Healthcare Employers Focus On Employee Turnover
By: John Rossheim
“Employee turnover is coming.”
Those three words strike fear in the hearts of healthcare managers everywhere. And Beth Carvin says that employee turnover will be the inevitable trend.
Carvin, CEO of Nobscot Corp., a Honolulu vendor of employee retention management and metrics services, believes that after years of economic storms that have kept clinicians, HIT experts and other healthcare workers hunkered down, retention will soon become a greater concern.
Indeed, healthcare provider organizations will face retention challenges on two major fronts this year:
- Structural and regulatory changes in the industry that are stressing out employee.
- Departmental and individual discontents that employers ignore at their own peril.
Employee Turnover Comes at a High Price
In healthcare, declining retention is extraordinarily expensive. The cost of turnover at one major medical center represented a loss of more than 5 percent of the total annual operating budget, according to an article in Health Care Management Review.
For many hospitals, that margin could be the difference between black ink and red.
“Attrition is so, so costly to the organization, not only in money but also quality,” says Randal Dabbs, MD, president of practice development at TeamHealth, a Knoxville, Tenn., provider of physician services to hospitals.
When an RN leaves, her shift may be filled with expensive overtime hours put in by overtaxed colleagues; when a permanent replacement finally arrives, it may take months more to get the new hire up to speed with customized EMRs, doctors' idiosyncrasies and so on.
Healthcare System Change Brings Stress
From the Affordable Care Act (ACA) to the prolonged rollout of the ICD-10 coding protocol, the US healthcare apparatus is undergoing a period of extraordinary change.
“There is so much stress and change going on now; managers must see that EMR recording is done correctly, and new charge codes are coming out,” says Heidi Toppel, consulting director for compensation in healthcare and nonprofit organizations at HR consulting firm Towers Watson.
How could this impact your employee retention? An employee whose institution is just beginning a years-long EMR implementation may be tempted to jump to an organization that has completed this often painful process.
A hospital may also lose employees as the organization copes with potential increases in its own health insurance costs.
As in other industries "healthcare organizations are stressing over whether they want to keep people to a 30-hour work week, that being the ACA cutoff to provide insurance,” says Toppel. “They will lose people if they cut back hours from 40 to 30.”
Mergers and Acquisitions
As community hospitals merge with much larger systems and teaching institutions buy up physician groups, employee dissatisfaction will increase — especially when those employees are burned out physicians who once owned practices.
“There’s a whole generation of physicians not inclined to become part of a health system or hospital,” says Toppel.
Smart employers will respond to this threat to employee retention.
“We go out and let employees at our new partner know what it’s like being part of a larger health system," says Veronica Zaman, corporate vice president of human resources and learning at Scripps Health, a San Diego health system. "We have an employee assistance program for people who would struggle with becoming part of a larger organization."
Confronting Disengagement, Promoting Engagement
Whether for lack for foresight or resources, many providers don't actively scan the horizon for retention problems — a potentially expensive oversight.
“You have to have the courage to confront a disengaged physician,” says Dr. Dabbs. “You have to recognize that one of your physicians is somehow checking out, not coming to meetings, not participating in social events. You have to have the courage to ask what’s going on – before they sign with another group."
Large providers often take a programmatic approach to employee engagement as a retention tool.
Scripps Health uses internal surveys, focus groups, town hall meetings, and leadership trainings and retreats to keep in touch with employee concerns, says Zaman.
Every Unhappy Workforce Is Unhappy In Its Own Way
Some providers improve retention by examining and acting on their particular organizational and cultural shortcomings. “Every healthcare organization has its own unique issues,” says Carvin.
“One company we work with had high turnover in its pharmacy. We examined data from exit interviews and found that people were joining the company and then leaving right away. One pharmacy technician actually said, ‘I was afraid I was going to kill somebody,’ meaning a pharmacy client.”
It turned out that employee training was inadequate, leaving new employees vulnerable to committing dangerous errors. The company expanded its training and turnover dropped.
Creating deeper working partnerships between veteran workers and new employees can also improve retention. “Mentoring programs have been shown to reduce turnover,” says Carvin.
At one such institution, giving each new nursing assistant a mentor helped to dramatically drive down turnover, from 64 percent to 4 percent, she says.