Exit Spirals in Hospital Clinics: : ConceptualizingTurnover Contagion Among Nursing Staff
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This article introduces the concept of the exit spiral to conceptualize processes in whichpoorly functioning hospital clinics or wards enter a phase of decline due to widespreaddissatisfaction among staff, prompting turnover contagion. In describing and analyzingcases amassed during observations and interviews, the article provides tools to identify,analyze and halt exit spirals. Once a hospital ward finds itself in an exit spiral, employeesexperience increased workloads, loss of control and discontent. Managers may react withincreased rigidity. Instability, discontinuity, and insufficient knowledge transfer areprocesses sparked by exit spirals. The article suggests that exit spirals can be halted ifmanagement recognizes the depth of organizational decline and directs resources toresolve it. This requires further analysis, stimulation of employee voice, innovation, andflexibility.