were valid/had met the loading factor value of >0.5. In addition to evaluating the value of the loading factor, the validity of the construct can also be assessed by looking at the AVE (Average Variance Extracted) value where the AVE value is able to show the ability of the latent variable value to represent the original data score. The higher the AVE value, the higher the ability to explain the value of indicators that measure latent variables. The cut-off value of the AVE used is 0.50 where the AVE value of at least 0.50 indicates a good measure of convergent validity, which means that the probability of the indicator in a construct entering another variable is lower (less than 0.50) so that the probability of the indicator being convergent and entering in the construct whose value in the block is greater than 50%. The following AVE values are generated from SEMPLS phase 2 data processing:

Figure 1. Graph of AVE values in SEM-PLS Phase 2 data processing

Table 8. AVE values in SEM-PLS Phase 2 data processing

Variable	AVE
HRM	0.532
Employee Engagement	0.730
Organizational Commitment	0.738
Turnover Intention	0.970

Source: SEM-PLS Phase 2 data processing

From Figure and Table 8. , it can be seen that the SEM-PLS data processing in phase 2 testing produces the AVE value of each variable can be declared good because it has met the requirements with a value of more than 0.5. This shows that latent variables can explain more than 50% of the variance of the indicators. So from Table 7. , Table 8. , and Figure, it can be concluded that all indicators and constructs in the model have met the criteria of the Convergent Validity test.

Furthermore, a discriminant validity test is carried out, to test whether the indicators of a construct are not highly correlated with indicators from other constructs. The discriminant validity of the measurement model with reflective indicators is assessed based on the cross loading measurement with the construct. If the correlation of the construct with the measurement item is greater than the size of the other construct, then it indicates that the latent construct predicts the size on the block better than the size of the other block. The following are the results of loading and cross loading values from the results of SEM-PLS phase 2 data processing:

Table 9. Loading and Cross Loading

	HRM	Organizational Commitment	Turnover Intention	Employee Engagement
X1	0.796	0.608	-0.670	0.210
X2	0.821	0.357	-0.541	0.216
X3	0.554	0.289	-0.360	-0.023
X4	0.717	0.253	-0.403	0.206
X5	0.457	0.926	-0.726	0.393
X6	0.404	0.869	-0.492	0.595
X7	0.397	0.910	-0.405	0.524
X9	0.027	0.716	-0.403	-0.559
X10	-0.652	0.987	-0.403	-0.378
X11	-0.701	0.983	-0.378	-0.206
X12	0.354	0.604	-0.449	0.887
X13	0.326	0.584	-0.498	0.806
X14	0.217	0.508	-0.055	0.815
X15	0.099	0.425	-0.045	0.905

Source: SEM-PLS Phase 2 data processing

An indicator can also be declared valid if it has a loading factor higher than its cross loading value. From Table 12. it can be seen that the construction correlation of all loading values has a greater value than cross loading. It can be concluded in the table above that each construct predicts the indicators on each block better than the indicators in the other blocks. Another method to find discriminant validity is to compare the square root value of the AVE (√AVE) of each construct with the value of the correlation between the construct and the other constructs (latent variable correlation). The model has a sufficient Discriminant Validity value if the AVE root for each construct is greater than the correlation between the construct and the other constructs as seen in the table below.

Table 10. Discriminant Validity Value

	HRM	Employee Engagement	Organizational Commitment	Turnover Intention
HRM	0.729	0.293	0.552	-0.685
Employee Engagement	0.293	0.854	0.609	-0.302
Organizational Commitment	0.552	0.609	0.859	-0.709
Turnover Intention	-0.685	-0.302	-0.709	0.985

Source: SEM-PLS Phase 2 data processing

Table 10. above shows that all the AVE root values of each construct are greater than the correlation between the construct and the other constructs. So from Table 9. and Table 10. , it can be concluded that all constructs in the estimated model have met the criteria of the Discriminant Validity test. The last thing done in the Outer Model evaluation is to conduct a Composite Reliability test. The Composite Reliability test is a better method compared to the cronbach alpha value in testing reliability in the SEM model. Composite reliability, which measures a construct, can be evaluated with two measures, namely internal consistency and cronbach's alpha (Ghozali, 2020, p.75). Cronbach's alpha tends to be a lower bound estimate in measuring reliability, while composite reliability does not assume reliability, while composite reliability is a closer approximation assuming that parameter estimation is more accurate (Ghozali, 2020, p.76). The composite reliability interpretation is the same as Cronbach's alpha where a limit value of 0.7 and above is acceptable. The following are the results of composite reliability and Cronbach's alpha from SEM-PLS phase 2 data processing:

Figure 2. Composite Reliability

Figure 3. Cronbasch’s Alpha

Table 11. Composite Reliability and Crombach Alpha Values

	Composite Reliability	Cronbach’s Alpha
HRM	0,817	0,721
Employee Engagement	0,915	0,876
Organizational Commitment	0,918	0,878
Turnover Intention	0,985	0,970

From the Figure and Table above, it can be seen that the research model is considered reliable because the Composite Reliability and Cronbach's Alpha values of all variables have been above 0.7. Thus, it can be concluded that the four variables have reliable reliability because they meet the criteria of the Composite Reliability test.

Hypothesis Testing

Testing hypotheses between constructs, namely exogenous constructs against endogenous constructs and endogenous constructs against endogenous constructs, was carried out using the bootstrap resampling method developed by Geisser (Ghozali, 2020: p. 25).

The test statistics used are t-statistics or t-test, the application of the resampling method allows the application of freely distributed data does not require normal distribution assumptions, and does not require a large sample.

Hypothesis testing uses full model analysis of Structural Equation Modeling (SEM) with smartPLS. In the full SEM model with PLS, in addition to predicting the model, it also explains whether or not there is a relationship between latent variables. The relationship of the path analysis of all latent variables in PLS in the research is as follows:

1. Outer model that specifies the relationship between indicators and latent variables.

2. Inner model that specifies the relationship between latent variables.

3. Weight relation where the case value of the latent variable can be estimated.

The decision on the acceptance of the hypothesis in this research was carried out with the provision that the t-table one tail test value determined in this research was 1.96 for a significance of 0.05. Furthermore, the t-table value is used as a cut off value for the acceptance or rejection of the hypothesis proposed:

1) The outer weight value of each indicator and its significance value. Weight value The recommended t-statistic is above and the t-statistic above the t-table value of 1.645 for α = 0.05 in the One Tailed test.

2) Look at the inner weight value of the relationship between latent variables. Weight value of The relationship must show a positive direction with a t-value above the t-table 1.96 for α = 0.05 on the one tailed test.

3) The research hypothesis is accepted if the weight value of the relationship between latent variables indicates the direction with a statistical t-value above the t-table value of 1.96 for α = 0.05:

4) The research hypothesis is rejected if the weight value of the relationship between variables shows a t-statistical value below the t-table value for α= 0.05;

There are 5 hypotheses that will be tried to be answered in this research, and from the results hypothesis testing as follows:

Table 12. Results of Hypothesis Testing

Relation	Original Sample (O)	T Statistics (O/STDEV)	Conclusion
HRM → Employee Engagement	0.061	0.678	There is a POSITIVE influence but the result is not significant/hypothesis REJECTED
HRM → Turnover Intention	-0.408	16.897	There is a NEGATIVE influence and the results are significant/hypothesis ACCEPTED
Organizational Commitment → Employee Engagement	0.705	12.321	There is a POSITIVE influence and the results are significant / hypothesis ACCEPTED
Organizational Commitment → Turnover Intention	-0.427	9.216	There is a NEGATIVE influence and the results are significant/hypothesis ACCEPTED
Turnover Intention → Employee Engagement	0.246	3.382	There is a POSITIVE influence and the results are significant / hypothesis ACCEPTED

Discussion

The discussion of the research results was carried out to obtain scientific arguments on the results of hypothesis testing. The following is a discussion of the results of the research:

a. Hypothesis 1 (HRM affects Employee Engagement)

b. Based on Table 12, the magnitude of the influence parameter coefficient of the HRM variable on employee engagement (original sample) is 0.061, which means that there is a POSITIVE influence between the two variables. Or can

c. It is interpreted that the higher the HRM, the better the employee engagement will be. Then from the T-statistical value produced is 0.678 which means that the result is said to be NOT SIGNIFICANT because of the statistical t value smaller than the t-table (0.678 < 1.96) or it can be said that the HYPOTHESIS is REJECTED.

d. Hypothesis 2 (HRM affects Turnover Intention)

e. Based on Table 4.16, the magnitude of the parameter coefficient of the influence of the HRM variable on turnover intention (original sample) is -0.408 which means that there is a NEGATIVE influence between the two variables. Or it can be interpreted that the lower the HRM, the higher the employee's turnover intention will be. Then the T-statistical value produced is 12.321 which means that the result is said to be SIGNIFICANT because the statistical t-value is greater than the t-table (12.321 > 1.96) or it can be said to be a HYPOTHESIS ACCEPTED.

f. Hypothesis 3 (Organizational Commitment Affects Employee Engagement)

g. Based on Table 4.16, the magnitude of the parameter coefficient of the influence of the variable of organizational commitment on employee engagement (original sample) is 0.705, which means that there is a POSITIVE influence between the two variables. Or it can be interpreted that the higher the organization's commitment, the better the employee engagement will be. Then from the T-statistical value generated is 16.897 which means that the result is said to be SIGNIFICANT because the statistical t-value is greater than the t-table (16.897 > 1.96) or it can be said that the hypothesis is ACCEPTED.

h. Hypothesis 4 (Organizational Commitment Affects Turnover Intention)

i. Based on Table 4.16, the magnitude of the parameter coefficient of the influence of the organizational commitment variable on turnover intention (original sample) is -0.472 which means that there is a NEGATIVE influence between the two variables. Or It can be interpreted that the lower the organization's commitment, the more turnover Employee intention will also be higher. Then from the T-statistical value is 9,216 which means the result is said to be SIGNIFICANT Because the statistical t-value is greater than the t-table (9.216 > 1.96) or it can be said that THE HYPOTHESIS WAS ACCEPTED.

j. Hypothesis 5 (Turnover Intention affects Employee Engagement)

k. Based on Table 4.16 The magnitude of the parameter coefficient of influence of the turnover variable intention to employee engagement (original sample) of 0.246 which means there is a POSITIVE influence between the two variables. Or it can be interpreted that the lower the turnover intention, the better the employee attachment will be. Then from the T-statistical value produced is 3.382 which means that the result is said to be SIGNIFICANT because the statistical t-value is greater than the t-table (3.382 > 1.96) or it can be said that the HYPOTHESIS is ACCEPTED.

CONCLUSION

Based on the analysis and discussion, several key conclusions can be drawn. First, the influence of human resource management (HRM) on employee engagement shows a positive relationship, although this influence is not statistically significant, as indicated by the original sample value of 0.061 and a T-value of 0.678, which is smaller than the critical t-table value (1.96). Consequently, the hypothesis regarding HRM's influence on employee engagement is rejected. However, the influence of HRM on turnover intention reveals a negative and significant relationship, with an original sample value of -0.408 and a T-value of 12.321, confirming that effective HRM practices can significantly reduce turnover intention. Additionally, organizational commitment demonstrates a strong and significant positive relationship with employee engagement, as reflected by an original sample value of 0.705 and a T-value of 16.897, supporting the hypothesis that higher organizational commitment increases employee engagement. Similarly, organizational commitment has a significant negative effect on turnover intention, with an original sample value of -0.472 and a T-value of 9.216, affirming that greater commitment reduces the likelihood of turnover.

Moreover, the study reveals a positive and significant relationship between turnover intention and employee performance, with an original sample value of 0.246 and a T-value of 3.382. This suggests that while turnover intention typically reflects negative employee sentiments, it can also serve as a critical indicator for performance outcomes, making it a valuable metric for HR planning. This research contributes to the understanding of the interconnectedness of HRM, organizational commitment, and employee behavior in the healthcare sector. Future research should explore external factors such as market conditions, leadership styles, and employee well-being programs to see how they influence turnover intention and engagement. Longitudinal studies or cross-sector comparisons could offer more comprehensive insights into the long-term impact of HR strategies on performance and retention outcomes.

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Copyright holder:

Pinky Sutrisno Saraswati, Justine Tanuwijaya, Andreas Wahyu Gunawan (2024)

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Asian Journal of Engineering, Social and Health (AJESH)

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