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EMPLOYEE RETENTION: An Empirical Study of Direct Care Employees at ACHIEVE

By Bridget K. Riley BA, The College of Saint Rose, 2005

CAPSTONE PROJECT Submitted in partial fulfillment of the requirements for the degree of Masters in Public Administration in the College of Community and Public Affairs Binghamton University State University of New York 2009

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Copyright by Bridget Kathleen Riley 2009 All Rights Reserve

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Accepted in partial fulfillment of the requirements for the degree of Masters in Public Administration in the Department of Public Administration in the College of Community and Public Affairs Binghamton University State University of New York 2009

David Campbell, PhD ________________________________________________ Assistant Professor Department of Public Administration April 29, 2009

Allison Alden, PhD___________________________________________________ Assistant Professor Department of Public Administration April 29, 2009

Ellen OConner_____________________________________________________ Performance Improvement Specialist ACHIEVE April 29, 2009

iv Abstract Employee retention is one of the most pressing issues in direct care service nonprofit agencies. Turnover among direct care service workers affects every aspect of nonprofit agencies including employee morale, client care and service provision. The research conducted in this study examines a variety of dimensions of employee satisfaction for ACHIEVE (formerly known as Broome Tioga ARC). The data used in this study came from an employee satisfaction survey conducted in January of 2009. The survey responses were evaluated using a variety of statistical tools including: simple ANOVA, correlation and multiple regression. The findings of the survey coupled with existing literature allowed the researcher to make recommendations to increase employee morale and ultimately increase employee retention. The recommendations are increasing team building trainings, conducting an organizational culture inventory, increase recognition, and implementation of 360 degree evaluations of all employees.

v Dedication Education is not the filling of a pail, but the lighting of a fire.- William Butler Yeats

I would like to dedicate my capstone project to my family for their support. My mother and step father have shown me that anything is possible and for that I am thankful.

Acknowledgements I would like to thank the department for assisting me to complete this capstone project. I am thankful to the professors of the MPA department from whom I have learned a great deal. Above all I would like to acknowledge professors, David Campbell and Allison Alden who have showed unwavering support on this project and many other projects I have worked on in the department. I would also like to thank my classmates for their help, especially Michael Myers and Sarah Maximiek. Last and certainly not least I would like to thank ACHIEVE for the opportunity to study the agency. I would especially like to thank Ellen OConner for her assistance in completing my capstone project.

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Table of Contents Abstract...............iv List of tables.vii List of figures.............vii Introduction..............1 Problem Definition...............2 Conceptual Framework............5 Literature Review.................6 Methodology12 Methods...........12 Data Collection................14 Limitations...............15 Data Analysis...15 Findings ....17 Recommendations..20 Conclusion.........22 Appendix A25 Appendix B26 Appendix C31 Appendix D41 References..45

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List of Tables Table 1: Correlation between Employee Retention Dimensions...16 Table 2: Average Satisfaction Score by Department Compared to Employee Turnover Rate.20

List of Figure Figure 1: Employee Turnover Rate by Department.3

Introduction Employee Retention is a problem that many nonprofit agencies face. Direct care service agencies are agencies that provide services that allow individuals to meet their basic daily needs through participation in their programs. Agencies that provide residential and day habilitation services to individuals with disabilities can be categorized as direct care service agencies. Many agencies that provide direct care service face high turnover rates. ACHIEVE is a non-profit agency that provides services to individuals with intellectual and other developmental disabilities in Broome and Tioga Counties in New York State. The agency provides a variety of services including Residential, Family Support Services, Medicaid Service Coordination, Day Habilitation and Prevocational Services. It is the mission of ACHIEVE to provide leadership, advocacy and opportunities which enable persons with intellectual and other developmental disabilities and their families to enhance the quality of their lives. To this end all of our services help to advance the skill levels of our participants, promote inclusion, integration and socialization, and encourage independence (ACHIEVE, 2009). ACHIEVE has recently experienced high employee turnover and the agency created a performance improvement department to help with this challenge. The Performance Improvement Program at ACHIEVE stands committed to ensuring the provision of comprehensive, high quality services to individuals, families, contract providers and employees. In an attempt to systematically identify opportunities for improvement, ACHIEVE has implemented a suggestion box. Suggestions are reviewed by the executive management team and responses are highlighted in the employee newsletter. In an effort to address the number of times people call in sick per year, decrease overtime hours used, and improve the quality of services provided, ACHIEVE implemented a scheduling committee for the

2 residential services department. The committee then canvassed all agency group homes with a survey tool, to identify house specific scheduling needs and implement improvements. Recently ACHIEVE has administered another employee which measured employee satisfaction, this survey tool has allowed employees to voice their opinions about work environment, supervision and services provided to clients. This survey, as well as agency hire and termination reports, will be the primary data used for this capstone project. Problem Statement Employee retention is one of the greatest challenges that ACHIEVE currently faces. In order to provide high quality services to clients, ACHIEVE needs to maintain an adequate number of well trained employees, in all program areas, most notably Residential Services. Peter Smergut (2007) states that among direct care service providers, turnover rates have continued to rise throughout the country. He estimates that the annual turnover among direct care staff averaged 50% in 2007. Smergut states that the vast majority of employees working in direct care environments with individuals with developmental disabilities range in age from 18-44 years. Additionally, Smergut expects that the turnover rate among direct care workers will rise even higher, as clients from the baby boomer generation continue to age. This is due to increase in client needs as they age. It is important to note that when a new house is established the state mandates how many employees will be required to adequately provide services, the number of employees to provide services does not increase as clients age (Smergut, 2007). The increased number of daily tasks that clients need assistance with puts additional stress on an already overworked employee pool. ACHIEVE currently has a workforce of approximately 300 employees. This number includes full time, half time and on call staff. The number of on-call staff varies based on the needs of the agency. For the past three years, the percentage of employee resignations and terminations at the agency

3 has been approximately 30%. In 2008, 62% of those who left the agency were from the Residential services program area. 69% of employees that left the agency resigned while the remaining 31% were terminated. 46% of employees that left ACHIEVE in 2008 had provided less than one year of service to the agency (C.Tokos, Personal Communication Jan. 27, 2009). Turnover rates in 2008 varied greatly by department. Direct care staff in the Residential Services had the highest turnover rate at 34.45%, which means that roughly one out of every three people in that program area left throughout the course of 2008. Chart 1 below shows the turnover rates by department in 2008.

Turnover leads to a variety of costs for ACHIEVE including training new hires, quality of service to clients and decreased morale in the remaining workforce. Training for new hires is a costly process. The average cost of training for a residential aide staff is $2212.60 in salary, in addition to

4 material costs, use of the agencys conference room, and cost of training staff and any indirect costs associated with training (C. Tokos, Personal Communication Feb. 3, 2009). As per state regulation,

Residential staff must be trained for 110 hours to be certified to provide services. An additional 120 hours of in-house training is also required by the Agency. In 2008, the salary cost of training all new residential aide staff at ACHIEVE amounted to $110,630.00 (C.Tokos, Personal Communication, Feb. 3, 2009). The agency costs of turnover are not only monetary but also the quality of service provisions provided to ACHIEVEs clients diminishes. Clients require time to build a relationship with their staff; this is due to the type of care that is provided. In many cases, employees assist clients with aspects of personal hygiene including, but not limited to, bathing and toileting. In addition, some clients of ACHIEVE have aggressive and sometimes self injurious behaviors and to prevent dangerous behaviors staff must know individual clients behavioral triggers. It is imperative that clients trust their staff in order to avoid behaviors escalating to the point where client safety is compromised. As clients are cared for by a changing array of staff members, service stability diminishes and best practice standards are impacted. High turnover also means that the remaining employees must continue to provide services without an adequate number of employees. The increase in workload may lead to job stress, as well as a decrease in the morale of the workforce. When one staff member leaves the agency, the remaining staff members are required to work additional hours. Overtime leads to fatigue and ultimately, lack of good judgment, which decreases the quality of client services. Research Questions 1. What causes employees to maintain or terminate their employment at ACHIEVE?

2. What strategies can ACHIEVE implement to improve employee retention rates?

5 Conceptual Framework Employee retention is a problem for many nonprofit agencies. The high cost of training staff, coupled with diminishment in service quality, in a time when nonprofits are competing for scarce resources, makes this issue even more pressing. Employee turnover adversely affects nearly every aspect of management, including cost, service quality, and morale of remaining employees. Public administration, more specifically human resources management offers extensive literature to help explain employee retention as a problem. Employee retention is a widely studied issue in many fields, such as sociology, public administration and psychology. To understand how to retain employees, one must first examine what motivates individuals within organizations. There are three major theories regarding employee motivation: Maslows Motivation Theory (1943), McGregors Theory X and Theory Y (1957), and Vrooms Expectancy Theory (1961). In addition, best practices literature surrounding direct care services providers was reviewed. Each researcher offers various frameworks for understanding employee desires. The theories share some similarities, in that they all recognize positive reinforcement and recognition as tools for creating a positive work environment, while denouncing the use of negative critiques of job performance. Each theory also concludes that individuals are motivated by a variety of factors that vary based on environmental and psychological needs of that individual. For that reason, each organization must recognize that what works to motivate one individual employee, may not work in a different agency.

6 Literature Review Motivation Theories Employee retention has been the topic of extensive research dating back to the early 20th century. The ongoing problem of employee turnover is the result of a variety of factors. Public administration looks to theories of employee motivation from many academic disciplines, including but not limited to psychology and sociology. Three major theories regarding employee motivation have emerged in the 20th century: Maslows A Theory of Human Motivation (1943), McGregors The Human Side of Enterprise (1957), and Vroom Industrial Social Psychology (1961). In addition to these theories more recent best practices were explored in order to gain additional knowledge about direct care staff motivating factors. Group Belonging Group dynamics play an immense role in employee motivation. If an employee feels that they are a part of the organization that he or she works for they are more likely to be motivated to work harder. According to some social psychologists, individuals are motivated by a desire to attain different levels of gratification. Maslow (1943) notes that employees are motivated by a variety of driving forces at any given time and these forces can be categorized based on physiological needs, safety, belonging, and esteem. According to Maslow, employees must first meet their basic physiological needs such as food and shelter. Once all basic physiological needs are met safety concerns become the next most important set of motivating forces. This means that when basic needs are provided through work then employees will become aware of their work environment. Once an employee feels safe within their work site other factors such as belonging to the group become a motivational consideration. Esteem is the next threshold that has to be met for an individual to reach fulfillment. The final level of motivation is called self actualization, which is when an individual reaches his or her full potential and is

7 completely motivated to do his or her best work as all of the psychological and physical needs are met (Maslow, 1943). Maslow understands that group belonging is essential in order to gain self actualization or a sense of fulfillment in the work that is done in the agency. Additionally, employees respond favorably to recognition for job performance. In this way

employees feel that the work they are doing is benefitting the agency that they work for. If the work that they are providing an organization is beneficial then the employee can feel connected to the overall operations of the organization. Conversely employees will not strive toward productivity in their work environment if they feel that the agency only responds to negative aspects of their job performance. The relationships developed between direct care staff and supervisory staff can either increase or reduce employee morale. The more connected a person feels to the work they are doing the closer they become to self actualization and fulfillment. Belonging to an agency and feeling a connection to the services provided are important characteristics of motivation in non-profit agencies. Group belonging goes beyond just employee cohesion with each other management style and relationships also play a key role in motivating employees. Douglas McGregor explains management styles through the lens of two distinct theories Theory X and Theory Y. Theory X posits that humans naturally dislike work and will choose to avoid it whenever possible. Due to this disdain for work, individuals must be controlled and punished to work (McGregor, 1957). Punitive actions against employees by supervisors would foster a hostile work environment and therefore diminish the relationship between supervisors and lower level employees. Theory Y asserts that when individuals work they exert both physical and mental effort which can be a motivating tool. Theory Y further states that employees have the ability to be responsible and will naturally seek work in order to assist an agency in achieving their goals and objectives. Additionally, the organization can gain from creating nurturing relationships with their employees. By

8 establishing an environment that is positive, individuals will respond by working harder to accomplish organizational objectives (McGregor, 1957). Employee Expectations In addition to group belonging employee expectations of the organization play a key role in motivating employees. Victor Vrooms theory of employee motivation is referred to as expectancy theory. Expectancy theory argues that individuals make conscious decisions to maximize pleasure and minimize pain in every aspect of their lives. Vroom states the way an individual responds to work is unique to a given individual and for that reason, motivation is much more complex than earlier theories indicate. Vroom states that an individuals performance is linked to many factors, such as skills and experience, as well as their personality and desire to accomplish the agencys objectives. The main tenants of Vrooms theory state that people will perform better if there is a desirable outcome or reward. The reward must be something that is not only desirable but also something that will make the effort exerted worthwhile (Borkowski, 2005). The organization must first understand what types of things will motivate their staff because what works for one individual may not be a reward that is desirable to another individual. The organization must understand many aspects of their individual employees personalities in order to see what types of benefits will motivate their workforce. For example some individuals may be motivated by recognition from their supervisors while others are motivated primarily by bonuses or benefits. Expectancy theory further posits that employees have a variety of expectations and that management needs to ensure that employees feel confident in the jobs they are performing. Employees expect that management will provide them with information regarding their job and will train them adequately so that they can perform their role within an organization. Employees also expect to be compensated for

9 the job they are performing. Essentially, in order to get the best results from your work force one must first understand what their expectations are and ensure these expectations are met (Borkowski, 2005). Locke (1975) criticizes expectancy theory by arguing that expectancy theory is little more than an attempt at understanding human behavior by assuming that all actions are hedonistic. Locke further explains that if all actions were strictly made on the basis of what outcome would provide the most amount of pleasure, then all employees would all be happy in their jobs because they chose them based on the pleasure that they would receive from the position. Hedonism is not the only basis for decision making and motivation based simply on pleasurably expected outcomes is a very limiting observation of human nature. Locke further refutes expectancy theory by noting that not all decisions are made consciously. In other words, individuals are sometimes impulsive and make choices based on emotions, not their values or beliefs about the pleasure or pain that they will receive from their actions. For example, if an employee does something against an agency policy based upon their anger toward a coworker, the given act may not have been thoroughly thought through and would result in punitive action rather than the pleasure they may have thought that they would receive from their behavior (Locke, 1975). Employees not only expect to gain a sense of accomplishment and belonging from their position, but they also want to know that the environment they work in is safe. If an organization understands what an employee expects from the agency as a whole the organization can better serve their employees. In this way the organization can provide better trainings, job descriptions and other human resource assistance. Additional Approaches to Employee Motivation Larson and Hewitt (2005) explain that motivating employees is only one aspect of the employee retention problem for agencies that provide direct care to individuals with intellectual and other

10 developmental disabilities. Although staff motivation is seen as an important aspect of employee retention, the ever changing demands placed upon individual employees have caused the recent high turnover trends throughout the country (Larson and Hewitt, 2005). Since the deinstitutionalization of individuals with intellectual and other developmental disabilities, the demands on direct care staff have shifted from providing basic needs such as: hygiene, shelter and food to full community integration and psychological support. This shift has not only increased demands on staff, but also lead to an increased amount of stress. The increase in community residential facilities for individuals with intellectual disabilities from 11,006 in 1977 to 145,581 in 2003 meant that the need for staff increased, while the number of quality workers was reduced. Similar increases in services are also observed in vocational service arenas for the same population. A lack of proper training on the new skills necessary for direct care staff has increased the stress that employees feel and has lead to increased turnover and low morale among workers (Larson and Hewitt, 2005). In 2008, New York State Association of Community and Residential Agencies (NYSACRA) hosted a statewide conference at which they encouraged direct support professionals from a variety of agencies to participate in a survey to express their concerns regarding the type of work and services provided to their clients. Staff from the New York State Office of Mental Retardation and Developmental Disabilities (NYSOMRDD) assisted the agency in facilitating the event. Direct care staff stated they understood their job as assisting people to reach their goals or empowering the individuals served. Additionally, 62% of individuals stated the conduct of other workers, high turnover, and lack of support and recognition, all contributed to an extremely stressful job and providing services to clients served even more difficult. Staff turnover was one of the most obvious issues, when remaining employees were asked to pick up the slack of employees that left the agency.

11 In addition to the identification of job stressors, the NYSACRA survey identified a need for additional training. Some of the types of training that direct care staff would like more of included: sign language, information on dual diagnoses, behavioral/medical information, aging related issues, autism, and seeing the entire person not just their disability. Other requested training included stress management, time management and a greater understanding of how to properly fill out all documentation used on the job (NYSACRA, 2008). Larson and Hewitts (2005) research explains the problems pointed out by the NYSACRA in detail. Larson and Hewitt understand that a variety of factors can influence the motivation level of employees. The three main aspects of employee satisfaction within an organization are relationship, personal growth and system maintenance. Each aspect is influential in a direct care workers desire to perform to their highest potential. In the NYSACRA conference, the relationship dimension could be seen by employees indicating that they did not feel that they were recognized for their exemplary work (NYSACRA, 2008). Similarly, the relationships between coworkers were indicated as stress factors. Personal growth was indicated in the NYSACRA conference in that employees noted a variety of different trainings that would assist direct care staff in providing higher quality services to the clients served. The system maintenance dimension of employee satisfaction was also shown in the NYSACRA conference responses. This is evidenced by individuals reporting a desire to more thoroughly understand their daily tasks such as medication concerns and completion of paperwork (NYSACRA, 2008). ACHIEVE used a survey tool that was based on different dimensions of employee satisfaction and motivation indicated in the above literature, the main dimensions of which were relationship, personal growth, and system maintenance. This survey was used to collect information, identify trends,

12 and offer planning ideas to decrease turnover rates, support current employees and enhance the retention of future employees. Methodology Methods In order to identify the issues associated with employee retention, ACHIEVE recently conducted a survey of all agency employees, examining three dimensions of employee satisfaction. The three aspects of employee satisfaction include: the relationship dimension, the personal growth dimension, and the system maintenance dimension. These aspects of employee satisfaction may determine whether or not an individual chooses to stay within the agency. The agency adapted this survey from a survey developed by the University of Minnesota, Institute on Community Integration, Research and Training Center on Community Living (Larson and Hewitt, 2005). The survey was modified to meet the needs of ACHIEVE and was used to identify trends within the agency and compare actual and preferred work environments. The tool was also used to plan and monitor change in work settings, evaluate the impact of intervention programs, and promote improvement in the workplace. Relationship Dimension The relationship dimension of the survey examines three subsets of employee satisfaction: involvement, co-worker cohesion and supervisor support. Involvement questions measure employee commitment to their jobs, as well as how concerned they are about maintaining their current position. Co-worker cohesion questions investigates how well employees work together, how comfortable new employees are, and how employees adapt to and train new hires. Supervisor support questions explore the relationship between supervisors and their subordinates. The questions in this section focus on the way that employees are recognized for exemplary job performance and ideas, as well as the relationships built between coworkers and supervisors are another focus of this section.

13 Personal Growth The personal growth dimension explores autonomy, task orientation and work pressure as components of employee satisfaction. Autonomy measures how well an agency encourages employees to be self sufficient within the organization, and how much drive and initiative people have within an organization. Work pressure examines how much pressure or stress an employee feels while at work which, not only measures stress, but also the related time constraints individuals feel while at work. Questions in this category look at if an employee feels that he or she has enough time to adequately complete all tasks that are assigned to them, and the autonomy individuals feel that he or she have over job tasks. System and Maintenance Dimension The system and maintenance dimension of ACHIEVEs employee satisfaction survey examines four subcategories: clarity, control, and innovation. Clarity addresses how well employees understand their daily tasks, and whether an employee has been given an appropriate understanding of the tasks associated with that position. The section also explores whether employees feel that the agency has properly trained them in order to complete the tasks assigned to them. Control focuses on how management uses rules and policies to keep employees on task. This subcategory also examines the extent that management closely supervises employees. Innovation investigates how well the agency explores new ideas and approaches. The dimensions of employee satisfaction explored through the survey conducted at ACHIEVE help to analyze and understand possible problems in a work group, appraise managers about their effectiveness in shaping the desired work climate in their area of the organization, and as an agency to increase effective delivery of quality services, in an effort to reduce current turnover rates and maintain best practice standards.

14 Data Collection The employee retention survey shown in Appendix B was distributed to 287 employees. The employees chosen for the survey included all full time and half time employees. On-call staff members were excluded from the survey, because of inconsistency in the amount of time worked in the agency on a weekly basis. The survey was returned by 213 employees, which is an overall response rate of 74.2%. The survey was hand distributed to the majority of employees during their already scheduled meetings by Ellen OConner, the Performance Improvement Specialist for ACHIEVE. OConner also mailed surveys to agency employees who were not present at the meetings. Survey participation was voluntary and information derived from the survey would not adversely affect employment within the agency. The survey included a cover sheet indicating employee job title, supervisor name and length of service in the agency. The survey and protocol were reviewed by the Human Subjects Research Review Board at Binghamton University, and because the survey was conducted by an outside agency, the survey tool was deemed exempt (see Appendix A). In addition to the survey that was administered in January of 2009, reports from 2006-2008 documenting the organizations hiring and termination practices were made available for my project. These hiring and termination reports were developed by the Human Resources director to gain an understanding of the individuals reasons leaving the agency. For example, the report documents whether the person was terminated due to rules violations, absences, or for family reasons. Moreover, the length of time that the employee was in their position is indicated on the form. This allows the agency to track, which service areas have employees who have a shorter tenure at ACHIEVE. The hiring reports indicate what type of position is being filled and the time that it took Human Resources to fill that position. I used this information to determine the turnover rate for 2008 by department by dividing the number of employees that left the agency by the total number of employees that worked in

15 that department in 2008. The agency was broken into eight departments: Administration (includes all

support staff, executive management and business offices), Day Habilitation, Medicaid Service Coordination, CVI (client employee services), Nursing, Support Services (food service, transportation and maintenance), Family Support Services (office staff only), and Residential Services. Limitations The survey administered by ACHIEVE had several limitations. Some questions could have been understood differently because of the way that they were worded. For example the length of service question on the first page of the survey included overlapping length of service intervals. This could have affected the overall reliability of some questions. Additionally, employees might have been more inclined to respond favorably with OConner present as she had developed the survey tool. Finally termination reports included reasons for people leaving as filtered through Human Resources and exit interviews were not made available throughout the course of this study. Data Analysis Three statistical tools were used in order to analyze the data gathered from the employee satisfaction survey: Correlation, Simple ANOVA and Multiple Regression. Correlation measures the degree to which different variables are related to one another. Simple ANOVA measures the variation between groups of questions (Salkind, 2004). Multiple Regression measures the relationship between a dependent variable and several independent variables (Virginia Tech., 2009). Multiple regression shows how much of the change in a dependent variable can be accounted for by several independent variables (Sykes, 2009). Eight factors of employee retention were measured in the correlation test: involvement, coworker cohesion, work pressure, clarity, supervisor support, control, innovation and autonomy. The factors were correlated to employee turnover rate. The table below shows the correlation rates for the factors.

16 The relationship between variables is shown on a scale between 1 and -1. A positive correlation is shown between 0 and 1. The closer the value is to 1 the higher the positive correlation is. If the value is listed between 0 and -1 then the relationship is negative. In the correlation table below the important positive correlation results include: coworker cohesion and supervisor support, coworker cohesion and innovation, coworker cohesion and autonomy, clarity and supervisor support, and clarity and autonomy, supervisor support and innovation, supervisor support and autonomy, and innovation and autonomy (Salkind, 2004). Table 1: Correlation between Employee Retention Dimensions

Employee Turnover rate Employee Turnover rate Involvement Coworker Cohesion Work Pressure Clarity Supervisor Support Control Innovation Autonomy 1 -0.098812427 0.458019682 0.097457631 0.249937041 0.654187701 0.026799791 0.748837378 0.549049272

Involvement

Coworker Cohesion

Work Pressure

Clarity

Supervisor Support

Control

Innovation

Autonomy

1 0.036477082 0.452004657 0.652892138 0.32122692 0.348101294 -0.04408124 0.526399297 1 -0.1009359 0.63549536 0.86566507 0.49718846 0.77179898 0.73739753 1 0.5393252 0.2613918 0.5629365 0.0224917 0.2660048 1 0.842428 0.690955 0.505514 0.840158 1 0.57132003 0.85652054 0.93628529 1 0.408953 0.615664 1 0.81191629 1

The next statistical test that was run is called a simple ANOVA. ANOVA tests were used to show the variation in responses on individual questions for each department at ACHIEVE. The departments include: Administration, Day Habilitation, Medicaid Service Coordination (MSC), CVI (workshops), Nursing, Support Services (maintenance, food services and transportation), Residential Services and Family Support Services. The combined variance was also measured in order to understand how variance in individual departments compared to the agency overall. All departments

17 showed statistical significance with the exception of Family Support Services. Family Support Services only had three participants and one of the surveys was only partially completed so that group was eliminated from use in the multiple regressions. Additionally, questions that showed a 1 point variance in 3 or more groups were eliminated from the groups. The questions that were eliminated from the survey (Appendix B) results were 4, 17, 18, 24, 26 and 27. Questions with high variance were eliminated because the questions may not have been interpreted in the same way by all participants. ANOVA outputs are available in Appendix C. After questions were eliminated from the results, multiple regressions were run on comparing employee turnover rate to as the dependent variable to each of the major dimensions of the study: relationship (includes involvement, coworker cohesion and supervisor support), personal growth (includes autonomy and work pressure) and system maintenance (includes control, innovation and clarity) making the sub-dimensions my independent variables. In addition multiple regressions were run on low and high variance groups of sub-dimensions as compared to turnover rate by department. None of the multiple regressions showed statistically significant results. This means that the relationship between the dimensions did not show a statistically significant causal relationship with the employee turnover rates by department. The outputs for all multiple regressions can be seen in Appendix D. Findings Finding 1- There was a lack of statistical significance found in the multiple regression tests conducted. A causal relationship could not be shown between employee turnover rates by department and the dimensions studied in the employee satisfaction survey conducted by ACHIEVE. The lack of significance indicates that the dimensions addressed in the employee satisfaction survey did not show all of the possible variables that effect employee turnover. The multiple regression tests were run on each

18 of the dimensions of the survey. For example the relationship dimension, which was broken into involvement, coworker cohesion, and supervisor support sub-dimensions, did not indicate that the subdimensions had a causal effect on employee turnover rates by department. Although, correlation tests

indicated that there is a positive relationship between the variables used, causality could not be determined from the survey data. Literature and this survey both indicate that individuals can be motivated by the type of work that is conducted by an agency. Respondents to the ACHIEVE survey, as well as, the NYSACRA survey in the literature review showed that individuals that worked in direct care positions did so because of their relationships with clients. This dimension of motivation was not explored fully in the ACHIEVE survey. The reason for the discrepancy may be that current employees are not the most dissatisfied individuals, but rather those who exited the agency might have been more dissatisfied with the agency overall. Finding 2- The ANOVA results suggests that variation in responses was not by chance. The variation in responses between departments on questions was statistically significant at the .05 level. This means that variation on questions did not happen by chance. The ANOVA was used as a basis for my multiple regression test in that questions were tested to determine their reliability prior to running the multiple regression test. Questions were eliminated from the sample if they had a variation level above 1 in three or more departments. In this way questions with reliability issues could be eliminated, meaning questions that may have been understood differently could be removed. Questions that were eliminated showed a variation of above 1 in three or more groups. In addition to eliminating 6 questions out of 35 questions in the survey a department was eliminated from the sample set. The Family Support Services department was eliminated from the sample set for two reasons. First, the department only consisted of three employees and was therefore considered too small

19 of a group. Second, the department showed extremely high variation on a number of questions. This variation was due to the fact that one of the surveys completed in the Family Support department was only partially filled out. The variation in the department was not statistically significant meaning that the variation in responses is not different than you would expect by chance. The null hypothesis, that there is no difference among respondent groups cannot be rejected. Finding 3- Departments with high turnover rates were not always departments with lower satisfaction rates. Perhaps most notable in this study is that departments that had high turnover rates were also departments that indicated high employee satisfaction levels. Before reviewing survey results I hypothesized that departments with higher turnover rates in this case Residential Services, Nursing and Administration, would rate their satisfaction levels lower than departments with low turnover rates. The chart below shows how employee turnover rates by department compare to the dimensions of employee retention. As indicated in the attached survey satisfaction scores range from 1 to 4: 1 poor, 2 fair, 3 good and 4 excellent. Satisfaction levels varied by department based on the sub-dimensions of satisfaction. The lowest satisfaction rate by category is highlighted. The departments with the three highest turnover rates: Residential Services, Nursing and Administration did not have the lowest satisfaction rates in any of the sub-dimensions of the survey. Their overall satisfaction rates for the departments with the highest turnover rate, were the three highest satisfaction scores. This may be because individuals that were the least satisfied with ACHIEVE as an employer already left the agency. It is also interesting to note that the departments with lower turnover rates such as MSC and Family Support showed the lower overall ratings of the agency, as well as, the lowest satisfaction in a variety of sub-dimensions.

20 Table 2: Average Satisfaction Score by Department Compared to Employee Turnover Rate

Employee Turnover Rate Overall Satisfaction Level

Department

Involvement

Coworker Cohesion

Work Pressure

Clarity

Supervisor Support

Control

Innovation

Autonomy

Administration Day Habilitation MSC CVI Nursing Support Services Residential Family Support

15.38% 14.71% 0.00% 8.33% 20.00% 14.29% 34.45% 0.00%

3.56 3.18 3.30 3.27 3.58 3.00 3.40 3.75

3.43 3.12 3.24 3.09 3.32 3.22 3.25 3.00

3.10 2.59 2.45 2.94 2.94 3.11 2.98 3.33

3.54 3.10 3.08 3.10 3.35 3.16 3.22 3.27

3.46 3.11 3.08 3.10 3.35 3.17 3.31 3.07

3.38 2.74 3.00 3.12 3.01 3.08 3.06 3.07

3.30 2.98 2.85 3.09 3.22 3.00 3.21 2.67

3.29 2.81 2.81 2.92 3.15 2.76 3.10 2.83

3.38 2.91 2.98 3.08 3.24 3.06 3.19 3.12

Recommendations Recommendation 1: Increased relationship training and recognition of employees should be implemented. The multiple regression data analysis test did not show statistical significance and because of that other data needs to be explored. Once ACHIEVE determines what motivating factors are influential for their employees, the agency can take steps to increase employee morale. Literature indicates that increasing trainings to facilitate relationship building and skill development can increase employee morale and ultimately increase employee motivation. In addition literature also indicates that increasing employee recognition can have a positive effect on employee morale. Larson and Hewitt (2008) indicate it is important that relationships between staff members are fostered from an early stage in an employees development. Direct service providers in particular need to be confident in the tasks that they will be performing on a daily basis. Larson and Hewitt argue that training should be done by an employees supervisor. When an employee is trained by their supervising staff, generally a better relationship is formed between those two employees. On-going training should

21 also be established in order to promote confidence in staff. When an individual feels confident in their abilities they are more motivated in their position. Providing direct care staff with advanced knowledge of their job tasks, as well as, other related skills such as sign language or sensitivity training can help to motivate employees to perform better and ultimately increase retention rates (Larson and Hewitt, 2008). The correlation tests indicated that there is a positive relationship between supervisor support and coworker cohesion, supervisor support and innovation, and supervisor support and autonomy. The positive correlation indicates that the relationship a supervisor has with their subordinates is one, which needs to be fostered through relationship building trainings and exercises. Additionally, Staff encouragement is an inexpensive way to boost employee morale and motivation. Larson and Hewitt (2005) state that it is important to recognize good work both verbally and formally. The literature indicates that while it is important to correct negative behavior it is equally important to point out good work. A simple verbal praise or note from a supervisor can make a big difference in an employees morale and sense of belonging to the agency. Currently ACHIEVE has a newsletter, which indicates an employees anniversary date but does not go beyond that to state what individual employees have accomplished. Employee of the month recognition by department in the news letter, which could be attached to pay checks could lead to better morale. Other gestures such as gift certificates on an employees agency anniversary date might also increase morale.

Recommendation 2: Collect additional data to gain a better understanding of why employees leave ACHIEVE. The agency should conduct additional surveys to determine what other variables can account for employee turnover rates by department. It would be important for the agency to gain a better understanding of the reasons employees leave the organization; I would suggest that exit interviews are

22 conducted and evaluated on a regular basis. The termination reports that have been collected up until now offer a basic understanding of why employees leave ACHIEVE, but more detailed reports might offer additional insight into employee motivation. Exit interviews should be distributed when an employee is dropping off their badge and keys so that the response rate will be as high as possible. The agency should also continue to monitor the satisfaction of current employees. The current survey offers one approach to measuring employee satisfaction, but I would urge the agency to look at other survey tools and adapt them to the employee group at ACHIEVE. Small focus groups from each department may be another way for the agency to collect data about the agencies overall satisfaction and motivating factors. Focus groups may be able to identify factors that the current survey tool missed. Additional research focused on proactive approaches to motivating current employees, including feasibility studies on such measures as changing current evaluation of employees might be another avenue for ACHIEVE to explore. Conclusion Employee retention is one of the principal problems that ACHIEVE currently faces. In order to provide high quality services to clients, ACHIEVE must retain an adequate number of well trained employees. Turnover rates for residential services in 2008 measured 34.5% meaning that one in every three employees in the residential program area left the agency in 2008. The high cost of training new staff, as well as service diminishment, make turnover one of the most pressing issues for ACHIEVE. In an attempt to understand what factors motivate employees at ACHIEVE a multidimensional survey was conducted in January of 2009. The survey measured relationships, personal growth and system maintenance. Survey questions were assessed using a variety of statistical tools in order to gain insight into which dimensions affected employee turnover. Unfortunately, causal relationships could not

23 be determined from the survey results. Correlations showed that a variety of dimensions had a relationship to one another. Survey results indicated that employee satisfaction and ultimately employee retention is a multifaceted problem that could not simply be categorized by the dimensions of the current survey. The ANOVA test results suggest that variation in responses was by chance. This means that some questions and one department could be eliminated from the overall sample. The final and perhaps most notable finding was that departments with high turnover rates were not always departments with lower satisfaction rates. This finding indicates that high turnover may not be based solely on the dimensions studied in the employee satisfaction survey. This also indicates that other survey tools and methods for evaluation should be explored. The study suggests recommendations based on findings of the employee satisfaction survey. Trainings for all staff should be conducted by direct supervisory staff so that relationships are established early on in an employees development. Continued trainings to strengthen relationships within work groups are also shown to increase employee morale and retention rates. The agency should also increases employee recognition for exemplary work. This suggestion is a low cost way to increase employee morale. Implementing employee of the month additions to the current agency news letter could increase morale in employees and ultimately reduce retention problems. The second recommendation from this study is that the agency should continue collect additional data to understand employee motivating factors. The agency should conduct exit interviews so that they can gain an understanding of what factors motivate employees to leave their positions within the agency. In addition to exit interviews, the agency should also continue to monitor the motivation and morale of current employees, in doing so the agency will be able to increase morale by understanding the needs and expectations of current employees.

24 This study sought to identify factors that affect employee retention and predict ways that the agency can improve on current practices. The study is a step toward understanding employee retention problems, but should not be seen as a final answer. Staff members are unique which means that continued research and analysis is needed to improve employee retention rates at ACHIEVE.

25 Appendix A
Date: March 27, 2009 To: Bridget Riley, MPA From: Anne M. Casella, CIP Administrator Human Subjects Research Review Committee Subject: Human Subjects Research Approval Protocol Number: 1145-09 Protocol title: Employee Retention: An Empirical Study of Direct Care Employee at ACHIEVE Your project identified above was reviewed by the HSRRC and has received an Exempt approval pursuant to the Department of Health and Human Services (DHHS) regulations, 45 CFR 46.101(b)(4) . An exempt status signifies that you will not be required to submit a Continuing Review application as long as your project involving human subjects remains unchanged. If your project undergoes any changes these changes must be reported to our office prior to implementation, using the form listed below: http://humansubjects.binghamton.edu/Forms/Forms/Modification%20Form52.rtf Any unanticipated problems and/or complaints related to your use of human subjects in this project must be reported, using the form listed below, http://humansubjects.binghamton.edu/Forms/Forms/Adverse%20Event%20Form.rtf and delivered to the Human Subjects Research Review Office within five days. This is required so that the HSRRC can institute or update protective measures for human subjects as may be necessary. In addition, under the Universitys Assurance with the U.S. Department of Health and Human Services, Binghamton University must report certain events to the federal government. These reportable events include deaths, injuries, adverse reactions or unforeseen risks to human subjects. These reports must be made regardless of the source of funding or exempt status of your project. University policy requires you to maintain as a part of your records, any documents pertaining to the use of human subjects in your research. This includes any information or materials conveyed to, and received from, the subjects, as well as any executed consent forms, data and analysis results. These records must be maintained for at least six years after project completion or termination. If this is a funded project, you should be aware that these records are subject to inspection and review by authorized representative of the University, State and Federal governments. Please notify this office when your project is complete by completing and forwarding to our office the following form: http://humansubjects.binghamton.edu/Forms/Forms/Protocol%20Closure%20Form.rtf Upon notification we will close the above referenced file. Any reactivation of the project will require a new application. This documentation is being provided to you via email. A hard copy will not be mailed unless you request us to do so. Thank you for your cooperation, I wish you success in your research, and please do not hesitate to contact our office if you have any questions or require further assistance. Cc: file David Campbell Anne M. Casella, CIP Administrator Human Subjects Research Office Binghamton University ITC Room 2205 casella@binghamton.edu Telephone (607) 777-3918 FAX (607) 777-5025

26

Appendix B Date Survey Administered: __________

Employee Satisfaction Survey

Job Title: _____________________________ Name:_____________________________

Supervisors

Length of Service: Less than 1 year 1 to 3 years 3 to 5 years years

5 to 7 years 7 to 9 years 9 to 11 years

11 to 15 years 15 to 20 years More than 20

This survey will be used to improve our workforce practices. Please answer each question as accurately as possible. If you do not understand a question, answer it as well as you can and note your question(s) in the margin. Your answers will be kept confidential and will not affect your status as an employee at our Agency. When you have completed this survey, please return it to the Performance Improvement Specialist. If you have any questions, please feel free to contact Ellen OConnor at 723-8361 x275. Please rate your work at our Agency in the following areas. For each numbered item, enter a checkmark in the column that most closely describes your overall opinion of each item. An area for additional comments is provided on the reverse of this form, you may affix additional attachments if necessary.

27 Please rate your work at our Agency in the following areas. For each numbered item, mark in the column that most closely describes your overall opinion of each item. Area for additional comments is provided on the reverse of this form, feel free to affix additional attachments if necessary.
1 Topic Poor (Strongly Disagree) 2 Fair (Disagree) 3 Good (Agree) 4 Excellent (Strongly agree) 0 No Opinion ~ N/A

I have been provided with a clear job description for my position. I have the opportunity to do what I do best every day. I receive recognition by my supervisor for my accomplishments. ACHIEVE is the premiere provider of quality services for our population. I have had opportunities to share my ideas about improving the service provided. I feel that my opinion(s) count. My co-workers are committed to doing quality work. I receive clear communication of the expectations about my job performance. My supervisor is available to answer questions and provide guidance and assist me in carrying out my duties. I have a general understanding of ACHIEVEs overall values & mission statement. The job I do, makes a difference. I have received sufficient training materials and training opportunities which allow me to perform my job well. I am able to complete my work assignments in a timely fashion. Overall morale in my office or program area is good. I receive intra-Agency communication of events, information and expectations regularly. The overall attitude of consumers and families toward our Agency is good. My rate of pay for the work I do is fair for the area and like agencies. There is fairness in supervision and employment opportunities are consistent throughout the Agency.

28
1 Topic Poor (Strongly Disagree) 2 Fair (Disagree) 3 Good (Agree) 4 Excellent (Strongly agree) 0 No Opinion ~ N/A

The benefits I receive (for example; health & dental insurance, retirement plan, HRA) meet my individual / family needs. Someone at work encourages my development. I received complete and timely orientation about our agency in general and about my position and job duties in particular. My relationship with my supervisor is Our policy for eligibility for paid time off is Rate the degree to which your skills are used. Rate the availability of follow-up training. My relationship with my co-workers is Rate the paid time off you receive. Rate the feedback and evaluation regarding your performance. I have opportunities to learn and grow. My relationship with my supervisors manager is Please rate ACHIEVEs policy regarding eligibility for benefits. My supervisor or someone at works cares about me as a person. Please rate your schedule / flexibility. The leaders in my work environment are positive role models. I am provided opportunities for ongoing professional development. I have access to internal job postings.

29
36. What do you like best about our Agency? (Mark up to 3 choices) a. Nothing _____ i. Location b. Benefits _____ j. Work atmosphere c.Training and Development Opportunities _____ k. Co-Employees d. Supervisors and Managers _____ l. Pay rate/salary e. Individuals Supported _____ m. Job variety f. The Agencys Mission and Values _____ n. Flexible hours / schedule g. The tasks I do for my job _____ o. Recognition for job well done h. Opportunity for personal / professional growth _____ p. Rewarding work _____ q. Other: ______________________ What could our Agency do differently to help you in your job? (Mark up to 3 choices) _____ a. Nothing _____ b. My Supervisor/Manger could be more supportive _____ c. Improve training and support for supervisors _____ d. Increase wages _____ e. Improve access to paid time off _____ f. Improve access to benefits (health, dental, retirement) _____ g. Clarify and communicate the Agencys Mission Statement and Core Values _____ h. Empower me to participate in decisions that affect my work _____ i. Provide more or better training _____ j. Reduce conflict between employees and/or improve team building _____ k. Improve supervisor-employee relations _____ l. Address low morale of workforce _____ m. Improve scheduling policies and practices _____ n. Improve communication between Administrative office and program sites _____ o. Improve communication between supervisors/managers and other staff _____ p. Increase number of staff members in my work site _____ q. Improve recognition and feedback _____ r. Improve orientation for new employees _____ s. Increase opportunities for advancement _____ t. Reduce vacancy rate and turnover _____ u. Other (specify): ________________________________________________________________ What are the top factors that make you want to leave our Agency? (Mark up to 3 choices) _____ a. Nothing ______ n. Lack of Staff _____ b. Low wages or benefits ______ o. Conflicts with co-workers _____ c. Not enough hours or unsatisfactory schedule ______ p. Personal reasons _____ d. Job is too stressful, difficult or demanding ______ q. Poor training _____ e. Our Agencys focus or mission has changed for the worse _____ f. Demands of my other job or primary employment _____ g. Lack of opportunities for professional growth or advancement _____ h. Relocating out of area _____ i. Conflict with supervisor or manager _____ j. Favoritism or lack of fairness _____ k. Too much criticism or lack of support _____ l. Challenges with clients/individuals served _____ m. None of the above _____ r. Other (specify): ________________________________________________________________

_____ _____ _____ _____ _____ _____ _____ _____

37.

38.

30
39. What makes you want to stay at our Agency? (Mark up to 3 choices) _____ a. Nothing _____ b. Benefits _____ c. Co-workers _____ d. Supervisors and managers _____ e. I like the clients/individuals we support _____ f. The individuals supported like and/or appreciate me _____ g. The Mission and Values of the Agency _____ h. The tasks or activities I do for my job _____ i. Opportunity for personal or professional growth _____ j. Location _____ k. Work atmosphere _____ l. Training and development opportunities _____ m. Pay rate or salary _____ n. Job variety _____ o. Flexible hours or schedule _____ p. Recognition for a job well done _____ q. Rewarding work _____ r. The staff members are team players _____ s. This is a good Agency to work for _____ t. Other (specify): ________________________________________________________________

40. a.

Please answer the following questions regarding Health Benefits / Employment at ACHIEVE:

Would you be interested in receiving a discount on health insurance benefits by participating in a Health Risk Program? YES NO Do you see yourself employed by ACHIEVE in the next? year 3 years 5 years Do you see yourself advancing from your current position in the next? year 3 years 5 years Do not plan to advance

b.

c.

31 Appendix C- ANOVA Results

Administration ANOVA SUMMARY Groups Ques 1 Ques 2 Ques 3 Ques 4 Ques 5 Ques 6 Ques 7 Ques 8 Ques 9 Ques 10 Ques 11 Ques 12 Ques 13 Ques 14 Ques 15 Ques 16 Ques 17 Ques 18 Ques 19 Ques 20 Ques 21 Ques 22 Ques 23 Ques 24 Ques 25 Ques 26 Ques 27 Ques 28 Ques 29 Ques 30 Ques 31 Ques 32 Ques 33 Ques 34 Ques 35

Count 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22

Sum 76.5 75 74.25 56.16667 67 65.42857 76 80.75 78 79.5 68.75 64.85714 68.07143 70.78571 59.14286 69.8125 64.4375 79.875 69.375 65.5 75.875 76.875 76.8125 69.25 75.07143 76.875 72.57143 72.6875 50.42857 76.375 73.21429 73.625 76.25 71 83.75

Average 3.477273 3.409091 3.375 2.55303 3.045455 2.974026 3.454545 3.670455 3.545455 3.613636 3.125 2.948052 3.094156 3.217532 2.688312 3.173295 2.928977 3.630682 3.153409 2.977273 3.448864 3.494318 3.491477 3.147727 3.412338 3.494318 3.298701 3.303977 2.292208 3.471591 3.327922 3.346591 3.465909 3.227273 3.806818

Variance 0.320887 0.467532 0.427083 2.268218 1.093074 1.293754 0.28355 0.198728 0.235931 0.236472 0.808036 0.807669 0.970547 0.87098 1.851577 0.565451 1.006806 0.810234 0.958232 1.487554 0.2361 0.334044 0.38255 0.789637 0.801716 0.334044 0.969697 0.416777 2.817254 0.249899 1.352118 0.987994 0.442235 0.398268 0.154356

ANOVA Source of Variation Between Groups Within Groups Total

SS 77.32759 580.2091 657.5367

df 34 735 769

MS 2.274341 0.7894

F 2.8811

P-value 1.6E-07

F crit 1.445588

32

Day Habilitation ANOVA

SUMMARY Groups Ques 1 Ques 2 Ques 3 Ques 4 Ques 5 Ques 6 Ques 7 Ques 8 Ques 9 Ques 10 Ques 11 Ques 12 Ques 13 Ques 14 Ques 15 Ques 16 Ques 17 Ques 18 Ques 19 Ques 20 Ques 21 Ques 22 Ques 23 Ques 24 Ques 25 Ques 26 Ques 27 Ques 28 Ques 29 Ques 30 Ques 31 Ques 32 Ques 33 Ques 34 Ques 35

Count 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31

Sum 95 85.5 94 94 75.5 106 92.5 107 105 113 97.5 83 83.5 94.5 96 65.5 79 94 89.5 88 101 78 97 89 101 81.5 80 96 88 95.5 99.5 97.5 96.5 86 95

Average 3.064516 2.758065 3.032258 3.032258 2.435484 3.419355 2.983871 3.451613 3.387097 3.645161 3.145161 2.677419 2.693548 3.048387 3.096774 2.112903 2.548387 3.032258 2.887097 2.83871 3.258065 2.516129 3.129032 2.870968 3.258065 2.629032 2.580645 3.096774 2.83871 3.080645 3.209677 3.145161 3.112903 2.774194 3.064516

Variance 0.395699 0.847849 0.965591 0.832258 0.712366 0.251613 0.341398 0.255914 0.311828 0.303226 0.619892 0.50914 0.81129 0.272581 0.623656 0.995161 1.072581 1.682258 0.761828 0.489785 0.597849 1.191398 0.382796 1.182796 0.597849 1.232796 1.451613 0.440323 0.723118 0.86828 0.97957 0.719892 0.695161 0.780645 0.995699

ANOVA Source of Variation Between Groups Within Groups Total

SS 106.7175 776.871 883.5885

df 34 1050 1084

MS 3.13875 0.739877

F 4.242259

P-value 2.42E14

F crit 1.440764

33 Medicaid Service Coordination ANOVA

SUMMARY Groups Ques 1 Ques 2 Ques 3 Ques 4 Ques 5 Ques 6 Ques 7 Ques 8 Ques 9 Ques 10 Ques 11 Ques 12 Ques 13 Ques 14 Ques 15 Ques 16 Ques 17 Ques 18 Ques 19 Ques 20 Ques 21 Ques 22 Ques 23 Ques 24 Ques 25 Ques 26 Ques 27 Ques 28 Ques 29 Ques 30 Ques 31 Ques 32 Ques 33 Ques 34 Ques 35

Count 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10

Sum 33.5 25 31 29.5 23 34 31 30 33 34.5 31.5 24.5 26 22 28.5 27 27 37 30 28.5 32.5 31.5 31.5 24.5 34 31.5 28.5 28.5 29.5 32 35.5 29.5 28 30 35

Average 3.35 2.5 3.1 2.95 2.3 3.4 3.1 3 3.3 3.45 3.15 2.45 2.6 2.2 2.85 2.7 2.7 3.7 3 2.85 3.25 3.15 3.15 2.45 3.4 3.15 2.85 2.85 2.95 3.2 3.55 2.95 2.8 3 3.5

Variance 0.336111 1.555556 0.266667 0.247222 0.955556 0.488889 0.822222 0.888889 0.455556 0.358333 0.447222 1.136111 0.433333 1.733333 0.225 0.677778 0.177778 0.233333 0.666667 0.336111 0.180556 0.113889 0.113889 0.413889 0.266667 0.336111 0.391667 0.169444 0.025 0.177778 0.580556 0.913889 0.455556 0.388889 0.277778

ANOVA Source of Variation Between Groups Within Groups Total

SS 44.51857 155.225 199.7436

df 34 315 349

MS 1.30937 0.492778

F 2.65712

P-value 5.01E06

F crit 1.466957

34 CVI Workshop ANOVA

SUMMARY Groups Ques 1 Ques 2 Ques 3 Ques 4 Ques 5 Ques 6 Ques 7 Ques 8 Ques 9 Ques 10 Ques 11 Ques 12 Ques 13 Ques 14 Ques 15 Ques 16 Ques 17 Ques 18 Ques 19 Ques 20 Ques 21 Ques 22 Ques 23 Ques 24 Ques 25 Ques 26 Ques 27 Ques 28 Ques 29 Ques 30 Ques 31 Ques 32 Ques 33 Ques 34 Ques 35

Count 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51

Sum 150.5 149 147.5 164 130 161.5 152.5 172 168 169.5 162 150 134.5 151.5 168.5 131 141 169 149.5 148.5 163 168.5 160.5 157 168 170.5 147 150.5 141 174.5 157.5 168 147 151.5 160

Average 2.95098 2.921569 2.892157 3.215686 2.54902 3.166667 2.990196 3.372549 3.294118 3.323529 3.176471 2.941176 2.637255 2.970588 3.303922 2.568627 2.764706 3.313725 2.931373 2.911765 3.196078 3.303922 3.147059 3.078431 3.294118 3.343137 2.882353 2.95098 2.764706 3.421569 3.088235 3.294118 2.882353 2.970588 3.137255

Variance 0.482549 0.583725 0.993137 0.702549 1.082549 0.516667 0.644902 0.438431 0.451765 0.598235 0.348235 0.476471 0.690784 0.654118 0.270784 0.640196 0.613529 0.699608 0.720196 0.497059 0.720784 0.490784 0.512941 0.393725 0.611765 0.324902 0.915882 0.802549 0.953529 0.343725 0.857059 0.371765 0.915882 0.914118 0.680784

ANOVA Source of Variation Between Groups Within Groups Total

SS 95.41933 1095.784 1191.204

df 34 1750 1784

MS 2.806451 0.626162

F 4.481985

P-value 4.46E16

F crit 1.436255

35 Nursing ANOVA
SUMMARY Groups Ques 1 Ques 2 Ques 3 Ques 4 Ques 5 Ques 6 Ques 7 Ques 8 Ques 9 Ques 10 Ques 11 Ques 12 Ques 13 Ques 14 Ques 15 Ques 16 Ques 17 Ques 18 Ques 19 Ques 20 Ques 21 Ques 22 Ques 23 Ques 24 Ques 25 Ques 26 Ques 27 Ques 28 Ques 29 Ques 30 Ques 31 Ques 32 Ques 33 Ques 34 Ques 35

Count 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9

Sum 27 24.5 31 23.5 30 32 31 33.5 33 34 28.5 26.5 26.5 27.5 27.5 22.5 12.5 22 30.5 21 32 19 30.5 22 28 19 22 29 15.5 22 33 30.5 30 20 20

Average 3 2.722222 3.444444 2.611111 3.333333 3.555556 3.444444 3.722222 3.666667 3.777778 3.166667 2.944444 2.944444 3.055556 3.055556 2.5 1.388889 2.444444 3.388889 2.333333 3.555556 2.111111 3.388889 2.444444 3.111111 2.111111 2.444444 3.222222 1.722222 2.444444 3.666667 3.388889 3.333333 2.222222 2.222222

Variance 0.1875 0.569444 0.277778 1.236111 0.5 0.277778 0.277778 0.194444 0.25 0.194444 0.75 0.902778 0.777778 1.652778 1.527778 0.625 2.236111 3.527778 0.486111 2.75 0.277778 2.611111 0.236111 2.340278 0.173611 2.611111 3.527778 0.506944 1.944444 2.277778 0.25 0.486111 0.3125 2.006944 2.944444

ANOVA Source of Variation Between Groups Within Groups Total

SS 114.3444 333.6667 448.0111

df 34 280 314

MS 3.363072 1.191667

F 2.822158

P-value 1.53E06

F crit 1.471617

36 Support Services ANOVA

SUMMARY Groups Ques 1 Ques 2 Ques 3 Ques 4 Ques 5 Ques 6 Ques 7 Ques 8 Ques 9 Ques 10 Ques 11 Ques 12 Ques 13 Ques 14 Ques 15 Ques 16 Ques 17 Ques 18 Ques 19 Ques 20 Ques 21 Ques 22 Ques 23 Ques 24 Ques 25 Ques 26 Ques 27 Ques 28 Ques 29 Ques 30 Ques 31 Ques 32 Ques 33 Ques 34 Ques 35

Count 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9

Sum 26.5 25.5 24 16 21.5 34 27.5 31 30.5 30 28 28 24 30 31 20 22 29 24.5 25 28.5 26.5 24 24 30 27 21 25 28 27 28 29 28 27 27

Average 2.944444 2.833333 2.666667 1.777778 2.388889 3.777778 3.055556 3.444444 3.388889 3.333333 3.111111 3.111111 2.666667 3.333333 3.444444 2.222222 2.444444 3.222222 2.722222 2.777778 3.166667 2.944444 2.666667 2.666667 3.333333 3 2.333333 2.777778 3.111111 3 3.111111 3.222222 3.111111 3 3

Variance 0.902778 1.375 0.5 2.944444 0.486111 0.194444 1.527778 0.277778 0.236111 0.25 0.611111 0.361111 0.25 0.25 0.277778 1.444444 1.027778 1.694444 0.819444 0.444444 0.875 1.777778 0.75 1.75 0.25 1.5 1.25 0.944444 0.111111 1.5 0.361111 0.444444 0.111111 0.75 0.25

ANOVA Source of Variation Between Groups Within Groups Total

SS 49.08254 228 277.0825

df 34 280 314

MS 1.443604 0.814286

F 1.772847

P-value 0.006907

F crit 1.471617

37 Family Support Services ANOVA

SUMMARY Groups Ques 1 Ques 2 Ques 3 Ques 4 Ques 5 Ques 6 Ques 7 Ques 8 Ques 9 Ques 10 Ques 11 Ques 12 Ques 13 Ques 14 Ques 15 Ques 16 Ques 17 Ques 18 Ques 19 Ques 20 Ques 21 Ques 22 Ques 23 Ques 24 Ques 25 Ques 26 Ques 27 Ques 28 Ques 29 Ques 30 Ques 31 Ques 32 Ques 33 Ques 34 Ques 35

Count 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3

Sum 8 9 8 10 8 9 7 10 12 12 11 10 9 11 9 7 8 8 4 5 7 7 7 7 6 8 4 5 7 7 6 7 6 5 6

Average 2.666667 3 2.666667 3.333333 2.666667 3 2.333333 3.333333 4 4 3.666667 3.333333 3 3.666667 3 2.333333 2.666667 2.666667 1.333333 1.666667 2.333333 2.333333 2.333333 2.333333 2 2.666667 1.333333 1.666667 2.333333 2.333333 2 2.333333 2 1.666667 2

Variance 0.333333 1 2.333333 0.333333 0.333333 0 0.333333 0.333333 0 0 0.333333 0.333333 0 0.333333 0 1.333333 0.333333 5.333333 2.333333 2.333333 4.333333 4.333333 4.333333 4.333333 3 5.333333 1.333333 2.333333 4.333333 4.333333 4 4.333333 4 2.333333 3

ANOVA Source of Variation Between Groups Within Groups Total

SS 49.04762 146.6667 195.7143

df 34 70 104

MS 1.442577 2.095238

F 0.688503

P-value 0.883478

F crit 1.596293

38 Residential Services ANOVA

SUMMARY Groups Ques 1 Ques 2 Ques 3 Ques 4 Ques 5 Ques 6 Ques 7 Ques 8 Ques 9 Ques 10 Ques 11 Ques 12 Ques 13 Ques 14 Ques 15 Ques 16 Ques 17 Ques 18 Ques 19 Ques 20 Ques 21 Ques 22 Ques 23 Ques 24 Ques 25 Ques 26 Ques 27 Ques 28 Ques 29 Ques 30 Ques 31 Ques 32 Ques 33 Ques 34 Ques 35

Count 76 76 76 76 76 76 76 76 76 76 76 76 76 76 76 76 76 76 76 76 76 76 76 76 76 76 76 76 76 76 76 76 76 76 76

Sum 235.5 242 233.5 231 221.5 246.5 244.5 263 265.5 265.5 239.5 226.5 230 220 244.5 195 247.5 238.5 221 214 265.5 226 233.5 211.5 250.5 223 200 234.5 216.5 235 243 227 236 204 217.5

Average 3.098684 3.184211 3.072368 3.039474 2.914474 3.243421 3.217105 3.460526 3.493421 3.493421 3.151316 2.980263 3.026316 2.894737 3.217105 2.565789 3.256579 3.138158 2.907895 2.815789 3.493421 2.973684 3.072368 2.782895 3.296053 2.934211 2.631579 3.085526 2.848684 3.092105 3.197368 2.986842 3.105263 2.684211 2.861842

Variance 0.640132 0.385614 1.124693 1.698421 0.582588 0.463289 0.482237 0.531754 0.276623 0.623289 0.380132 0.462939 0.659298 0.848772 0.588904 0.862281 13.55662 1.290658 1.191404 1.172281 0.623289 0.932632 0.738026 1.35557 0.594518 1.368947 1.302456 0.829254 1.240132 1.09807 0.927193 1.186491 0.788772 1.138947 1.317325

ANOVA Source of Variation Between Groups Within Groups Total

SS 140.8098 3244.766 3385.576

df 34 2625 2659

MS 4.141464 1.236102

F 3.350424

P-value 2.77E10

F crit 1.433999

39 All Departments ANOVA

SUMMARY Groups Ques 1 Ques 2 Ques 3 Ques 4 Ques 5 Ques 6 Ques 7 Ques 8 Ques 9 Ques 10 Ques 11 Ques 12 Ques 13 Ques 14 Ques 15 Ques 16 Ques 17 Ques 18 Ques 19 Ques 20 Ques 21 Ques 22 Ques 23 Ques 24 Ques 25 Ques 26 Ques 27 Ques 28 Ques 29 Ques 30 Ques 31 Ques 32 Ques 33 Ques 34 Ques 35

Count 210 210 210 210 210 210 210 210 210 210 210 210 210 210 210 210 210 210 210 210 210 210 210 210 210 210 210 210 210 210 210 210 210 210 210

Sum 649 632 640 621 573.5 685 658.5 723.5 721.5 734.5 663.5 610.5 598 624 661 535 598.5 673.5 615 592.5 702 630 657.5 601 689 634 571.5 638 572.5 666 672 658.5 644.5 591.5 640.5

Average 3.0905 3.0095 3.0476 2.9571 2.731 3.2619 3.1357 3.4452 3.4357 3.4976 3.1595 2.9071 2.8476 2.9714 3.1476 2.5476 2.85 3.2071 2.9286 2.8214 3.3429 3 3.131 2.8619 3.281 3.019 2.7214 3.0381 2.7262 3.1714 3.2 3.1357 3.069 2.8167 3.05

Variance 0.5205 0.653 0.9188 1.4025 0.8352 0.5268 0.5473 0.4312 0.3296 0.4868 0.4684 0.5595 0.7087 0.7887 0.6695 0.859 5.5791 1.281 0.959 0.9524 0.6331 0.9952 0.6012 1.0885 0.6097 1.1145 1.2869 0.7234 1.2608 0.882 0.9407 0.8655 0.7691 0.9913 1.0848

ANOVA Source of Variation Between Groups Within Groups Total

SS 344.46 6964.6 7309.1

df 34 7315 7349

MS 10.131 0.9521

F 10.641

Pvalue 7E-55

F crit 1.43

40 ANOVA Results Summary

Categories Involvement Coworker Cohesion Supervisor Support Autonomy Work pressure Clarity Control Innovation Question Numbers 4,10,23 6,13,25,31 3,7,8,21,29 2,5,11,19 12 1,9,14,24,27,33,35 16,17,18,22,26,30,32,34 15,20,28 24,27 17,18,26 Removed 4 Averages 3.31428571 3.14761905 3.13952381 2.95714286 2.90714286 3.12333333 2.93428571 3.00238095 Variance Average 0.544013443 0.696462748 0.758226247 0.728904648 0.559518113 0.698531556 0.918589656 0.781774512

41 Appendix D- Multiple Regression Results Relationship Multiple Regression

SUMMARY OUTPUT Regression Statistics 0.83050855 Multiple R 1 0.68974445 R Square 4 Adjusted R 0.37948890 Square 8 0.08341817 Standard Error 7 Observations 7 ANOVA df Regression Residual Total 3 3 6 SS 0.04640997 2 0.02087577 7 0.06728574 9 Standard Error MS 0.01547 0.00695 9 F 2.22314947 4 Significanc eF 0.26434069 4

Coefficients 0.11809208 0.16390526

t Stat 0.11956 0.64435 1.68907 2.41888 1

P-value 0.91238524 2 0.56522589 5 0.18978776 4

Intercept

0.98768174 0.25437282 6 0.60318700 8 0.52742126 6

Involvement Coworker Cohesion Supervisor Support

-1.0188266 1.27576943 4

0.09426334

Lower 95% 3.26133618 4 0.97343312 2 2.93843686 5 0.40272042 4

Upper 95%

Lower 95.0% 3.261336 2 0.973433 1 2.938436 9 0.402720 4

Upper 95.0%

3.025152 0.645622 6 0.900783 7 2.954259 3

3.025152 0.645622 6 0.900783 7 2.954259 3

42 Personal Growth Multiple Regression

SUMMARY OUTPUT Regression Statistics Multiple R 0.5837645 R Square 0.340781 Adjusted R Square 0.0111715 Standard Error 0.1053044 Observations 7 ANOVA df Regression Residual Total 2 4 6 Coefficient s SS 0.022929 7 0.044356 0.067285 7 Standard Error 0.652012 6 MS 0.011464 9 0.011089 F 1.033893 1 Significance F 0.43456969 2

t Stat 1.159087 6 0.669846 8 0.737970 4

P-value

Intercept

-0.7557397

0.310901 0.539639 1 0.501484 7

Autonomy

0.1638559

0.244617 0.198390 7

Lower 95% 2.56601693 8 0.51530973 4

Upper 95% 1.054537 5 0.843021 5 0.697227 4

Lower 95.0% 2.566016 9 0.515309 7 0.404414 5

Upper 95.0% 1.054537 5 0.843021 5 0.697227 4

Work Pressure

0.1464065

-0.40441447

43

System Maintenance- Multiple Regression

SUMMARY OUTPUT Regression Statistics 0.82158866 Multiple R 3 0.67500793 R Square 1 Adjusted R 0.35001586 Square 1 0.08537629 Standard Error 4 Observations 7 ANOVA df Regression Residual Total 3 3 6 SS 0.04541841 4 0.02186733 5 0.06728574 9 Standard Error 0.71251600 9 0.25666501 6 0.40075145 6 0.41486881 8 MS 0.015139 5 0.007289 1 F 2.07699 8 Significanc eF 0.28181028

Intercept

Control

Coefficients 0.87982450 5 0.24768350 6 0.84244660 3 0.25318175 9

t Stat 1.234813 7 0.965006 9 2.102167 3 0.610269 4

P-value 0.30479 6 0.40572 6 0.12630 4 0.58480 5

Lower 95%

Upper 95% 1.3877194 4 0.5691391 2 2.1178165 9 1.0671159 8

Lower 95.0% 3.14736 8 1.06450 6 0.43292 3 1.57347 9

Upper 95.0% 1.387719 4 0.569139 1 2.117816 6

-3.1473684

-1.0645061

Innovation

-0.4329234

Clarity

-1.5734795

1.067116

44 Low Variance Multiple Regression

SUMMARY OUTPUT Regression Statistics Multiple R 0.59366783 R Square 0.35244149 Adjusted R Square -0.9426755 Standard Error 0.1475999 Observations 7 ANOVA df Regression Residual Total 4 2 6 SS 0.023714 0.043571 0.067286 Standard Error 2.156536 0.529277 1.36985 0.382849 1.333773 MS 0.005929 0.021786 F 0.272131 Significance F 0.875784996

Coefficients Intercept Involvement Coworker Cohesion Work Pressure Clarity -0.714695 0.26340518 0.04251082 0.29504634 -0.308841

t Stat -0.33141 0.49767 0.031033 0.77066 -0.23155

P-value 0.77184 0.668049 0.978062 0.521497 0.838418

Lower 95% 9.993521241 2.013889966 5.851478639 1.352219594 6.047603122

Upper 95% 8.56413 2.5407 5.9365 1.94231 5.42992

Lower 90.0% 7.0117 1.2821 3.9574 0.8229 4.2034

Upper 90.0% 5.58236 1.808886 4.042453 1.41296 3.585757

45 References ACHIEVE (2009, January). Mission Statement. Retrieved January 29, 2009 from http://www.achieveny.org/index.php Borkowski, N.(2005). Organizational behavior in healthcare. Jones and Bartlet publishers. Heathfield, S. M. (2009). 360 Degree feedback : The good, the bad, and the ugly. Retrieved April 10, 2009 from http://humanresources.about.com/od/360feedback/a/360feedback_2.htm Larson, S. A., & Hewitt, A.S.(2005). Staff recruitment, retention & training strategies for community human service organizations. Baltimore: Paul H. Brooks publishing company. Locke, E.A.(1975). Personnel attitudes and motivation. Annual Review of Psychology, Volume 26: pg 457-80. Maslow, A.H.(1943). A theory of human motivation. Psychological Review, Volume 50: pg 370-396. McGregor, Douglas M.(1957). The human side of enterprise. Management Review. NYSACRA(2009). Direct support professionals voices from the frontlines. Albany, N.Y. Salkind, N. J. (2004). Statistics for people who think they hate statistics, 2nd edition. Sage Publications. Smergut, P. (2007). Minimizing turnover among support counselors through a value based culture. Journal for Nonprofit Management, Volume 11. Retrieved Feb 03, 2009, from http://www.supportctr.org/images/minimizingturnover.pdf. Sykes, Alan O. The Inaugural Coarse Lecture. Retrieved on February 27, 2009 from http://www.law.uchicago.edu/Lawecon/WkngPprs_01-25/20.Sykes.Regression.pdf Virginia Tech. Multiple Regression. Retrieved on March 2, 2009 from http://pse.cs.vt.edu/SoSci/converted/MRegression/

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