5 strategies for improving employee retention in healthcare

Even before the COVID-19 pandemic, employee turnover in the healthcare industry was high. According to the U.S. Bureau of Labor Statistics, in 2016, turnover was nearly 32%. By 2020, that figure had risen to just over 45%.

Some of the issues related to the high turnover rate among healthcare workers include: an aging workforce, especially among nurses and physicians; the so-called leaky pipeline, in which workers enter the field, but quit for personal or professional reasons; and a lack of educational opportunities, such as the shortage of nurse educators that prevents many prospective nurses from getting the training they need to enter the field.

Other issues affect turnover rates as well: burnout, salary, career development, work-life balance — the list goes on. However, there are methods that healthcare leaders can use to help maintain employee satisfaction. The following are five strategies for improving employee retention in healthcare.

1. Improve recruiting and onboarding

Attracting candidates requires a combination of a good salary, good benefits, and a good work environment. But with turnover so high, recruiting has to look beyond filling open positions. Employers must give people reasons to stay. Recruiting with job satisfaction in mind can be difficult, but it will pay off in higher retention rates. A good salary is only one factor in why people take and remain at a job. Good benefits, training, continuing education, and professional development also influence whether or not they stay.

• Sign-on bonuses: Sign-on bonuses for nurses have reached record heights and will get people in the door. However, unless employees have good reasons to stay, they’ll be apt to take another company’s bonus. 
• Tangible benefits: It’s no good to offer excellent vacation time if employees can’t take advantage of it. Likewise, when possible, allowing employees to choose their shifts or offering autonomy in other areas can lead to greater job satisfaction.
• Well-organized onboarding: Training employees on administrative tasks and technology (phones, payroll and timesheet software, electronic health records, and other applications) can give them the confidence to step comfortably into their new role. Peer introductions, a tour, a team lunch, or another staff activity can make a new hire feel welcome.

2. Adopt scheduling best practices 

Adequate staffing and proper scheduling are critical to improving employee retention in healthcare. They directly affect quality of care, according to long-term nursing studies on nurse-to-patient ratios in the intensive care unit. High patient loads can cause burnout among nurses and lead to employee turnover. The COVID-19 pandemic, plus a shortage of nurses and doctors in some areas of the U.S., has caused staffing levels to fluctuate in many healthcare facilities.

Healthcare providers who need to schedule staff to adequately meet patient needs can use a variety of strategies. For example:

• Flexible scheduling: Staggered start times, overlapping shifts, and job sharing are some possibilities. These flexible options have the advantage of meeting the needs of nurses and other health professionals who are balancing work and family or other demands.
• Self-scheduling: Giving workers autonomy in scheduling their shifts leads to greater job satisfaction. This gives nurses and other healthcare workers control over when they work and how much overtime they take on.
• Data analytics: Workforce planning applications can help managers predict demand using data analytics. These applications use artificial intelligence and machine learning to help identify likely surges in demand.

3. Prevent employee burnout

According to the American Psychological Association, burnout is a physical, emotional, and mental condition caused by overwork and stress. It results in lack of motivation, poor job performance, and increased negativity. Burnout can lead to poor care quality, and overwork and exhaustion can lead to medical mistakes.

A 2021 study by the Mayo Clinic found that one in five healthcare workers said they intended to reduce work hours or quit the profession in two years, due to burnout, fear of infection, anxiety, or a high workload.

Tactics for addressing burnout include:

• Adequate staffing and scheduling: Overwork is one of the primary causes of burnout. Hiring temporary and permanent staff and scheduling appropriately can help alleviate overwork.
• Prepare staff for risk of burnout: Starting when they are students and newcomers to the profession, employees should be informed about the signs and symptoms of burnout and given the tools to help prevent it.
• Focus on patient care, not paperwork: Reducing administrative tasks allows clinicians to focus on what they do best — caring for patients.
• Improve technology: Technology should improve patient care, not get in the way.
• Treat burnout: Burnout sometimes carries a stigma. Employers should make sure employees get care as needed.

4. Invest in employee engagement 

Employee engagement is a key indicator of job satisfaction. Engaged employees are more likely to be involved in decision-making, feel as if they are valued, and believe they have a stake in the organization. Some tips for boosting employee engagement include:

Coaching and mentoring programs

These programs are vital for all healthcare providers: those who are new to the workforce and those who have years of experience. They send the message that employers are invested in their staff’s career goals. Coaching most often refers to a short-term goal, such as helping someone gain responsibility in a new area. A mentor is often a career adviser, and the relationship between a mentor and mentee is usually a long-term one. 

Encourage continuing education and certification

Most healthcare professions require continuing professional development (CPD), often referred to as continuing medical education (CME) credits or continuing education units (CEUs). Studies show that CPD has a positive impact on patient outcomes. According to the Journal of American Medicine, CPD programs in prescription drugs were associated with reduced healthcare costs for patients.

According to the American Association of Critical-Care Nurses, the many benefits of nursing certifications include the following:

• Job satisfaction: Nurses who are certified in critical care or other specialties often have higher job satisfaction. Their certification recognizes their professional experience.
• Salary: Certification can result in a higher salary.
• Peer respect: Certification leads to respect from peers and employers.
• Patient satisfaction: Patients are more apt to be satisfied with their care if they know their nurse is certified.  

Employee-led initiatives and autonomy

What do some employers do when they’re not sure how to increase their employees’ engagement? They ask them. Employee-led initiatives can have a large impact on a healthcare organization. An initiative may be as simple as providing a meditation room or healthy snacks in the break room. It could also be a solution related to scheduling, such as split shifts, or technology changes. Employees know their needs and their jobs best.

Likewise, autonomy affects job satisfaction. A report in the Journal of Healthcare Leadership showed that nurses who had autonomy and agency in their practice were more likely to stay in the profession, despite the pressures caused by the COVID-19 pandemic.

5. Address social barriers to work

COVID-19 has placed healthcare employees at great personal risk of infection and death. Even workers who don’t provide direct care to patients are vulnerable. Some healthcare workers are at higher risk than others, due to several social factors, such as their age, health, or ethnicity. 

The Centers for Disease Control and Prevention recommends taking social barriers into account when working around staffing shortages. For example, a healthcare worker may have transportation or housing needs that make it difficult to get to work at certain hours or on certain days. Or they may be living with a high-risk family member and need special consideration.

Strong healthcare leaders are needed to improve worker retention

Improving employee retention in healthcare is crucial for all healthcare organizations. Healthcare leaders who understand why employees leave can build a working environment that supports staff members and lets them know they’re valued. Northern Arizona University and OpusVi’s Master of Business Administration in Healthcare degree program provides a solid foundation in healthcare business management. Find out how you can make a difference in the rewarding field of healthcare leadership. 

Sources:

• Academic Medicine, “Effect of Continuing Professional Development on Health Professionals”
• American Association of Colleges of Nursing, Data Spotlight: Insights on the Nursing Faculty Shortage
• American Association of Critical-Care Nurses, “Certification Benefits Patients, Employers and Nurses”
• American Medical Association, “Medicine’s Great Resignation? 1 in 5 Doctors Plan Exit in 2 Years”
• Arbor Associates, “How Offering Flexible Scheduling Can Boost Employee Morale”
• Centers for Disease Control and Prevention, Strategies to Mitigate Healthcare Staffing Shortages
• DailyPay, "Health Care Turnover Rates [2021 Update]"
• HealthStream, “Post COVID-19 Nurse Retention Strategies”
• HRMorning, "Employee Retention in Health Care: 4 Keys to Keep Your Best and Brightest"
• Hospital IQ, “Overcoming Staffing Challenges with Predictive Analytics”
• Intrigma, “Poor Staffing and Scheduling Are Causing Nurses to Leave the Profession”
• Journal of American Medicine, “Cost-Effectiveness and Economic Benefit of Professional Development”
• Journal of Healthcare Leadership, “Creating Empowering Conditions for Nurses”
• Mayo Clinic Proceedings, “COVID-Related Stress and Work Intentions in US Health Care Workers”
• Medical Economics, “Six Ways Healthcare Leaders Can Reduce Burnout”
• NPR, “For Travel Nurses, Jobs at Home Can’t Come Close to Pay They Get on the Road”
• NPR, “The Nursing Home Staffing Crisis Right Now Is Like Nothing We’ve Seen Before”
• Nursing Management, “Coaching vs. Mentoring”
• PeopleScout, “Medical Staffing: How to Engage and Retain Healthcare Workers"
• Radiology Management, "Employee Retention: An Issue of Survival in Healthcare"
• U.S. Bureau of Labor Statistics, Table 16. Annual Total Separations Rates by Industry and Region