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Volume 4
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Issue 2

Reducing Staff Turnover Risk in Ambulatory Care: A Survey-Based Analysis of Workload, Leadership Trust, Well-Being, and Intent to Stay

By:
Susan
Hilerio
Workforce turnover in healthcare threatens operational stability, staff well-being, and the quality and continuity of patient care. Ambulatory care settings are especially sensitive to turnover because lean staffing models amplify workload strain and disrupt team-based workflows. This cross-sectional study analyzed a staff experience survey administered in an adult ambulatory care setting (N = 86; response rate = 43%). The survey assessed current work experience, intent to stay, scheduling and workload, leadership presence and trust, stay conversations, well-being signals, and growth and recognition. Results showed that 69.8% of respondents reported workloads that were frequently or unsafely overwhelming, and 76.7% reported very little or no control over their schedules. Perceptions of leadership engagement were low; 74.4% disagreed that leaders are regularly present to understand barriers, and 69.8% reported that feedback is rarely or never acted upon. Nearly all respondents (97.7%) reported no recent stay conversation with a supervisor about what helps them want to stay. Burnout signals were prominent: 58.1% reported emotional exhaustion often or almost always in the prior two weeks. Collectively, the findings indicate a substantial retention risk and support the need for multifaceted retention strategies that target staffing and workload, scheduling flexibility, leadership follow-through, and scalable well-being supports.
Published:
June 5, 2026
View Manuscript

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Frank Marshall Valier, D.B.A., CAIBP

Professor of Healthcare Administration & Technology

Health Sciences & Technology Department

Charter Oak State College

New Britain, CT
Email:  fvalier@charteroak.edu

Dr. Frank Marshall Valier is a Distinguished Charter Oak Professor and a Certified Artificial Intelligence and Blockchain Technology Management Healthcare Professional whose career exemplifies the highest ideals of scholarly leadership, transformative teaching, and academic innovation. As the founder, publisher, and editor of the Journal of Healthcare Administration and Policy (JHCAP), he has created a vital forum for advancing knowledge at the intersection of healthcare administration, policy, and emerging technology.

Over a distinguished 25-year career, Dr. Valier has made enduring contributions to healthcare administration education through excellence in faculty leadership, graduate-level instruction, scholarly research, and academic publication. At Charter Oak State College in New Britain, Connecticut, he serves as Lead Faculty Instructor for the Master of Healthcare Administration (MHA) program, where he has played a pivotal role in shaping the program's academic identity — most notably through the development and teaching of the MHA Capstone course. His curriculum design reflects a sophisticated command of both healthcare administration and information technology management, preparing students to lead with confidence in an increasingly complex and technology-driven healthcare landscape.

Dr. Valier earned his Doctor of Business Administration in Information Technology Management, with a specialization in Healthcare, from Nova Southeastern University in Fort Lauderdale, Florida. His doctoral dissertation, "A Primary Study of the Perception of Characteristics of Innovation during Pre-Diffusion Stage," earned a Best Paper Award nomination from the Association of Information Systems and was subsequently published in the Journal of International Technology and Information Management — a testament to his significant scholarly contributions to the study of technology adoption in healthcare settings.

As an educator, Dr. Valier is widely recognized for his ability to make complex healthcare concepts both accessible and meaningful. He brings to the classroom a rare combination of rigorous academic standards and genuine investment in student success, consistently bridging theoretical frameworks with real-world application. His pedagogical approach reflects a deep alignment with Charter Oak State College's mission of delivering relevant, career-focused, and student-centered education.

Dr. Valier's professional interests continue to evolve at the forefront of healthcare innovation. His expertise in artificial intelligence and blockchain technology management positions him as a thought leader in the digital transformation of healthcare administration — and as a tireless advocate for preparing the next generation of healthcare leaders to meet that challenge.

© 2026 Journal of Healthcare Administration Practice. all rights reserved
Updated 6/1/26