Retention! Who is Accountable?

February 15

As HR professionals, how often are you targeted as the "cause" of turnover? Most organizations monitor turnover metrics, but a much smaller number know what to do to change it. The Studer Group shares data that for every 1% in turnover that a company can reduce, it can save $250,000 in direct costs and $500,000 in indirect costs.

No one in healthcare has an abundance of funds, so dealing with turnover has become an important issue in most organizations. ASHHRA data from February 2010 reports that turnover of all employees, by head count, is 13.5%, with specific job titles such as RNs at 11.2% and imaging professional/technicians at 8.9%. Although rates have been down in the past 12-18 months due to the economic situation, it is time to make sure that issues have been addressed as we move forward to the changes that are coming.

Although it is Human Resources that often gets tagged as the keeper of retention, we must be realistic and accept the fact that each employee plays a part in this. First let's begin with HR and their accountability. All of the attraction components clearly lie in the HR domain, and might include clear job descriptions, competitive benefits and compensation, targeted recruitment, swift hiring process, pre-employment testing and successful interviewing techniques by skilled recruiters. Those are the items that HR can control and has accountability for. Their skill in knowing the overall brand and employee value proposition (EVP) must be on target as they are the ones doing the recruitment marketing for the organization.

But what happens once the employee signs on the dotted line and accepts the position? Remember, retention has already started even though the employee may be finishing another job before coming on board. This period of time and the accountability for continued communication varies from one organization to the next. Frequently, this task remains in HR, while other companies hand this communication over to the hiring department. Either one can work-as long as it happens!

The next step for accountability is the initial onboarding and orientation. This too should be a period of time that is welcoming, clear, concise and continues with the overall brand message. From the general hospital or facility orientation to the department orientation, retention now encompasses the department employees.

The manager has tremendous accountability for the retention efforts in any organization and, recently, more and more companies are monitoring this in performance reviews. Leadership skills, communication, fairness, consistency and other skills are often the reasons that employees list in exit interviews, and most of those go right back to the manager accountabilities. Departing employees tend to leave managers - not companies.

Taking the responsibility even further certainly includes other departments and the relationships between them. Working within a culture of common goals and solutions rather than separate silos will ensure that a healthy work environment is available.

An additional function of HR and leadership is continuing to evaluate competencies and satisfaction of each employee. The entire life cycle of an employee is valuable and it is essential to have touch points periodically, especially during the first year. It is important to know how the overall brand is being influenced from the employee attraction period, during general and department orientation to the actual performance of the job.

In a recent article in Health Leaders ( entitled CEOs: Employee Retention Is Your Job, a very clear statement was made. "If costs, patient mortality, and patient satisfaction are important, then turnover should be at the top of your list." Yes, it is the CEO's job too-it is everyone's job. Retention does start at the top of any company and is evidenced by the skills of the "C" level employees. Communication, culture, work environment, financial stability and staff consistency are all important to the success of any company. Healthcare is about patient satisfaction and positive outcomes but it takes a committed staff. And it takes everyone in an organization to make that happen.

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