Factors associated with health CEO turnover - a scoping review.

BACKGROUND: Chief Executive Officer's (CEO) are integral leaders of health care organisation. Over the last two decades in United States (US) hospitals, it has been noted that CEO turnover rates are increasing, and it was reported that the CEO turnover rates have augmented from 14% in 2008 to 18% in 2017 in the private sector. In Australia, it was discovered that during two years, 41 executives had 18 distinct positions. It has been highlighted that the increasing CEO turnover is a major issue for Australian and international health care organisations. Some of the negative consequences of CEO turnover include organisational instability, high financial costs, loss of human capital and adverse effects on staff morale and patient care. OBJECTIVE: Our scoping review aimed to map and summarise the evidence associated with CEO turnovers in both health and non-health setting, and answer the following questions: 1. What are the reasons for CEO departure?, 2. What are the strategies to minimise CEO turnover? RESULTS: A protocol explaining the objectives, inclusion criteria and methods for this scoping review were specified in advance and published. This scoping review included 17 studies (13 health and 4 non-health setting) published over a 31-year period that investigated and described the increasing CEO turnover rates. All 17 studies identified causes of CEO turnover along with certain studies identifying facilitators of CEO retention. We classified CEO's departure reasons into three major themes: organizational, performance, and personal. Organisational factors include CEO departures due to issues within the organisation, performance factors include issues with CEO's work and personal factors captures personal reasons for CEO's leaving their job. CONCLUSION: CEOs are under immense pressure to deliver good results and drive growth while satisfying the interests of internal and external stakeholders. There are various reasons for CEO's departure however the most common factor identified is organisational.

Causes & Consequences of Health Care CEO Turnover in Australia and Retention Strategies: A Qualitative Study.

It has been highlighted the increasing CEO turnover is a major issue for Australian and international health care organizations. Some of the negative consequences of CEO turnover includes organizational instability, high financial costs, and affecting patient care. On average, CEOs leave their role within 1 to 2 years after commencement, which can be detrimental to the hospital's overall functioning. Therefore, this study aims to identify the causes and consequences of increasing CEO turnover in health care, so retention strategies could be devised. Fourteen hospital CEOs across Australia were interviewed online to answer 5 open ended questions related to qualities of a CEO, challenges of the CEO role, Causes and consequences of increasing CEO turnover and recommendation for CEOs retention. Interviews followed a semi-structured schedule to prompt discussion in relation to the above. The study has identified that CEOs possess certain qualities such as self-awareness, leadership style, resilience that enable them to perform their role well. Challenges of this role such as COVID-19, managing organizational change staff management has been found and discussed. Broadly, causes have been divided into 5 major categories such as Organization, Performance, Pressure, Personal and Health reform. It was found that increasing CEO turnover can be damaging to the hospital, not just the staff and patients suffer but the surrounding community gets adversely affected. To minimize CEO turnover, it was suggested that the board needs to support their CEO by advocating and investing in organizational culture and leadership programs. The findings of this study aid, the board with certain strategies through which CEO can be supported. CEOs made certain recommendations in this study to minimize the turnover which can make such a big impact on health care as this may lead to better functioning hospitals in Australia. Moreover, these strategies could be used internationally to help them CEOs retain in their position.