Through the deep recession of 2008-2009, healthcare employers could pretty well count on their workers to stay put, even clinical specialists in particularly high demand. But with the economy on the mend, some health care professionals inevitably will start to look for greener pastures.
That’s why executives and managers at hospitals and other health care providers are renewing their efforts to retain those hard-to-replace specialists in whom they’ve invested substantial resources. How high a priority should retention be? “I don’t think there’s anything more important that I do than be chief retention officer,” says Richard Ford, director of respiratory services at the University of California San Diego Medical Center.
Hospitals across the country are pushing policies, programs and organizational cultures that make their wards and labs the place their workers want to stay. Here’s a sampling of their approaches.
Scheduling for Flexibility
Although patient care must come first in the scheduling of shifts for specialist clinicians, hospitals can’t afford to ignore the preferences of their workers. And those preferences vary, among individuals and across generations.
Flexible scheduling seeks to accommodate the labor and leisure lives of workers -- the concept rolls easily off the tongue, but it’s no simple feat. In addition to covering the complex 24/7 needs of patients, a flexible scheduling program must also be clearly defined, systematic, fair and transparent if it is to earn the confidence and loyalty of workers.
Even the broad architecture of shift scheduling can help retain value specialists -- or drive them away. Twelve-hour shifts are popular with younger critical-care nurses who like having as many days off as working days, says Pam Shellner, a clinical nurse specialist at the American Association of Critical-Care Nurses. But some nurses want to go back to 8-hour shifts because they believe a 5-day week enables them to provide better continuity of care, she adds. So the choice of scheduling paradigm may depend in part on the retention priorities of the institution and its employees.
Education for Growth
In their career choice, health care specialists implicitly convey to their employers that education is particularly important to them. And many seek to advance their training through their careers.
“The average lab technologist is over 50,” says Irina Lutinger, senior administrative director of clinical laboratories at NYU Langone Medical Center. "We encourage them to put off retirement by earning the ASCP certification, which gets them an extra $2,000 salary increase.”
Generous tuition benefits are another strong retention incentive. “We offer 100 percent tuition reimbursement for big specialties in nursing,” says Dayla Randolph, a human resources consultant with Advocate South Suburban Hospital in Hazel Crest, Illinois.
Many clinicians want to take the initiative to keep up with advances in their specialties. For them, access at work or from home to medical databases and research literature is a real draw. In-house education initiatives such as teleconferences, speaker series and learn-at-lunch programs are also popular.
Career Development for Advancement
Most specialists want to do more than just move patients through the health system; they seek to follow a career arc. That’s why at NYU Langone Medical Center, “we give opportunities to internal candidates to advance to the next level, to lead technologist, supervisor or manager,” says Lutinger.
For highly trained specialists who are not physicians, opportunities to use their own finely-tuned medical judgment can be an important retention tool. “We’ve implemented programs that enable respiratory therapists to have some say-so in patient care,” rather than having physicians make every decision, says Ford.
The neatest trick of all may be to keep health care workers happy in their current roles, while mixing in a little variety. “We have four levels of nurse-clinician to encourage our nurses to remain at bedside as they advance,” says Randolph. At the higher levels, nurses take on research projects or become preceptors, for example.
Technology to Ease the Burden
Health care information systems can be so frustrating and counterproductive that some health care workers, especially those who are nearing retirement, may actually quit rather than learn to jump through a new set of technological hoops.
But technology, carefully crafted with clinicians in mind, can also bind workers to their hospitals. “Our clients’ specialist surgeons often work at multiple institutions,” says Paul Brient, CEO of PatientKeeper, which makes patient information and workflow software for physicians. “The software gets doctors out of the hospital faster, and with a BlackBerry or iPhone they have everything they need on patients, wherever they go.”
Indeed, much health care technology helps to lighten clinicians’ daily burden. “We bring in as much automation as possible, to improve efficiency,” says Lutinger, the NYU lab director. “Workers like to reduce their manual tasks, and it’s also better for patients.”
Recognition and Support for Employee Satisfaction
Employee recognition is easy to write off as an HR gimmick, but specialist clinicians do appreciate genuine expressions of gratitude for their professional excellence. Ford puts plainly the importance he assigns these expressions: “We expect our leaders to recognize their staff and we check that they do.”
The clarity of the recognition is often more important than the magnitude of the reward, which might be an inexpensive gift card. “Our managers give staff members cards noting their specific above-and-beyond accomplishments,” says Randolph.
Shellner draws a direct line between the health of staff-to-manager relationships and the retention of critical-care specialists: “Our nurses will stay according to how supportive their managers and workplaces are.”