Predictors and effects of hospital chief executive officer turnover: A systematic review.

BACKGROUND

Chief executive officer (CEO) turnover is especially frequent in hospitals and represents a critical organizational event, yet its predictors and effects remain poorly understood.

PURPOSE

We conducted a systematic review of the empirical literature on the predictors and effects of hospital CEO turnover worldwide to synthesize and assess the multiple findings scattered across studies.

METHODOLOGY

In this systematic review, 30 empirical studies published between 1987 and 2024 were identified from three databases: Business Source Complete, MEDLINE, and APA PsycInfo. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

RESULTS

We found that the methodological quality of the studies was highly variable. Furthermore, we identified 46 unique predictors of hospital CEO turnover, including organizational, environmental, and personal characteristics, as well as characteristics related to prior performance. The findings regarding the effects of CEO turnover suggest that it can result in a temporary decline in financial performance and an elevated risk of organizational failure for hospitals.

PRACTICE IMPLICATIONS

Our results underscore that, in hospitals with a higher likelihood of CEO turnover, early and systematic succession planning is crucial to increase leadership stability, reduce recruitment costs, and ensure organizational resilience.