IJARSAI International Journal of Advanced Research Scientific Analysis & Inferences International Multidisciplinary Biannual Double-Blind Peer-Reviewed & Refereed Print Research Journal Vol. 1 No. 3 (July - December 2025) ISSN: 3049-1789 21 Transforming Healthcare Infrastructure Management in Kerala: Innovations, Challenges, and the Path to a Resilient Future Discipline: Commerce Ms. Ananya. P Research Scholar, Department of Commerce, Karyavattom Campus, University of Kerala, India Email: ananyaprasad1116@gmail.com Dr. R. Vasanthagopal Senior Professor & Dean, Faculty of Management Studies, University of Kerala, India Received: 19.06.2025 | Revised Submission: 28.06.2025 | Accepted: 03.07.2025 | Available Online: 12.07.2025 Abstract This study examined the relationships between job satisfaction, organisational commitment, employee engagement, and turnover intentions among hospital employees (N = 324). A one-way ANOVA revealed significant differences in job satisfaction by department, F(2, 321) = 3.13, p = .045, with the Administration department reporting significantly higher job satisfaction than the Nursing department. A Pearson correlation indicated a positive, moderate association between job satisfaction and organisational commitment (r = 0.52, p < .01).Multiple regression analysis showed that job satisfaction significantly predicted employee engagement (â = 0.48, p < .001) even when controlling for age and tenure (R² = 0.29, F(3, 320) = 44.83, p < .001). At the same time, the demographic variables were not significant predictors. Furthermore, mediation analysis demonstrated that organisational commitment fully mediated the relationship between job satisfaction and turnover intentions. The direct effect of job satisfaction on turnover intentions (B = -0.32, p < .001) became non-significant (B = -0.06, p = 0.506) when the organisational commitment was included, and the bootstrap indirect effect was significant (B = -0.26, 95% CI [-0.36, -0.18], p < .001).These findings underscore the importance of improving job satisfaction to enhance engagement, strengthen organisational commitment, and subsequently reduce turnover intentions. Targeted interventions that foster a supportive work environment may yield long-term benefits in workforce stability and organisational performance. Keywords: Job Satisfaction, Organizational Commitment, Employee Engagement, Turnover Intentions, Healthcare Workforce, Mediation Analysis.