Background: The objective of this study is to explore the nature of the association of discrete systems of human resource management practices and the rate of voluntary turnover of registered nurses (RNs) in a large sample of Canadian acute care hospitals and nursing homes. Healthcare quality, cost and access are impacted by excessive turnover of nursing staff. The rate of annual turnover for registered nurses has been estimated to be about 20 percent in Canada, with a total cost of almost $27,000 for each RN. Healthcare organizations that employ large numbers of registered nurses are keen to learn more about the role that organizational policies and practices play in reducing voluntary turnover. The relationship of human resource management (HRM) practices and employee turnover has generally been under-investigated. Three HRM systems, composed of bundles of discrete workplace or employment practices, were conceptualized in order to assess the relationship of HRM practice systems with the rate of RN turnover, at the establishment or facility level. Three HRM practice systems were constructed to test their systemic impact on nursing turnover: a technical HRM system that focuses on bureaucratic policies and practices that regulate the employee-employer relationship; a quality-of-worklife HRM system that includes a variety of employee-centered and family-friendly employment practices; and a high-involvement HRM system that utilize workplace arrangements that increase the commitment, engagement, accountability and participation of nurses.