Exploring the impact of workforce turnover on the sustainability of evidence-based programs: A scoping review
- PMID: 37090007
- PMCID: PMC9981891
- DOI: 10.1177/26334895211034581
Exploring the impact of workforce turnover on the sustainability of evidence-based programs: A scoping review
Abstract
Background: Evidence-based programs (EBPs) are used across disciplines to integrate research into practice and improve outcomes at the individual and/or community level. Despite widespread development and implementation of EBPs, many programs are not sustained beyond the initial implementation period due to many factors, including workforce turnover. This scoping review summarizes research on the impact of workforce turnover on the sustainability of EBPs and recommendations for mitigating these impacts.
Methods: We searched 10 databases for articles that focused on an EBP and described an association between workforce turnover and the sustainment or sustainability of the program. We created a data abstraction tool to extract relevant information from each article and applied the data abstraction tool to all included articles to create the dataset. Data were mapped and analyzed using the program sustainability framework (PSF).
Results and discussion: A total of 30 articles were included in this scoping review and mapped to the PSF. Twenty-nine articles described impacts of workforce turnover and 18 articles proposed recommendations to address the impacts. The most frequent impacts of workforce turnover included increased need for training, loss of organizational knowledge, lack of EBP fidelity, and financial stress. Recommendations to address the impact of workforce turnover included affordable and alternative training modalities, the use of champions or volunteers, increasing program alignment with organizational goals, and generating diverse funding portfolios.
Conclusion: The sustainment of EBPs is critical to ensure and maintain the short- and long-term benefits of the EBP for all participants and communities. Understanding the impacts of workforce turnover, a determinant of sustainability, can create awareness among EBP-implementing organizations and allow for proactive planning to increase the likelihood of program sustainability.
Keywords: Evidence-based practice; determinant of sustainability; evidence-based program; implementation; retention; scoping review; sustainment; workforce turnover.
© The Author(s) 2021.
Conflict of interest statement
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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References
-
- Aarons G. A., Sawitzky A. C. (2006). Organizational climate partially mediates the effect of culture on work attitudes and staff turnover in mental health services. Administration and Policy in Mental Health and Mental Health Services Research, 33(3), 289–301. 10.1007/s10488-006-0039-1 - DOI - PMC - PubMed
-
- Aarons G. A., Sommerfeld D. H., Hecht D. B., Silovsky J. F., Chaffin M. J. (2009). The impact of evidence-based practice implementation and fidelity monitoring on staff turnover: Evidence for a protective effect. Journal of Consulting and Clinical Psychology, 77(2), 270–280. 10.1037/a0013223 - DOI - PMC - PubMed
-
- Arksey H., O’Malley L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology: Theory and Practice, 8(1), 19–32. 10.1080/1364557032000119616 - DOI
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