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

Psychological Services

Volumn 8, Issue 4, 2011, Pages 269-281

  Aarons, Gregory A ^a,b   Sommerfeld, David H ^a,b   Willging, Cathleen E ^c  

^a UNIVERSITY OF CALIFORNIA   (United States)

^b RADY CHILDREN'S HOSPITAL   (United States)

^c PACIFIC INSTITUTE FOR RESEARCH AND EVALUATION   (United States)

Author keywords

Behavioral health policy; Implementation; Leadership; Organizational studies; Safety net institutions; Turnover

Indexed keywords

EID: 82955186377     PISSN: 15411559     EISSN: None     Source Type: Journal    
DOI: 10.1037/a0026196     Document Type: Article

References (74)

1. Aarons G.A. Transformational and transactional leadership: Association with attitudes toward evidence-based practice. Psychiatric Services 2006, 57:1162-1169. doi: 10.1176/appi.ps.57.8.1162.
2. Aarons, G. A., & Horowitz, J. (2010, August). Leading evidence-based practice implementation in mental health and social services. Paper presented at the meeting of the American Psychological Association, San Diego, CA.
3. Aarons G.A., Hurlburt M., Horwitz S.M. Advancing a conceptual model of evidence-based practice implementation in public service sectors. Administration and Policy in Mental Health and Mental Health Services Research 2011, 38:4-23. doi: 10.1007/s10488-010-0327-7.
4. Aarons G.A., Sawitzky A.C. Organizational climate partially mediates the effect of culture and work attitudes and staff turnover in mental health services. Administration and Policy in Mental Health and Mental Health Services Research 2006, 33:289-301. doi: 10.1007/s10488-006-0039-1.
5. Aarons G.A., Sawitzky A.C. Organizational culture and climate and mental health provider attitudes toward evidence-based practice. Psychological Services 2006, 3:61-72. doi: 10.1037/1541-1559.3.1.61.
6. Aarons, G. A., & Sommerfeld, D. H. (2011). Leadership, innovation climate, and attitudes toward evidence-based practice during a statewide implementation. Manuscript submitted for publication.
7. Aarons G.A., Sommerfeld D.H., Hecht D.B., Silovsky J.F., Chaffin M.J. The impact of evidence-based practice implementation and fidelity monitoring on staff turnover: Evidence for a protective effect. Journal of Consulting and Clinical Psychology 2009, 77:270-280. doi: 10.1037/a0013223.
8. Aarons, G. A., Woodbridge, M., & Carmazzi, A. (March, 2002). Examining leadership, organizational climate, and service quality in a children's system of care. Paper presented at the 15th Annual Research Conference, A System of Care for Children's Mental Health: Examining the Research Base, Tampa, FL.
9. Avolio B.J., Bass B.M., Jung D.I. Re-examining the components of transformational and transactional leadership using the Multifactor Leadership Questionnaire. Journal of Occupational and Organizational Psychology 1999, 72:441-462. doi: 10.1348/096317999166789.
10. Avolio B.J., Gardner W.L., Walumbwa F.O., Luthans F., May D.R. Unlocking the mask: A look at the process by which authentic leaders impact follower attitudes and behaviors. Leadership Quarterly 2004, 15:801-823. doi: 10.1016/j.leaqua.2004.09.003.
11. Bass B., Avolio B. MLQ: Multifactor leadership questionnaire (Tech. Rep. No.) 1995, Binghampton University, Center for Leadership Studies, Binghampton, NY.
12. Bass B.M. Does the transactional-transformational leadership paradigm transcend organizational and national boundaries?. American Psychologist 1997, 52:130-139. doi: 10.1037/0003-066X.52.2.130.
13. Bass B.M., Avolio B.J. Transformational leadership development: Manual for the Multifactor Leadership Questionnaire 1990, Consulting Psychologist Press, Palo Alto, CA.
14. Castle N.G. Administrator turnover and quality of care in nursing homes. Gerontologist 2001, 41:757-767. doi: 10.1093/geront/41.6.757.
15. Coomber B., Barriball K.L. Impact of job satisfaction components on intent to leave and turnover for hospital-based nurses: A review of the research literature. International Journal of Nursing Studies 2007, 44:297-314. doi: 10.1016/j.ijnurstu.2006.02.004.
16. Corrigan P.W., Lickey S.E., Campion J., Rashid F. Mental health team leadership and consumers satisfaction and quality of life. Psychiatric Services 2000, 51:781-785. doi: 10.1176/appi.ps.51.6.781.
17. De Hoogh A.H.B., Den Hartog D.N., Koopman P.L., Thierry H., Van den Berg P.T., Van der Weide J.G., Wilderom C.P.M. Leader motives, charismatic leadership, and subordinates' work attitude in the profit and voluntary sector. Leadership Quarterly 2005, 16:17-38. doi: 10.1016/j.leaqua.2004.10.001.
18. Drake B., Yadama G.N. A structural equation model of burnout and job exit among child protective service workers. Social Work Research 1996, 20:179-187.
19. Dunn G., Everitt B.S., Pickles A. Modeling covariances and latent variables using EQS 1993, Chapman and Hall, New York, NY.
20. Farkas A.J., Tetrick L.E. A three-wave longitudinal analysis of the causal ordering of satisfaction and commitment on turnover decisions. Journal of Applied Psychology 1989, 74:855-868. doi: 10.1037/0021-9010.74.6.855.
21. Felland L.C., Lesser C.S., Staiti A.B., Katz A., Lichiello P. The resilience of the health care safety net, 1996-2001. Health Services Research 2003, 38:489-502. doi: 10.1111/1475-6773.00126.
22. Gallon S.L., Gabriel R.M., Knudsen J.R. The toughest job you'll ever love: A Pacific Northwest Treatment Workforce Survey. Journal of Substance Abuse Treatment 2003, 24:183-196. doi: 10.1016/S0740-5472(03)00032-1.
23. Garfield R.L. Mental health policy development in the States: The piecemeal nature of transformational change. Psychiatric Services, 2009, 60:1329-1335. doi: 10.1176/appi.ps.60.10.1329.
24. Glisson C. The organizational context of children's mental health services. Clinical Child and Family Psychology Review 2002, 5:233-253. doi: 10.1023/A:1020972906177.
25. Glisson C., Dukes D., Green P. The effects of the ARC organizational intervention on caseworker turnover, climate, and culture in children's service systems. Child Abuse and Neglect 2006, 30:855-880. doi: 10.1016/j.chiabu.2005.12.010.
26. Glisson C., Durick M. Predictors of job satisfaction and organizational commitment in human service organizations. Administrative Science Quarterly 1988, 33:61-81. doi: 10.2307/2392855.
27. Glisson C., Hemmelgarn A. The effects of organizational climate and interorganizational coordination on the quality and outcomes of children's service systems. Child Abuse and Neglect 1998, 22:401-421. doi: 10.1016/S0145-2134(98)00005-2.
28. Glisson C., James L.R. The cross-level effects of culture and climate in human service teams. Journal of Organizational Behavior 2002, 23:767-794. doi: 10.1002/job.162.
29. Glisson C., Schoenwald S.K. The ARC organizational and community intervention strategy for implementing evidence-based children's mental health treatments. Mental Health Services Research 2005, 7:243-259. doi: 10.1007/s11020-005-7456-1.
30. Glisson C., Schoenwald S.K., Hemmelgarn A., Green P., Dukes D., Armstrong K.S., Chapman J.E. Randomized trial of MST and ARC in a two-level evidence-based treatment implementation strategy. Journal of Consulting and Clinical Psychology 2010, 78:537-550. doi: 10.1037/a0019160.
31. Gray A.M., Phillips V.L., Normand C. The costs of nursing turnover: Evidence from the British National Health Service. Health Policy 1996, 38:117-128. doi: 10.1016/0168-8510(96)00854-8.
32. Gray B.H., Rowe C. Safety-net health plans: A status report. Health Affairs 2000, 19:185-193. doi: 10.1377/hlthaff.19.1.185.
33. Griffeth R.W., Hom P.W., Gaertner S. A meta-analysis of antecedents and correlates of employee turnover: Update, moderator tests, and research implications for the next millennium. Journal of Management 2000, 26:463-488. doi: 10.1177/014920630002600305.
34. Hackman J.R., Oldham G.R. Work redesign 1980, Addison Wesley, Reading, MA.
35. Hauenstein E.J., Petterson S., Rovnyak V., Merwin E., Heise B., Wagner D. Rurality and mental health treatment. Administration and Policy in Mental Health and Mental Health Services Research 2007, 34:255-267. doi: 10.1007/s10488-006-0105-8.
36. Hedeker D., Gibbons R.D. Application of random-effects pattern-mixture models for missing data in longitudinal studies. Psychological Methods 1997, 2:64-78. doi: 10.1037/1082-989X.2.1.64.
37. Horton S., McCloskey J., Todd C., Henriksen M. Transforming the safety net: Responses to Medicaid managed care in rural and urban New Mexico. American Anthropologist 2001, 103:733-746. doi: 10.1525/aa.2001.103.3.733.
38. Hough, R. L., Willging, C. E., Altschul, D., & Adelsheim, S. (in press). Workforce capacity for reducing rural disparities in public mental health services for adults with severe mental Illness. Journal of Rural Mental Health.
39. Howard B., Gould K.E. Strategic planning for employee happiness: A business goal for human service organizations. American Journal of Mental Retardation 2000, 105:377-386. doi: 10.1352/0895-8017(2000)105<0377:SPFEHA>2.0.CO;2.
40. Hu L., Bentler P.M. Fit indices in covariance structure modeling: Sensitivity to underparameterized model misspecification. Psychological Methods 1998, 3:424-453. doi: 10.1037/1082-989X.3.4.424.
41. Hu L., Bentler P.M. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling 1999, 6:1-55. doi: 10.1080/10705519909540118.
42. Huang L., Macbeth G., Dodge J., Jacobstein D. Transforming the workforce in children's mental health. Administration and Policy in Mental Health 2004, 32:167-187. doi: 10.1023/B:APIH.0000042745.64582.72.
43. America's health care safety-net: Intact but endangered 2000, Institute of Medicine, National Academic Press, Washington, DC.
44. Jayaratne S., Chess W.A. Job satisfaction, burnout, and turnover: A national study. Social Work and Society 1984, 29:448-453.
45. Judge T.A., Piccolo R.F. Transformational and transactional leadership: A meta-analytic test of their relative validity. The Journal of Applied Psychology 2004, 89:755-768. doi: 10.1037/0021-9010.89.5.755.
46. Kano M., Willging C.E., Rylko-Bauer B. Community participation in New Mexico's behavioral health care reform. Medical Anthropology Quarterly 2009, 23:277-297. doi: 10.1111/j.1548-1387.2009.01060.x.
47. Kelloway E.K. Using Lisrel for structural equation modeling: A researcher's guide 1998, Sage, Thousand Oaks, CA.
48. Klein K.J., Kozlowski S.W.J. Multilevel theory, research, and methods in organizations: Foundations, extensions, and new directions 2000, Jossey-Bass, San Francisco, CA.
49. Knudsen H.K., Ducharme L.J., Roman P.M. Research participation and turnover intention: An exploratory analysis of substance abuse counselors. Journal of Substance Abuse Treatment 2007, 33:211-217. doi: 10.1016/j.jsat.2006.12.013.
50. Knudsen H.K., Johnson J.A., Roman P.M. Retaining counseling staff at substance abuse treatment centers: Effects of management practices. Journal of Substance Abuse Treatment 2003, 24:129-135. doi: 10.1016/S0740-5472(02)00357-4.
51. Kreft I., de Leeuw J. Introducing multilevel modeling 1998, Sage, Thousand Oaks, CA.
52. Lawler E.E., Hall D.T., Oldman G.R. Organizational climate: Relationship to organizational structure, process, and performance. Human Performance 1974, 11:139-155.
53. Maslach C., Schaufeli W.B., Leiter M.P. Job burnout. Annual Review of Psychology 2001, 52:397-422. doi: 10.1146/annurev.psych.52.1.397.
54. McArdle J.J., Hamagami F. Multilevel models from a multiple group structural equation perspective. Advanced structural equation modeling: Issues and techniques 1996, 89-124. Erlbaum, Mahwah, NJ. G.A. Marcoulides, R.E. Schumacker (Eds.).
55. Mowday R.T., Porter L.W., Steers R.M. Employee-organization linkages: The psychology of commitment, absenteeism and turnover 1982, Academic Press, New York, NY.
56. Muthen L.K., Muthen B.O. Mplus User's Guide 1998-2008 2008, Muthen & Muthen, Los Angeles, CA.
57. Patton M.Q. Qualitative research and evaluation methods 2002, Sage, Thousand Oaks, CA. 3rd ed.
58. Pritchard R.D., Karasick B.W. The effects of organizational climate on managerial job performance and job satisfaction. Organizational Behavior and Human Decision Processes 1973, 9:126-146.
59. Reschovsky J.D., Staiti A.B. Access and quality: Does rural America lag behind?. Health Affairs(Millwood) 2005, 24:1128-1139. doi: 10.1377/hlthaff.24.4.1128.
60. Schein E. Organizational culture and leadership 2010, Jossey-Bass, San Francisco, CA. 4th ed.
61. Semansky R.M., Altschul D., Sommerfeld D., Hough R., Willging C.E. Capacity for delivering culturally competent mental health services in New Mexico: Results of a statewide agency survey. Administration and Policy in Mental Health Services Research 2009, 36:289-307. doi: 10.1007/s10488-009-0221-3.
62. Semansky R.M., Hodgkin D., Willging C.E. Preparing for a public sector mental health reform in New Mexico: The experience of agencies serving adults with serious mental illness. Community Mental Health Journal 2011, doi: 10.1007/s10597-011-9418-5.
63. Singer M.I., Yankey J.A. Organizational metamorphosis: A study of eighteen nonprofit mergers, acquisitions, and consolidations. Nonprofit Management and Leadership 1991, 1:357-369. doi: 10.1002/nml.4130010406.
64. Stodgill R.M. Handbook of leadership: A survey of theory and research 1974, Free Press, New York, NY.
65. Tett R.P., Meyer J.P. Job satisfaction, organizational commitment, turnover intention, and turnover: Path analysis based on meta-analytic findings. Personnel Psychology 1993, 46:259-293. doi: 10.1111/j.1744-6570.1993.tb00874.x.
66. Venzon L.M. Nurses' rapid turnover: Effects on quality nursing care. Philippine Journal of Nursing 1985, 55:85-90.
67. Waitzkin H., Williams R., Bock J., McCloskey J., Willging C., Wagner W. Safety-net institutions buffer the impacts of Medicaid managed care: A multi-method assessment in a rural state. American Journal of Public Health 2002, 92:598-610. doi: 10.2105/AJPH.92.4.598.
68. Walsh J.P., Ashford S.J. Feedback obstruction: The influence of the information environment on employee turnover intentions. Human Relations 1985, 38:23-46. doi: 10.1177/001872678503800102.
69. Walumbwa F.O., Wang P., Wang H., Schaubroeck J., Avolio B.J. Psychological processes linking authentic leadership to follower behaviors. Leadership Quarterly 2010, 21:901-914. doi: 10.1016/j.leaqua.2010.07.015.
70. Wang P., Rode J.C. Transformational leadership and follower creativity: The moderating effects of identification with leader and organizational climate. Human Relations 2010, 63:1105-1122. doi: 10.1177/0018726709354132.
71. Willging C.E., Semansky R.M. State mental health policy: It's never too late to do it right: Lessons from behavioral health reform in New Mexico. Psychiatric Services 2010, 61:649-651. doi: 10.1176/appi.ps.61.7.646.
72. Willging C.E., Tremaine L., Hough R., Reichman J., Adelsheim S., Meador K., Downs E.A. " We never used to do things this way": Behavioral health reform in New Mexico. Psychiatric Services 2007, 58:1529-1531. doi: 10.1176/appi.ps.58.12.1529.
73. Willging C.E., Waitzkin H., Lamphere L. Transforming administrative and clinical practice in a public behavioral health system: An ethnographic assessment of the context of change. Journal of Healthcare for the Poor and Underserved 2009, 20:866-883. doi: 10.1353/hpu.0.0177.
74. Willging C.E., Waitzkin H., Nicdao E. Medicaid managed care for mental health services: The survival of safety net institutions in rural settings. Qualitative Health Research 2008, 18:1231-1246. doi: 10.1177/1049732308321742.