Today in the
healthcare field, employers are faced with personnel shortages and an
insufficient number of experienced staff, forcing healthcare organizations to
put forth an even greater effort to attract and keep current employees. While
most physicians are spending their time in clinic and running a practice,
interviewing the steady stream of qualified applicants that walk through the
door can be a daunting task. The easiest way to relieve yourself of the
pressure of hiring new personnel is to decrease the occurrences of employee
turnover. Employee turnover is costly and disruptive, and the resulting strain
on a physician's practice or business cannot only limit your ability to compete
effectively in today's medical climate, but also lead to significant decreases
in revenue. If a 1000-employee hospital loses 84 nurses a year (approximate
average), the facility will spend nearly $5,000,000 in replacement costs. That
comes to $416,000/month. The first step in increasing employee retention is to
understand the incredible value in retaining your personnel vs. the expenditure
of funds to replace a valued employee. The cost of hiring and training a new
nurse for an Emergency Department is approximately $80,000 for the first year
based on a salary of $47,000 and administrative costs of $33,000.
The United States
Department of Labor estimates the cost of employee turnover at one-third of the
annual salary of a newly hired employee. Many costs of employee turnover are
measurable, such as recruiting, screening, interview costs, advertising for
replacements, background checks, and training expenses. Additional costs to
consider are the loss of productivity while the position is vacant, the
detrimental effect of the remaining co-workers when a valued colleague resigns,
patients lost to another provider due to lack of organization, and the cost of
reduced efficiency as the new employee learns their job.
Employee loyalty is way down according
to a recent survey conducted by Sibson & Company; 55% of employees plan to
quit or think often of quitting. Physicians and practice managers should be
asking themselves how they can keep talent from leaving their practice.
Employee turnover cannot be completely alleviated; it is a fact of business
that people change jobs. You can however, reduce needless employee turnover by
doing all that you can to make sure that your current employees are happy with
their job.
Recently, the Families and Work Institute published a national
study of the changing work force, and they found that earnings and benefits
have only a 2% impact on job satisfaction, while job quality and workplace
support have a combined 70% impact. Management icons, such as Frederick
Hertzberg and Abraham Maslow, have long maintained that the quality of work and
workplace support are far more important to employees than their salary.
Physicians and management must adopt an attitude that they will take the
necessary steps to increase employee retention. Healthcare organizations must
come to the realization that if they keep their employees happy, the employees
will then give an honest, productive day's work and remain loyal. The problem
is, words like job quality and workplace support are intangibles. It is
difficult for employers to know exactly what they can do to impact their
employees in a positive manner.
The following outlines programs employers can put into place to
increase employee retention:
1. Compensation - It is important to understand that
while compensation may sometimes cause employees to leave, it is not generally
the major motivating factor in an employee's happiness. The fact remains that
increased compensation is a powerful tool to entice employees to remain loyal
to their company. Imagine if you paid salaries 5-10% above the market average
for your employees. How many fewer employees would you lose? (Remember again
the cost of high employee turnover.) While employers cannot simply throw money
at its employees and hope that this makes up for shortcomings, paying above
industry standards for a particular position will give an employer a new sense
of security that he is less likely to lose his star
employees.
2. Be
Sincere - Management must exhibit their commitment to their employees in such a
manner that employees are not on guard and waiting to see what the "catch" is.
If employees feel patronized or feel as if management is insincere, then
efforts at employee retention will be wasted. Physicians and management must
adapt the attitude that they will do what it takes to make their employees
happy, and in return, their employees will give them an honest day's work.
Employee retention means employee happiness. You cannot have employee retention
without having happy employees. What are the benefits of happy employees?
Magnet hospitals as designated by the American Nurses Credentialing Center
showed lower turnover and better patient outcomes than non-magnet facilities,
and showed savings not only in turnover costs but also in the form of shorter
patient stays.
3.
Management Must be Supportive - Many studies indicate that the most common
reason for high employee turnover is what is viewed by employees as unfair
treatment by management. When physicians and managers are supportive of the
needs of their employees, they are oftentimes viewed as treating employees
fairly. This does not mean that the employees must be pandered to, but they
should be treated in a respectful manner. Throughout years of interviewing
multitudes of job applicants, there are a few common traits that ring true for
applicants' favorite managers. "Firm but fair" is the overall consensus of the
best description of a good manager. Also remember, a successful manager must be
flexible, willing to bend the rules for employees on occasion. Working with
employees lets your staff know that they are valued, and you are willing to
accommodate their needs. Oftentimes, it is the smaller problems that cause once
happy employees to become disgruntled employees and start them down the pathway
of looking for a new job. Sometimes, it is just worth it for a physician or
practice manager to allow an employee a little bit of latitude if it means the
company does not suffer, and employees are happy.
4. Provide Adequate Training -
Unfortunately, it is not uncommon for a practice to hire a replacement in haste
as the work piles up for the new hire. In these instances, training usually
consists of the new hire sitting with a co-worker for a day or so, and then the
employee is thrown to the wolves. These scenarios almost always doom the
employer-employee relationship from the start. Since employees inherently want
to do a good job, it is imperative that employers offer adequate training to
their new hires, so that employees can do their job effectively. If your new
hires do not receive adequate training, and they are forced to ascertain how to
do the job themselves, then usually by the time the new hire has learned their
way around, it is too late, and they are destined to become poor
performers.
5.
Provide Guidelines - It is important that employees know exactly how management
wants them to carryout their job duties. It is absolutely necessary to have
written protocols and procedures so that an employee knows what is expected of
him/her. If the employee does not have a set of rules to follow, then how can
they perform to management's satisfaction? In addition to providing employees
with a framework as to how to carry out their daily job duties, protocols are
also invaluable when turnover does occur. Having correct protocols in place
keeps the employer from being forced to "reinvent the wheel." It is frustrating
and a waste of time to constantly re-train new hires on information that was
known only by the person who previously held the position.
6. Opportunity for Advancement - Why
are employees in this industry forced to move from one job to another in order
to receive promotions? It should be possible for physicians and management to
realize who their stellar employees are and find a way for them to grow within
their organization. Employees must know that there is an opportunity for
advancement within your practice or organization. This does not necessarily
mean that every employee has the potential of joining the ranks of management;
it does mean, however, that employees can become a valued and integral part of
your organization or the team lead person in their
department.
Career
development planning has become a hot topic amongst HR professionals. Career
development planning is an increasingly popular process by which management
establishes long-term career pathways for its employees. The purpose of having
an effective career development plan in place is to allow employees to take
charge of their career and know that should they desire to climb the ladder,
employees will not have to leave their job for a brighter future. These stellar
employees can be developed to grow with the practice and add valuable tenure to
help your healthcare organization run smoothly.
7. Human Resources Support - Employees
must feel that someone within your organization is accessible and can assist
them with their needs. This may take the form of lower management or Human
Resources personnel. Without a compassionate go-to person, employees feel as if
there is no mechanism in place to voice legitimate concerns without giving the
appearance of being a complainer. For example, if an employee receives a denied
vacation request with no explanation as to why their request was denied, they
could soon become embittered with the callousness of management. Taking the 2
or 3 minutes, however, to explain to an employee why they cannot have a day off
may diminish the resentment the employee has toward the company. Management may
find that the employee does have a legitimate reason for the vacation request.
With a go-to person in place to talk to, the employee can shed some light on
this situation. One misconstrued conversation can become the "straw that breaks
the camel's back" and causes a star employee to leave their job. Remember,
sometimes it doesn't do an employer any good to be right if being right causes
him to lose a star performer. Be flexible and understand the needs of your
employees.
8. Be
Creative - What creative things can you do to keep your employees happy and let
them know that they are appreciated? What stories do they tell about their
employer when they go home to their spouses or talk to their friends? Are they
inclined to discuss their health insurance and the fact that they had an easy
day at work, or are they more likely to talk about how the physician or someone
from management took the entire department to lunch because they had a record
billing month? Time and time again, I have received the compliments of
motivated, happy employees who appreciate the small things that a company can
do for them.
There
are a number of incentives that you can offer that cost little or nothing, and
time requirements are not obtrusive:
- Personal
Notes Thanking Employee for Achievements
- Desirable
Assignments
- Peer
Recognition
- Titles
- Tickets to
Sporting Events and Shows
- Free
Beverages and Snacks and Occasional Meals as appropriate
Fun
Days have proven to be an effective tool in helping businesses maintain
employee morale. A physician can close his office one Friday afternoon at 2
o'clock to allow his staff to go to the movies or bowling. Rest assured your
business will not dry up and go away if you take 3 hours off one Friday
afternoon. Physicians and management can still have access to their pagers via
the answering service or if necessary allow someone from management to stay at
the office to hold down the fort. These small tokens of appreciation go a long
way toward letting your employees know that you appreciate the hard work that
they do for you. Imagine the good will created when your employees brag to
their associates how much fun it is to work for your
organization.
9.
Acknowledge Achievements - Because of the time constraints placed on physicians
and management, oftentimes the only time employees may hear from their
superiors is when they are reprimanded for some indiscretion. All too often, we
hear of stellar employees who left their job after years of devotion to a
physician because the physician failed to acknowledge him/her with positive
feedback. Oftentimes, performance reviews are not given, and pay raises are put
off until a later date. The later date never comes, and the employee feels as
if they should not have to beg for their scheduled annual
review.
Have you
ever lost a stellar employee that you later pleaded with to stay and offered
them unimaginable pay raises or concessions in an attempt to retain the
employee? In many occasions after you have received the resignation, it is just
too late to salvage the relationship. This valued employee possesses such a
level of dissatisfaction that they have given up on their current employer, and
are now looking forward to working for a new physician who is excited about all
that they have to offer. Imagine how much time and money could be saved by
taking the 30 minutes to give the employee their evaluation, pat them on the
back, and give them a small raise versus losing this valued employee and
starting all over again with a new hire.
Physicians and management must let their personnel
know that they are appreciated - catch them doing something right. When an
employee does a good job, tell him or her. During a busy clinic when employees
come to you excited about a claim that was paid or a patient compliment they
received, do you patronize them and stifle their exuberance by shrugging them
off with, "That's nice"? Or do you sincerely tell them how proud you are of
their achievement and recognize them in front of their
peers?
Remember
the golden rule: If you take care of your employees, they will take care of
you. You must invest in your employees' happiness in order to reduce your
turnover. This reduced turnover will reward your business many times
over.
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