▁within ▁an ▁organization ▁can ▁be ▁a ▁worth while ▁exercise , ▁especially ▁since ▁“ turn over ▁costs ” ▁are ▁unlikely ▁to ▁appear ▁in ▁an ▁organization ’ s ▁balance ▁sheets . ▁Some ▁of ▁the ▁direct ▁costs ▁can ▁be ▁readily ▁calculated , ▁while ▁the ▁indirect ▁costs ▁can ▁often ▁be ▁more ▁difficult ▁to ▁determine ▁and ▁may ▁require ▁“ ed uc ated ▁guess es .” ▁Nevertheless , ▁calculating ▁even ▁a ▁rough ▁idea ▁of ▁the ▁total ▁exp enses ▁rel ating ▁to ▁turn over ▁can ▁sp ur ▁action ▁planning ▁within ▁an ▁organization ▁to ▁improve ▁the ▁work ▁environment ▁and ▁reduce ▁turn over . ▁Sur ve ying ▁employees ▁at ▁the ▁time ▁they ▁leave ▁an ▁organization ▁can ▁also ▁be ▁an ▁effective ▁approach ▁to ▁understanding ▁the ▁drivers ▁of ▁turn over ▁within ▁a ▁particular ▁organization . ▁ ▁In ▁a ▁health care ▁context , ▁staff ▁turn over ▁has ▁been ▁associated ▁with ▁worse ▁patient ▁out comes . ▁ ▁In ternal ▁versus ▁external ▁ ▁Like ▁rec ruit ment , ▁turn over ▁can ▁be ▁class ified ▁as ▁" internal " ▁or ▁" external ". ▁In ternal ▁turn over ▁involves ▁employees ▁leaving ▁their ▁current ▁positions ▁and ▁taking ▁new ▁positions ▁within ▁the ▁same ▁organization . ▁Both ▁positive ▁( such ▁as ▁increased ▁mor ale ▁from ▁the ▁change ▁of ▁task ▁and ▁super visor ) ▁and ▁negative ▁( such ▁as ▁project / rel ational ▁dis ruption , ▁or ▁the ▁Peter ▁Princi ple ) ▁effects ▁of ▁internal ▁turn over ▁exist , ▁and ▁therefore , ▁it ▁may ▁be ▁equally ▁important ▁to ▁monitor ▁this ▁form ▁of ▁turn over ▁as ▁it ▁is ▁to ▁monitor ▁its ▁external ▁counter part