Wraparound Blog

A Study of Turnover among Wraparound Care Coordinators and Supervisors: Part II

July 17, 2017 | Janet Walker

Part II: Causes of turnover and retention

Part I of this blog post described why our staff at the National Wraparound Initiative (NWI) and the National Wraparound Implementation Center thought it was important to explore the issue of turnover among Wraparound care coordinators and supervisors. That post also described the national survey that we used to gather data about turnover, as well as some of the findings (what types of people responded, caseloads in their Wraparound programs, annual turnover rates, impacts of turnover).

In Part II, we continue on with reporting on some further findings. We asked our respondents to consider a list of possible causes of turnover among Wraparound care coordinators, and to select the ones they thought were "important" causes of turnover in their organization. Respondents were then asked to rank the causes they thought they were important. The chart below summarizes the responses.

As you can see in the chart, three causes of turnover – better job opportunities elsewhere, job stress and demands, and too much paperwork/bureaucracy – were selected by 70-80% of respondents as being important causes of turnover. Among these three causes, better job opportunities elsewhere was selected as the number one cause of turnover by just over 40% of respondents.

Causes of Turnover

Causes of Turnover

The remaining causes of turnover were ranked as important by much smaller numbers of respondents, from around 40% for care coordinator skills not a good match for Wraparound to just over 10% for unfair treatment/feel unwelcome by supervisors or co-workers. However, the disparity between the percentages of respondents endorsing each cause as the number one cause of turnover was much smaller. In other words, while some causes of turnover are seen as important by many more respondents, a fair number of respondents see each cause as the most important one for their organization.

We asked respondents about causes of retention – things that make care coordinators attached to their jobs in Wraparound – in a similar way.

The chart below makes it clear that respondents think Wraparound care coordinators are most attached to their jobs for reasons connected to loyalty and commitments. This includes commitment to the children and families they work with, to Wraparound itself and to their co-workers and their organizations.

Contributors to Retention

Contributors to Retention

When you compare the reasons for turnover to the reasons for retention, the contrast is quite striking. Respondents are saying that care coordinators stay in their jobs primarily because of the intangibles (commitments and loyalty) but are most likely to leave their jobs due to more tangible causes such as the opportunity to get a “better” job or the stress and demands of the care coordinator position.

Finally, we wanted to know if there was a relationship between respondents’ estimates of turnover in their organization and the turnover they reported for that same organization. We were a bit surprised to find only a very weak relationship between the two.

The survey provided us with a good base of information but left us with many questions about the causes of turnover and retention. We are currently wrapping up a series of follow-up interviews with selected survey respondents. Through these interviews, we are learning more in depth about these issues. We plan to present a webinar that summarizes our findings from the interview data in the Fall of 2017, so if you are interested, keep an eye on the website or our newsletter to learn about when that webinar will occur.

This document was prepared with support from the National Technical Assistance Network for Children’s Behavioral Health operated by and coordinated through the University of Maryland, and under contract with the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Contract #HH280201500007C. The views, opinions, and content expressed in this presentation do not necessarily reflect the views, opinions, or policies of the Center for Mental Health Services (CMHS), the Substance Abuse and Mental Health Services Administration (SAMHSA), or the U.S. Department of Health and Human Services (HHS).


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