Best Leadership Practices for Retaining Direct Care Staff in Residential Treatment Centers

The purpose of this study is to identify best leadership practices in retaining direct-care staff in residential treatment centers. While research exists on employee retention, there is a lack of research focused on employee retention in residential care. How leaders engage with direct-care staff members in residential care can have a significant influence on increasing employee retention rate. The literature review revealed transformational leadership theory as the theoretical framework, including 4 components: idealized influence, individualized consideration, inspirational motivation, and intellectual stimulation. The design for this research was a qualitative case study. The residential treatment center was selected as the study case because of its exemplar performance reporting a 73% employee retention rate in contrast to the national retention rate of 40%. The theoretical framework served as a foundation for the purpose and research questions. Semistructured questions were developed to interview leaders at a residential treatment center in order to identify best practices. In combination with a thorough review of the literature, an expert panel of researchers established the validity of the interview instrument. Content analysis was applied to code themes and a 2nd reviewer provided reliability. Participants responses revealed 9 best practices in 4 categories: 3 best practices linked to idealized influence, 2 best practices connected to individualized consideration, 2 best practices aligned with inspirational motivation, and 2 best practices specific to intellectual stimulation. In addition to correlating with the 4 components of transformational leadership, more than 100 authors supported the 4 theoretical components. The results of the study highlight the influence leaders can have on retaining employees. The identified best practices represent key approaches that health care leaders can apply. This study is helpful in identifying leadership practices in the health care field that will assist in increasing employee retention. Consequently, the results of this study can assist other residential treatment center leaders to consider these leadership practices in an effort to improve employee retention