The soft underbelly of system change: The role of leadership and organizational climate in turnover during statewide behavioral health reform.

Abstract

This study examined leadership, organizational climate, staff turnover intentions, and voluntary turnover during a large-scale statewide behavioral health system reform. The initial data collection occurred nine months after initiation of the reform with a follow-up round of data collected 18 months later. A self-administered structured assessment was completed by 190 participants (administrators, support staff, providers) employed by 14 agencies. Key variables included leadership, organizational climate, turnover intentions, turnover, and reform-related financial stress ("low" versus "high") experienced by the agencies. Analyses revealed that positive leadership was related to a stronger empowering climate in both high and low stress agencies. However, the association between more positive leadership and lower demoralizing climate was evident only in high stress agencies. For both types of agencies empowering climate was negatively associated with turnover intentions, and demoralizing climate was associated with stronger turnover intentions. Turnover intentions were positively associated with voluntary turnover. Results suggest that strong leadership is particularly important in times of system and organizational change and may reduce poor climate associated with turnover intentions and turnover. Leadership and organizational context should be addressed to retain staff during these periods of systemic change.

Evidence-Based Physiotherapy Culture—The Influence of Health Care Leaders in Sweden

“…Similar roles are described in numerous frameworks and models applied in implementation science (Nilsen, 2015). Although having champions of EBP has been shown to be important for successful implementation of EBP in various settings (Aarons, Sommerfeld, & Willging, 2011;Berta et al, 2005;Greenhalgh et al, 2004;Simpson, 2002), there are also disadvantages in becoming too dependent on individuals because sustainability of EBP may be compromised if these individuals retire or take up other job opportunities (Damschroder et al, 2009;Ridelberg & Nilsen, 2015).…”

Expanding the Frontiers of Population Nutrition Research: New Questions, New Methods, and New Approaches

“…Among the many factors receiving attention in terms of theoretical development and measurement are organizational climate and culture (243), organizational and staff readiness to change (244)(245)(246)(247), implementation fidelity (248), and leadership (247,(249)(250)(251)(252)(253), among others (254). The relevance of these topics to nutrition implementation is readily apparent yet they have received little or no attention in nutrition research.…”

“…A third dimension relates to social engagement, with some work proceeding in a more detached and objectivist mode and other work engaging implementers to greater or lesser degrees in the research questions; the design, execution, and interpretation of the research; and the application of findings (261). Finally, some research focuses more narrowly on particular implementation constructs or processes [such as leadership, climate, or employee readiness (250,253,262,263)], whereas other work focuses on the program as a whole and seeks to incrementally improve implementation processes and outcomes (e.g., through strengthened management, monitoring, and evaluation systems or quality improvement systems (264,265).…”

“…A corollary premise of DE is that current approaches and practices for summative and formative evaluation are not suited for coping with the realities of complex adaptive systems. These realities are becoming widely recognized in global health (253)(254)(255) and have equal relevance to nutrition (271,272).…”

Transformational Leadership Moderates the Relationship Between Emotional Exhaustion and Turnover Intention Among Community Mental Health Providers

“…One factor that may affect both emotional exhaustion and turnover intention is leadership of mental health program managers, in particular, transformational leadership (Aarons, Sommerfeld, & Willging, in press; Stordeur, D'Hoore, & Vandenberghe, 2001). Transformational leadership, as described by the full range model of leadership, is characterized by four leader behaviors – idealized influence, inspirational motivation, intellectual stimulation, and individual consideration (Bass, 1990).…”