Impact, Predictors, and Mediators of Therapist Turnover

描述（由申请人提供）：由于与招聘和培训替代员工相关的高财务成本，人员流动是组织关注的主要问题。在物质使用障碍（SUD）治疗领域，离职也是一个值得关注的问题，因为离职率高于平均水平，而且人们认为离职会对治疗患者的护理质量和治疗结果产生负面影响。然而，部分由于收集与治疗师数据相关的治疗结果数据的困难，迄今为止还没有研究明确检查治疗师离职与患者治疗结果之间的关系。利用在一个大型卫生服务示范项目背景下收集的现有数据，其中包括来自3,021名青少年患者、208名治疗师和34个组织的数据，拟议的研究将是已知的第一个量化治疗师更替对患者护理质量和治疗结果的直接和间接影响的研究之一。无论治疗师的离职是否会对患者的治疗质量和结果产生负面影响，仅离职的财务成本就表明，我们需要提高对导致离职因素的认识。虽然已经进行了数百项与离职相关的研究，但大多数现有文献的主要局限性是主要依赖于横断面调查方法。因此，为了更全面地了解员工离职的过程，本研究将使用现有的重复测量治疗师数据来检验离职的纵向预测因子和中介因子。确定导致人员流失的因素对于制定减少人员流失和随后的财务成本的可测试策略可能是非常宝贵的。

DESCRIPTION (provided by applicant): Turnover is a major concern for organizations due to the high financial costs associated with recruiting and training replacement staff. In the substance use disorder (SUD) treatment field, turnover also is a concern due to higher than average rates of turnover and the belief that turnover negatively impacts quality of care and treatment outcomes for treatment patients. However, due in part to the difficulty of collecting treatment outcome data linked to therapist data, no research to date has explicitly examined the relationship between therapist turnover and patient treatment outcomes. Using existing data collected within the context of a large health services demonstration project, which includes data from 3,021 adolescent patients, 208 therapists, and 34 organizations, the proposed study would be one of the first known studies to quantify the direct and indirect impact of therapist turnover on quality of care and treatment outcomes of patients. Regardless of whether or not therapist turnover negatively impacts treatment quality and outcomes for patients, the financial costs of turnover alone suggest the need to improve our knowledge regarding factors that lead to turnover. Although hundreds of turnover-related studies have been conducted, a major limitation of most of the existing literature is that it has relied primarily on cross-sectional methods of investigation. Thus, in order to better understand the process of staff turnover more fully, the proposed study will use existing repeated measures therapist data to examine longitudinal predictors and mediators of turnover. Identification of factors that lead to turnover may be invaluable in developing testable strategies for reducing turnover and subsequent financial costs. PUBLIC HEALTH RELEVANCE: Within human service organizations, staff turnover is thought to not only have significant financial costs, but have a significant adverse impact on the quality of care and treatment outcomes for patients. The proposed study is highly relevant, as it would be the first known study with the substance use disorder field to (a) quantify the direct and indirect impact of therapist turnover on treatment quality and outcomes and (b) use longitudinal data collection methods and analyses to identify factors that lead to therapist turnover.