Diagnosing and treating the healthcare employee retention problem

By and large, healthcare workers in any department are not squeamish. But the words “employee turnover” make even the most seasoned healthcare managers feel a little unsettled. That’s because the loss of healthcare workers, their continual turnover, and the over-worked employees who fill in the gaps can mean life-or-death in the real world.

There are a number of factors leading to problems with healthcare employee retention, but beyond that diagnosis, what treatments are available to keep your healthcare team intact?

The pain points for retention

Beth Carvin, CEO of Nobscot Court, a vendor of management and metrics services, says employee retention is a great concern of healthcare providers. They face retention challenges on two major fronts:

  • Structural and regulatory changes in the industry that are stressing out employees.
  • Departmental and individual discontent that employers ignore at their own peril.

It’s bad enough when sirens blare and patients come pouring in with serious injuries, but it’s virtually impossible when there aren’t enough doctors, nurses, and others to care for them. That’s when healthcare employee retention is out of control.

Employee turnover comes at a high price

In healthcare, employee turnover is extraordinarily expensive. The cost of turnover at one major medical center represented a loss of more than five percent of the total annual operating budget, according to 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 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

As government administrations change, healthcare in the U.S. also undergoes periods of extraordinary transition. This also has an impact on healthcare employee retention.

Heidi Toppel, consulting director for compensation in healthcare and nonprofit organizations at HR consulting firm Towers Watson, says governmental changes cause HR managers a lot of stress. They have to keep an eye on data management, patient privacy, charge codes, and more.

How could this impact your employee retention? An employee whose institution is just beginning a years-long changeover may be tempted to jump to an organization that has already 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,” says Toppel. “They will lose people if they cut back hours from 40 to 30.”

Crunch time from mergers and acquisitions

As community hospitals merge with much larger systems and teaching institutions buy up physician groups, employee dissatisfaction increases. That includes 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 respond to this threat by focusing on 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. “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 companies don’t actively scan the horizon for retention problems. It’s a potentially expensive oversight — particularly with healthcare employee retention.

“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, for example, uses internal surveys, focus groups, town hall meetings, leadership trainings, and retreats to keep in touch with employee concerns.

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,” she said. “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.

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