Finding-and Keeping-Good Employees

It’s a good time to apply for a job in healthcare.

Per the U.S. Department of Labor’s Bureau of Labor Statistics, job numbers, across the board are up-but there have been particularly notable gains in the healthcare industry. But despite-or perhaps because of-some of the lowest unemployment numbers in decades, many hospitals and health plans are struggling to attract and maintain quality employees.  As noted in a 2017 Leaders for Today survey, there is “unprecedented” employee turnover among hospitals and other healthcare organizations-for both clinical and non-clinical staff. Joseph Parente, a principal with KPMG’s Management Consulting Practice who works specifically with provider and payer organizations, says this not surprising.

“These results are a couple years old, but they are pretty representative of what we’re seeing in the industry even now,” says Parente. “The Leaders for Today survey found that more than one-third of employees were planning to leave their hospital within two years. Nearly 70% said they’d be leaving in the next five years. And, although we talk a lot about physician and nursing shortages these days, it’s not just clinical staff who are looking to leave their positions. The survey also found that, when asked if they plan to leave their current job, it’s non-clinical administration staff that are most likely to say yes.”

The downstream effects of this kind of employee turnover results in the sort of vicious cycle that leads to even more employee dissatisfaction and turnover, says David Wilkins, chief strategy officer for HealthcareSource, a healthcare talent management firm, in Woburn, Massachusetts.

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“With so many people leaving, healthcare organizations will have a hard time attracting new, qualified employees because of the existing gaps,” he says. “When people are working understaffed, and they don’t have the right team to help support their work, it leads to a more challenging workday, more responsibilities, longer hours, and increased stress. With so many other opportunities outside of healthcare, people have a choice-and they are choosing positions that will allow them a better work/life balance.”

So, given this kind of “seller’s market,” how can healthcare organizations better recruit and retain experienced staff? The key, experts say, is to focus on ways to improve employee satisfaction for employees at all levels.

Take a hard look at technology

Numerous studies now suggest that clinical staff, in particular, are experiencing a high rate of burnout-and many of them blame different information technology (IT) platforms, such as electronic health record (EHR) systems for those frustrated feelings. But Parente says it’s not just doctors and nurses who are aggravated by the various systems they need to interact with.

“They are being asked to use a lot of different technologies that are really cumbersome and out-of-date. It’s not just EHRs, though those are frustrating-some of the health plan systems are even more staid and difficult to use,” he says. “It’s a problem when an employee can go home, use a computer or smart phone to easily order food or clothing but have to go through dozens of onerous steps just to restock surgical supplies at work. They want to have more of the same kind of easy-to-use experience at work that they can get at home.”

Parente recommends that healthcare organizations look at their legacy systems and see where they can improve workflows to decrease the amount of time-and the amount of exasperation-employees face when using them.

Consider span of control

Wilkins says another issue is management practices in healthcare.  In many cases, employees don’t feel like there is room to advance.

“In healthcare, too often, the person who gets promoted isn’t the person who is best for the job but the person who has ‘paid his dues,’ so to speak,” he says. “So instead of looking at whether you have the person with the right leadership qualities and skillset, you see the person who’s been there the longest moving up. That’s not the right thing for the organization.”

Yet even when the right person is promoted, there is still an issue of span of control.

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“The average span of control, of number of people someone is supervising, is about 9.7 people per manager,” Wilkins says. “But the average span of control for a nurse manager is 49 to 1. You can see even larger ratios in other healthcare jobs. So, if you are a manager and are responsible for that many people, how can you see who is doing well? How can you evaluate an individual employee’s strengths and weaknesses? There’s just too much load on a manager to be able to keep up with. People will not get the recognition they deserve. They won’t get the training opportunities they need to advance. And they will end up leaving.”

By looking at your organization’s management structure and reducing the span of control ratios, while also putting in appropriate recognition and reward programs that incentivize employees to work toward your organization’s mission and values, you can help reduce turnover-and help promote more appropriate internal mobility, where individual employees are being groomed to advance and take on new roles that may be harder to fill in the marketplace.

Filling in gaps with freelancers

Zoë Harte, senior vice president of human resources and talent innovation at UpWork, a company located in Mountain View, California, that connects companies with freelance talent, says that contract employees can help fill in for one of healthcare’s greatest challenges, the industry’s aging workforce, particularly when it comes to IT needs.

“There is a need for new skills driven by telemedicine as well as the talent scarcity seen across care delivery organizations. Since healthcare is so highly regulated, there are a lot of very specialized certifications and needs when it comes to IT,” she says. “Freelancers can help organizations grow and operate as the market dictates-and healthcare organizations should shift their mindset so they don’t see hiring freelancers as a stop-gap measure, but rather a highly strategic way to get to where they want to go.”

Looking toward other Industries

Parente says that healthcare can also look toward other industries to develop the right strategies to recruit and retain the right employees.

“Outside healthcare, companies have developed deliberate employer of choice initiatives that are intended to enhance the employee experience by improving work/life balance, quality of work, and supporting an employee’s individual needs,” he says. “So, having more flexible schedules for employees, not doing things the way they’ve always been done before, can go a long way.”

Certainly, not every organization can address employee turnover in the same way. Your mileage will vary.  Yet, Managed Healthcare Executive Editorial Advisor Don Hall, a principal with Delta Sigma, a healthcare consulting firm in Littleton, Colorado, says there are some basics that should be considered. He recommends that all healthcare managers, regardless of organization type, read First, Break All the Rules, a groundbreaking 1999 management book by Marcus Buckingham and Curt Coffman.

“The things that this book highlights, the things that are most important to making an employee want to stay with you, haven’t really changed,” he says. “It’s about employees understanding what is expected of them, having the right equipment and materials to do their work, and being recognized for doing good work. And that’s what healthcare should be looking at. This isn’t a problem that is going to be solved with higher salaries or a ping pong table in the break room. It’s about, whether you are talking about claims management, care management, or IT, looking at these really integral elements of employee satisfaction and making sure you are doing everything you can to make sure they are addressed in a way that helps both your employees and your organization as a whole.”

Kayt Sukel is a science and health writer based outside Houston.