• Judith D Schaechter, Emily M Silver, Ross D Zafonte, and Julie K Silver.
• Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA.
• J Womens Health (Larchmt). 2025 Jan 10.

AbstractBackground: The attrition of health care professionals from institutions has historically been high, with reports of higher rates in women than men. High attrition jeopardizes the institution's financial stability, quality of patient care, and scholarly contributions to advancing health care. The disproportionate loss of women reduces the diversity of perspectives and skills needed to meet patient needs. Attrition risk has been demonstrated to relate to both the leadership behaviors of supervisors and the sense of belonging in the workplace. Toward informing health care institutions about strategies for curtailing high attrition, we sought to assess the relative strength of the association of attrition risk with leadership behaviors of supervisors versus workplace belonging. Methods: Attendees of a continuing education course on women's leadership skills in health care were surveyed about the intent to leave (ITL) their institution within 2 years, perceived leadership behaviors of their supervisor, and experiences of workplace belonging. Dimensions of workplace belonging were identified by factor analysis. The strength of association of ITL with supervisor's leadership behaviors and each workplace belonging dimension was analyzed in a multivariable ordinal logistic regression model. Results: Women comprised 94% of survey participants. In the regression analysis, lower ITL was associated strongly with more frequent experiences of institutional culture supporting workplace belonging, modestly with more favorable perceptions of supervisor's leadership behaviors, and not with frequency of experiences of interpersonal relationships supporting workplace belonging. Conclusions: An institutional culture that supports workplace belonging is particularly important for reducing attrition risk in health care professionals. For health care institutions seeking to improve retention of its professionals and women in particular, our findings point to investing in a culture of workplace belonging that involves a diverse workforce, an environment in which its professionals feel heard, supported, and empowered and are provided strong career advancement opportunities.

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