Date of Conferral



Doctor of Business Administration (D.B.A.)


Business Administration


Jamie Patterson


Frequent turnover among a hospital's nursing staff can profoundly impact organizational operating costs. With a national turnover rate of 17% in 2015, understanding the impact of management approaches on nurse attrition is vital to business success. Guided by Homan's social exchange theory, the purpose of this single case study was to explore leadership strategies used by safety-net hospital leaders to increase nursing personnel retention. Data collection consisted of semistructured interviews from a purposive snowball sampling of 8 senior directors working at a safety-net hospital in southern Maryland. Additional information collected involved documents and artifacts related to human resources management policies and guidelines. Constant comparative method enabled the analysis and identification of latent patterns in words used by respondents. Through methodological triangulation, several themes emerged. These themes included engagement and management support, education and career development, teamwork and work atmosphere, recognition, relationship building and communication, and health reform and innovation. According to the study results, increasing employee engagement, offering training and career development, performing technological upgrades, and developing sustainable relationships are appropriate approaches for gaining nursing personnel commitment. The findings of this study are important to senior leaders and middle managers in healthcare and other industries as they seek to attract talented staff members to sustain their organizations. The conclusions in this study may contribute to positive social change through improved nursing staff retention, leading to better patient experiences, healthier communities, and more satisfied customers.