Leader–member exchange and organizational climate effects on clinician turnover intentions

Abstract

PurposeClinician turnover in mental health settings impacts service quality, including availability and delivery of evidence-based practices. Leadership is associated with organizational climate, team functioning and clinician turnover intentions (TI). This study examines leader–member exchange (LMX), reflecting the relationship between a supervisor and each supervisee, using mean team LMX, dispersion of individual clinician ratings compared to team members (i.e. relative LMX) and team level variability (i.e. LMX differentiation), in relation to organizational climate and clinician TI.Design/methodology/approachSurvey data were collected from 363 clinicians, nested in children's mental health agency workgroups, providing county-contracted outpatient services to youth and families. A moderated mediation path analysis examined cross-level associations of leader–member exchange with organizational climate and turnover intentions.FindingsLower relative LMX and greater LMX differentiation were associated with higher clinician TI. Higher team-level demoralizing climate also predicted higher TI. These findings indicate that poorer LMX and more variability in LMX at the team level are related to clinician TI.Originality/valueThis study describes both team- and clinician-level factors on clinician TI. Few studies have examined LMX in mental health, and fewer still have examined relative LMX and LMX differentiation associations with organizational climate and TI. These findings highlight the importance of leader–follower relationships and organizational climate and their associations with clinician TIs. Mental health service systems and organizations can address these issues through fostering more positive supervisor–supervisee relationships.

Engaging to innovate: an investigation into the implications of engagement at work on innovative behaviors in healthcare organizations

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Requested to do right things excessively: how citizenship pressure/future focus influence health-related work outcomes in health organizations during the pandemic

“…Healthcare employee turnover has been an increasing public concern throughout the world (e.g. Aarons et al, 2021;Robson and Robson, 2016). Cognitively, we argue that employees experiencing strong citizenship fatigue may feel that it is beyond their job responsibility to conduct OCBs and are reluctant to engage in subsequent OCBs in the future.…”

“…Healthcare employee turnover has been an increasing public concern throughout the world (e.g. Aarons et al. , 2021; Robson and Robson, 2016).…”

“…Recent studies have documented the unusual turnover trend of frontline healthcare practitioners due to substantially intensified job demand, perception of resource loss during the pandemic (e.g. Aarons et al, 2021;Enwereuzor and Ugwu, 2021;Cole et al, 2021;Hassan et al, 2022).…”

The Influence of Leader-Member Exchange Relationship, Perceived Organizational Support, and Work-Life Balance on Tertiary Hospital Nurses’ Retention Intention

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