Health systems are planning to invest heavily in employee retention and upskilling next year to solve workforce shortages and reduce reliance on contract labor. It seems, for now, supporting nurses and staff with additional wellness programs, benefits and professional development opportunities could positively affect the hospital's bottom line.
Warner Thomas, president and CEO of Sutter Health in Sacramento, Calif., has focused on retaining talent by investing in programs for a strong workplace culture, enhancing safety, offering competitive benefits and offering professional growth opportunities. Sutter has also focused more on bringing physician voices into operations and decision-making, as well as elevating diversity, equity and inclusion.
"As a result of our efforts, staff turnover has dropped to 14%, down nearly 28% since last year at this time and far below the national average," Mr. Thomas told Becker's. "Our journey toward supporting our teams continues , and the driving force behind all our efforts is simple: we deeply care about our people and supporting them is not just a commitment but the essence of our purpose."
The C-suite executives of large health systems and community hospitals alike espouse the benefits of building trust with their front-line caregivers and embracing technology that can reduce burnout and make their organizations more efficient.
"A key area of focusing our strategy discussions for the coming year will be opportunities to improve the work experience for our healthcare team members," Angelo Milazzo, MD, vice chair of practice and clinical affairs in the department of pediatrics at Duke Health in Durham, N.C., told Becker's. "We are asking more and more of physicians, advanced practice providers, nurses, technicians and support staff, and so we must consider the impact of increasing service demands on our workforce. It would be foolish to ignore shifting societal attitudes toward work and toward the relationship between management and front-line employees."
Charleston, S.C.-based MUSC Health is also developing an ambitious hiring plan to fill community needs and account for a better work-life balance for the clinical and non-clinical workforce. The strategy also takes into consideration meaningful work and the impact MUSC Health has beyond the core function of team members.
"As with many organizations, we are focusing on retention, employee engagement and rewards and recognition [next year]," said Carrie Herzke, MD, chief medical officer - Charleston of Medical University of South Carolina. "We continue to focus on how we can serve our community, which in many cases comprises meeting the quaternary care needs of the state of South Carolina."
But high retention will only be a successful strategy if employees stay engaged and excited about their work. If not, the focus on retention can backfire with disastrous results.
"Over the next three years, I believe retaining the right staff and promoting positive attrition with those who we are not well-matched with is the biggest opportunity we have to reduce costs," said Annie Thomas-Landrum, MSN, RN, board member of Sunshine Community Health Center in Talkeetna, Alaska. "In times of staffing challenges, I think it can be natural and easy to focus on retaining staff, regardless of the fitness of the match. However, when we become laser-focused on the need to retain, we often miss the cost of that retention."
A poorly performing employee could make mistakes in documentation that hinder patient care or accreditation and results in litigation, theft and poor morale. It also takes considerable effort to manage poor performers.
"Leadership hours are spent in trying to coach skills that never sustain improvement, team attitudes that develop when toxic negativity takes center stage, clients and patients who decide to seek care elsewhere, or worse, not at all," said Ms. Thomas-Landrum. "These are all secondary risks when employees should be coached out but remain. Beyond this, we also see tertiary consequences, with a loss of team efficiency as morale and cohesion erode, loss of creative thinking, loss of motivation and drive to create new partnerships, and the inability to use resources in sustainable and thoughtful ways."
Attrition has slowed across industries, and even large companies are feeling the heat. The Wall Street Journal noted in a Nov. 6 article that employee turnover has declined in recent months, and many large employers are now over budget with their current teams. As a result, companies may begin cutting jobs or having workforce reductions next year.
It's also harder to keep star employees engaged when there are fewer open positions and opportunities for growth. A Nov. 2 report from Challenger, Gray & Christmas showed job cuts in healthcare are up 109% from last year. After the stressful pandemic years and emerging from financial hardship, the last thing hospital executives want is to announce job cuts because they need to reduce expenses.
"It can be hard to embrace the idea that we will benefit from a staff reduction when the toughest questions we face are related to a lack of stable staffing," said Ms. Thomas-Landrum. "However, I believe and have seen over and over again the power of embracing the reality of each employee relationship and prioritizing and fiercely fighting for the culture we as a team believe in, despite the fear."
There is also the possibility that retention efforts don't produce the right return on investment, and could cripple organizations if they're not careful. Paula Ellis, DNP, interim CEO of F.W. Huston Medical Center in Winchester, Kan., said budget discussions are focusing on eliminating contract labor and whether to continue initiatives to "grow our own" in difficult-to-fill positions.
"We need to look at the cost-benefit of those initiatives and consider what to keep in place," she said. "We also improved benefits aimed at attracting professionals. Again, we need to determine the cost-benefit of those changes."