Reducing turnover is not enough: The need for proficient organizational cultures to support positive youth outcomes in child welfare

https://doi.org/10.1016/j.childyouth.2013.09.002Get rights and content

Highlights

  • Organizational culture interacts with turnover to predict child welfare outcomes

  • Reduced turnover predicts improved outcomes in proficient child welfare systems

  • Reduced turnover does not predict improved outcomes in non-proficient systems

  • Turnover reduction must be coupled with a proficient culture to improve services

Abstract

Objective

High caseworker turnover has been identified as a factor in the poor outcomes of child welfare services. However, almost no empirical research has examined the relationship between caseworker turnover and youth outcomes in child welfare systems and there is an important knowledge gap regarding whether, and how, caseworker turnover relates to outcomes for youth. We hypothesized that the effects of caseworker turnover are moderated by organizational culture such that reduced caseworker turnover is only associated with improved youth outcomes in organizations with proficient cultures.

Methods

The study applied hierarchical linear models (HLM) analysis to the second National Survey of Child and Adolescent Well-being (NSCAW II) with a U.S. nationwide sample of 2346 youth aged 1.5- to 18-years-old and 1544 caseworkers in 73 child welfare agencies. Proficient organizational culture was measured by caseworkers' responses to the Organizational Social Context (OSC) measure; staff turnover was reported by the agencies' directors; and youth outcomes were measured as total problems in psychosocial functioning with the Child Behavior Checklist (CBCL) completed by the youths' caregivers at intake and at 18-month follow-up.

Results

The association between caseworker turnover and youth outcomes was moderated by organizational culture. Youth outcomes were improved with lower staff turnover in proficient organizational cultures and the best outcomes occurred in organizations with low turnover and high proficiency.

Conclusions

To be successful, efforts to improve child welfare services by lowering staff turnover must also create proficient cultures that expect caseworkers to be competent and responsive to the needs of the youth and families they serve.

Introduction

Child welfare systems in the United States are under increasing pressure to improve outcomes for the children and families they serve. Wide variation in the success of child welfare systems nationally has led to the search for system-level explanations of differential outcomes for youth (U.S. Department of Health & Human Services, 2011). Of the many system-level factors cited as potential causes of ineffectiveness, high caseworker turnover has received the most attention (Strand et al., 2010, Strolin et al., 2007, U.S. General Accounting Office, 2003). High turnover is endemic in U.S. child welfare systems (Cyphers, 2001, Cyphers, 2005, Drake and Yadama, 1996, U.S. General Accounting Office, 2003) and, given the central role played by caseworkers in the care process (Ryan et al., 2006, Westbrook et al., 2012), numerous scholars have hypothesized that high turnover is detrimental to youth outcomes (DePanfilis & Zlotnik, 2008). However, almost no empirical research has examined the relationship between caseworker turnover rates and youth outcomes in child welfare systems (Strolin et al., 2007). Thus, there is an important knowledge gap regarding how caseworker turnover relates to outcomes for youth served by child welfare systems.

An understanding of the association between caseworker turnover and youth outcomes is important for child welfare systems because of its implications for administrative practice, resource expenditures, and intervention development (Collins-Camargo, Ellett, & Lester, 2012). Child welfare administrators control limited resources and exercise circumscribed influence over the many factors that affect the well-being of children who are referred, assessed, and treated for abuse and neglect (Webb, Dowd, Harden, Landsverk, & Testa, 2010). Accordingly, administrators must prioritize malleable and impactful causes of system ineffectiveness. To the extent that high turnover contributes to poor youth outcomes, investments in caseworker retention strategies represent cost-effective methods to enhance youth well-being (Kacmar et al., 2006, U.S. General Accounting Office, 2003). However, these strategies may represent wasted resources and significant opportunity-costs if the turnover–outcomes relationship is contingent on other unaddressed agency factors or if caseworker turnover is not associated with youth outcomes.

Studies of the relationship between organizational turnover and performance in the broader organizational literature support the view, derived from human capital (Strober, 1990) and social capital theories (Shaw, Duffy, Johnson, & Lockhart, 2005), that employee turnover rates are negatively and linearly associated with a wide range of organizational outcomes. However, these studies also indicate that moderators play an important role in the strength of this relationship (Park & Shaw, 2013). For example, organizational culture has recently been identified as a moderator of the turnover–performance relationship in human services organizations (Mohr, Young, & Burgess, 2012). Studies of child welfare systems indicate that organizational culture is both an important predictor of service quality (Glisson and Green, 2006, Glisson and James, 2002, Yoo and Brooks, 2005) and associated with the development of caseworker human and social capital (DePanfilis and Zlotnik, 2008, Westbrook et al., 2012). These studies suggest that a contingent relationship may exist between caseworker turnover and youth outcomes depending on the quality of organizational culture within the agency (Glisson, Green, & Williams, 2012). This study advances knowledge on strategies for increasing child welfare system effectiveness by examining the relationship between caseworker turnover and youth outcomes as moderated by organizational culture in a national sample of child welfare agencies.

Studies of employee turnover in the organizational and child welfare literatures have focused primarily on understanding the antecedents to turnover, emphasizing such factors as employee characteristics (e.g., age, education, burnout, organizational commitment), supervisory relationships (e.g., supportiveness), and job characteristics (e.g., caseload, flextime polices, on-call requirements, and compensation) (Griffeth et al., 2000, Strolin et al., 2007). Much less well-developed is the body of literature examining the consequences of employee turnover. Recent reviews have characterized this literature as underdeveloped, minimally integrated, and in need of further study (Park and Shaw, 2013, Shaw, 2011). Surveying the turnover literature in child welfare settings, Strolin et al. (2007, p. 29) noted “the empirical research on the effects of workforce turnover in child welfare is scant” and called for large-scale, empirical studies that test the hypothesized cross-level links between caseworker turnover and youth outcomes in child welfare systems.

The relationship between employee turnover and organizational performance is most often explained using human and social capital theories (Shaw et al., 2005, Strober, 1990). Human capital theory contends that more experienced employees accumulate specialized tacit and formal knowledge and skills through extended task-specific practice, training, and experience (Kacmar et al., 2006). The loss of these experienced employees through turnover damages organizational performance because of the loss of their accumulated expertise. Although organizations can replace employees who leave, newer employees require time to develop similar levels of competence and organizational performance suffers as a result.

Social capital theory emphasizes the importance of interpersonal relationships and the quality of social ties to an organization's effectiveness (Shaw et al., 2005). Networks of interpersonal relationships developed by employees over time (i.e., social capital) contribute to organizational performance by facilitating the development and application of knowledge, uniting employees around collective goals, building mutual trust, and generating a store of goodwill and mutually reinforcing favors among employees (Dess & Shaw, 2001). Increased turnover impedes organizational performance by disrupting these networks of relationships and social ties. Both human and social capital theories predict a negative linear relationship between turnover rates and organizational performance. Human and social capital theories have strong empirical support for predicting organizational effectiveness (Crook et al., 2011, Dess and Shaw, 2001) and for explaining the relationship between employee turnover and organizational performance (Park & Shaw, 2013).

Human and social capital are believed to be especially important to the effectiveness of human services organizations such as child welfare systems because these organizations rely on relationship-based and person-centered technologies to achieve targeted outcomes (Collins-Camargo et al., 2012, Mohr et al., 2012). Caseworkers are responsible for determining the validity of child abuse and neglect reports, assessing safety and making placement decisions, determining eligibility for benefits and sanctions, making timely and appropriate referrals for treatment and other supports, and implementing prevention and crisis services (Ryan et al., 2006, Westbrook et al., 2012). Effectiveness in this role requires the expert use of specialized knowledge and skills in complex, dynamic, and emotion-laden situations (Glisson & James, 2002). New caseworkers typically lack the specialized expertise, training, and experience (i.e., human capital) necessary to perform this job well and as a result, service effectiveness decreases when more experienced employees leave (U.S. General Accounting Office, 2003). Effective casework also requires well-developed social networks with care providers from other sectors, community resources, and colleagues within child welfare and other state bureaucracies (i.e., social capital). High turnover disrupts these social ties and may contribute to less effective casework as a result (Ryan et al., 2006).

A growing number of studies support the prediction, based on human and social capital theories (Shaw, 2011), of a negative linear association between employee turnover rates and organizational performance. A recent meta-analysis (Park & Shaw, 2013) indicated that the population average correlation between turnover rates and organizational performance was significant and negative (ρ =  .15). However, this meta-analysis indicated that moderators played an important role in the strength of the relationship. For example, the turnover–performance correlation varied from ρ =  .02 to ρ =  .29 depending on the type of performance criteria (e.g., financial performance vs. service quality), type of employee (e.g., manual labor vs. skilled professional), and industry (e.g., manufacturing vs. healthcare). Organizational culture has also recently been identified as a significant moderator of the relationship between turnover rates and outcomes, particularly in organizations that rely on knowledge-based professions such as hospitals and human services agencies (Mohr et al., 2012). These studies indicate that simplistic linear models may be inadequate to describe the complex and contingent relationship between turnover and organizational performance in child welfare systems. In particular, organizational culture is likely to play an important role in the strength of the turnover–outcomes relationship in child welfare systems (Glisson and Green, 2006, Glisson and James, 2002).

Organizational culture refers to the shared behavioral norms and expectations that characterize a work environment and determine the way employees prioritize, approach, and complete their work (Glisson, Green and Williams, 2012, Verbeke et al., 1998). Organizational culture signals to employees the types of work activities and strategies that are valued, rewarded, and supported by the organization and forms the basis for a shared understanding and enactment of meaningful responses to the work environment (Cooke and Szumal, 1993, Schein, 2010, Verbeke et al., 1998). Decades of empirical studies, summarized by a recent meta-analysis of 84 studies (Hartnell, Ou, & Kinicki, 2011) and comprehensive narrative review of 55 studies (Sackmann, 2011), support the link between organizational culture and organizational performance across a wide range of settings and outcome criteria including studies in child welfare and youth mental health (Glisson and Green, 2006, Glisson et al., 2013, Glisson, Green and Williams, 2012, Glisson and James, 2002, Olin et al., 2013, Yoo and Brooks, 2005). These studies confirm that the shared behavioral norms and expectations in a work environment are associated with meaningful differences in individual employee behavior and organizational effectiveness.

Applied to child welfare settings, organizational culture theory posits that shared behavioral norms and expectations impact youth outcomes by directing caseworkers in prioritizing their work, guiding their selection of assessment methods and intervention models, determining the availability, responsiveness, and continuity of services to youth throughout the care process, and contributing to the development and expression of human and social capital among child welfare caseworkers (Glisson, Green and Williams, 2012, Glisson and James, 2002). Within this conceptualization, organizational culture is a multi-faceted construct consisting of specific domains of shared norms and expectations that influence targeted caseworker behaviors. For example, one prominent theory of organizational culture for child welfare settings, proposed by Glisson et al. (2012), hypothesizes that three dimensions of organizational culture–proficiency, rigidity, and resistance–impact three domains of workforce behaviors which ultimately relate to youth outcomes. Rigidity describes behavioral norms and expectations related to caseworkers' discretion and flexibility in decision-making. Resistance describes norms related to openness to new innovations. Proficiency assesses agency expectations and norms for caseworker competence, up-to-date knowledge, and prioritization of client well-being (Glisson et al., 2012).

Of these three dimensions, proficiency is most relevant to the development of human and social capital among caseworkers and therefore is most likely to moderate the effect of turnover on child outcomes in child welfare systems. Although rigidity and resistance may have implications for youth outcomes in child welfare settings, these relationships may be orthogonal to the development of human and social capital (e.g., resistance to new innovations does not imply that an agency's current operations, training procedures, and services are ineffective), may represent distal influences unrelated to current workforce turnover (e.g., failure to adopt newer, more effective practices may reduce effectiveness over the long-term but does not necessarily imply that current services are ineffective), or may be contingent on other factors (e.g., high rigidity may be beneficial when paired with best practices). In contrast, cultural norms and expectations related to proficiency bear directly on the extent to which agencies focus on achieving positive client outcomes through the development and expression of human and social capital within their current workforce. Proficient organizational culture represents a critical social context that sustains caseworkers' focus on client well-being, encourages the development of competencies they need to successfully serve youth, and sustains their motivation to effectively meet the challenges of achieving safety, permanency, and well-being of children who have been neglected or abused (Grant, 2007).

Building on human capital, social capital, and organizational culture theories, this study tests the interaction between caseworker turnover rates and proficient organizational culture in their association with youth outcomes in a national sample of child welfare systems. Drawing on these theories we argue that optimal youth outcomes will occur in child welfare systems with low caseworker turnover and high proficiency cultures. In agencies with high proficiency cultures, norms and expectations that focus on client well-being, up-to-date knowledge and skills, and availability and responsiveness to clients' needs contribute to effective service provision and positive youth outcomes. Proficient organizational culture contributes to the development and effective use of human and social capital as caseworkers are rewarded, supported, and recognized for developing competencies that contribute to positive outcomes for youth. Because caseworkers in these systems accrue human and social capital that enhance youth outcomes, and because the services provided by these caseworkers are more likely to focus on and achieve child well-being, turnover will be negatively and linearly associated with youth outcomes (i.e., lower turnover, better outcomes) in agencies with high proficiency cultures.

Conversely, in child welfare systems with low proficiency cultures, minimal agency-level expectations for improvements in client well-being and caseworker responsiveness generate poor youth outcomes. In these systems lower turnover is not associated with better youth outcomes because the development and optimal use of human and social capital is stunted and the loss of more experienced employees does not represent a significant reduction in the already limited operative capacity of the service system. Agencies with low-proficiency cultures lack the shared behavioral norms and expectations that evoke and support effective casework and thus fail to develop the human and social capital of their workforces necessary for optimal work with clients. Thus, higher turnover in these systems will not result in worse youth outcomes.

Hypothesis 1

Organizational culture moderates the relationship between caseworker turnover rates and youth outcomes such that high turnover is negatively associated with youth outcomes in child welfare agencies with high proficiency cultures and unrelated to youth outcomes in agencies with low proficiency cultures.

This hypothesis implies that increased caseworker retention will be associated with improved outcomes for youth in agencies with high-proficiency cultures but will not be associated with improved outcomes in agencies with low-proficiency cultures. If confirmed, it suggests that reducing turnover alone is insufficient to improve youth outcomes in child welfare systems with low proficiency cultures.

Section snippets

Setting and sample

Data for this study are from the second and most recent National Survey of Child and Adolescent Well-being (NSCAW II), a national probability survey of youth, ages 0 to 18 years old who were investigated and monitored by the U.S. child welfare system due to allegations of abuse or neglect. Details of the NSCAW II study design are presented elsewhere (Dowd et al., 2012) and summarized here.

The target population for NSCAW II includes “all children in the US who were subjects of child abuse or

Descriptive statistics

The sample included N = 2346 youth who received services from k = 73 child welfare agencies. Organizational culture (i.e., proficiency) scores were based on responses from 1544 caseworkers employed in the 73 agencies. Rates of missing data on demographic and risk variables for youth were generally low and ranged from 0% to 2.3% with the exception of 18-month CBCL score which was missing for 17.7% of youth. This rate of attrition is typical of longitudinal studies of at-risk youth and of youth who

Discussion

Findings from this study indicate that decreased caseworker turnover is associated with improved outcomes for youth only in child welfare agencies with proficient organizational cultures that are above the national average in their expectations for caseworkers to have up-to-date knowledge and skills and an emphasis on improving youth well-being as their top priority. Reductions in caseworker turnover are not associated with improvements in youth outcomes in child welfare systems with

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    Funding: This research was supported in part by a grant from the National Institute of Mental Health to NJW (F31MH099846). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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