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Discretion in Context: A Moderated Mediation Model of the Relationship between Discretion and Turnover Intentions





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    •  The authors’ affiliations are School of Labor and Employment Relations, University of Illinois at Urbana Champaign, Champaign, IL. Krannert School of Management, Purdue University, West Lafayette, IN; School of Business, Konkuk University, Seoul, Korea. E-mail: Our sincere thanks to David B. Lipsky from Cornell University for his leadership on the broader Nursing Home Demonstration Project. We are deeply grateful to the members of the Quality Care Oversight Committee (Martin Scheinman, Jay Sackman, and William Pascocello) and to Mary Jane Koren of the Commonwealth Fund for their support and guidance. We also want to thank Scott White, the coordinator of the New York Nursing Home Demonstration Project, for his close collaboration and insights about nursing homes. We thank Yasamin Miller, Director of Cornell s Survey Research Institute, and her dedicated staff. Finally, we are grateful to Eunkyung Lee for her insights and invaluable assistance.


This paper examines the relationship between employee discretion and turnover intentions. We test the proposition that this relationship is mediated by employee stress and moderated by employee perceptions of staffing adequacy. We maintain that in assessing the potential effects of increased employee discretion, scholars must also examine the mechanisms through which these benefits are delivered, and the context in which it is provided. In an effort to study discretion in context, we develop and test a “moderated mediation” model in the healthcare setting. Our findings support the hypotheses that employee stress mediates the relationship between discretion and turnover intentions. In addition, employee perceptions of staffing adequacy are shown to moderate the relationship between employee discretion and stress.