Department Climate: A Major Driver of Clinician Turnover

Clinician well-being is increasingly recognized as a fundamental organizational concern, with occupational burnout and disengagement reflecting issues in the practice environment rather than individual shortcomings. Unfortunately, suboptimal work conditions are pervasive in health care, and a growing body of evidence points to their impact not only on clinician well-being and turnover, but also on patient safety, care quality, and workforce sustainability. In this issue of Academic Medicine , Qeadan and colleagues provide compelling evidence that characteristics of departmental climate are closely linked to faculty turnover, adding to a robust body of evidence demonstrating the link between occupational well-being and turnover. Organizations seeking to reduce turnover should develop system-level approaches to enhance the microclimate within each work unit. Health care systems demonstrate that well-being is an organizational priority by establishing leadership to guide organizational well-being improvement efforts and creating the structures and processes necessary to drive iterative improvement at the system level. Inclusion of well-being as a domain in the organization's operational and strategic plans demonstrates the organization's prioritization of clinician well-being. Unit-level incentives and accountability metrics can be used to drive leader action to promote clinician well-being at all levels of the organization. Work unit climate is cocreated by both work unit leaders and the members of the work unit. Accordingly, leadership development programs that foster development of wellness-centered leadership skills are also critical to improving unit-level microclimates. Ultimately, unit-level efforts to create more optimal microclimates have profound implications for both retention in the work unit and overall organizational health.