Retention Strategies

Baptist Hospital East

June 15, 2004

Points to Ponder…• Turnover Perceptions versus Realities.

• Healthcare Recruitment and Retention from a Global Perspective.

• Turnover/Vacancy Information.

• Identifying Generational issues and the Impact on Front Line Supervisors.

• Selection as a Part of Retention.

• Fatal Errors for the Supervisor.

• Engagement and Leadership.

Introductions

• Your Name.

• Years of Service at Baptist Hospital East.

• Unit where you work.

• Share a Hobby or Interest .

Turnover Perceptions versus Realities

Perceptions of Turnover

Why do employees leave a company?

Take 5 minutes and come up with your top 5 reasons why employees terminate. Think about reasons why you have left previous jobs (if applicable). We will see how your answers compare to national statistics.

How do you feel about these suggestions:

People leave for more money

People have no loyalty and they move on to the next company.

People don’t want more work.

True or False? People leave jobs for more money.

Mostly False• Due to the competitive market, there is not a

large spread in clinical/nursing salaries.• Generally professionals do not change

positions for more money.• Money is an easy excuse…no one will really

question that reason.

True or False? Loyalty to a company is dead.

• Mostly False.• Loyalty is more complex to define in today’s

modern times.• Loyalty in the current and future workplace

will depend on how the new generations will allow it to be defined.

• Loyalty is actually defined by the balance of lifestyle and work life.

True or False? People don’t want more work.

• True– People don’t want more work but they do want

more responsibility.

– Growth and development is a critical retention component of young and less experienced staff.

National Statistics on “Why People Leave Jobs”

• 47% of people leave positions due to dissatisfaction with management and leadership.

• 38 % of people leave positions because they do not feel appreciated.

• Wm. M Mercer and Gallup Organization (3-4 point spread)

Again, why does an employee leave a company?

• “Employees do not leave companies….they leave managers or supervisors”

– First, Break all the Rules

• “It is easy to leave a workplace where no one will miss you. People stay at jobs because they can’t bear leaving their co-workers”

– Love ‘Em or Loose ‘Em

The Best Boss Ever

• Take 5 minutes and come up with 10 traits your “best boss” would have.

Best Boss Exercise

• What are the Common Themes?

• Is there agreement among groups?

• Do you find the results surprising?

• What do you do well?• What could you do

better?• Could any of your

staff members benefit from increasing the use of some themes?

Healthcare Retention from a Global Perspective

Healthcare…the big retention picture

• Unlimited opportunity for women in both school and work worlds.

• Fewer students enrolled.• Scholarships offered to “buy” students well

before graduation.• Zero gain game.• Fewer middle and high school students

being encouraged to the medical field.

What is your Dream Job and Why?

• If you could have any job in the world what would it be and why?

• You must choose an actual job…can’t use retiree or volunteer.

Through a child’s eyes..

• Dream Jobs…The students from a high school were asked “what are some of your dream jobs”

– What are their dream jobs?– How many can you come up with?

Huron High School Dream Jobs

• Go-cart attendant

• Interior decorator

• Action figure sculptor

• Guy who builds monster statues out of Legos

• Joe’s Crab Shack waitress

• Child Psychologist

• Budweiser promotions guy

• Any magazine job

• VJ for MTV

• High School Principal

• Wall Street Broker

• Video Game Designer

• Fashion Designer

• Movie Critic

• Supermodel

Advertising

Talk show host

Actor

Designer of cars

Flight attendant

Computer marketer

Back up singer or dancer

Restoring old houses

Computer engineer

Pilot

Business consultant

Professional Wrestler

TV Anchor Person

Tornado Chaser

Professional Assassin

Sports Agent

Deli-counter guy

Voice actor for cartoons

More about the students…

• Students were also asked about “uncool” jobs and to place them under headings as to why they were “uncool”.

• What do you expect the results to be and why?

Uncool Jobs Fall Into Three Categories:

• Routine– Data Entry

• Unpleasant– Healthcare jobs

– Psychologist

– Executioners

– High School Teachers

• Stressful– Police Officer

– President of the United States

Turnover Information

A Bit about Turnover in General

• What is the national average RN Turnover rate?

• What do you think BHE’s turnover was for last year?

• Do you know where to find these statistics?

• What about vacancy rates?

RN Turnover Rate Comparison

• National RN TO Average for BHE bed size is approximately 17%.

• National RN TO Average for hospitals located in a suburban area is approximately 22%

• National TO Average hospital wide is 23%

• Baptist Hospital East 2003 Fiscal Year RN turnover = 13%

• Hospital Wide turnover = 15%

BHE Turnover and Vacancy Rates can be found by:

• Opening your Excel Spreadsheet Package.

• Locating the G (common) Drive.

• Going to “Human Resources”.

• Choose Turnover/Vacancy Reports.

• Select appropriate report (RN or Hospital Wide).

The Price of Turnover…

• The cost of replacing an employee is approximately 30% of the individual’s first year salary.

• Example:– RN making $20 per

hour or 41,600 annually.

– Cost in Turnover to replace this person is $12,480

Hospital Wide Turnover Comparison 2003-2004As of May31, 2004

1.7

2.9

4

5

6.7

7.9

9.1 9.3

10.5

11.9

13.4

15

1.3

2.5

3.3

4.6

5.96.6

8.3

10

11

0

2

4

6

8

10

12

14

16

September October November December January February March April May June July August

2003 2004

Note…May Turnover Rate representsan estimation due to system lags of paperworkkeyed by payroll dates. Verified numberavailable during month of June.

RN Turnover Comparison 2003 - 2004As of May 31, 2004

1.1

2.4

3.3

4.6

6.4

7.4

8.1

9.1

10.6

11.3

12.312.9

0.7

1.6

2.4

3.74.2

5.1

6.6

7.5

8.7

0

2

4

6

8

10

12

14

September October November December January February March April May June July August

2003 2004

Note…May Turnover Rate representsan estimation due to system lags of paperw ork keyed by payroll dates. Verif ied number available during month of June.

Recognizing Generational Differences“There are some employees who

actually think having a contest that uses a turkey as a bowling ball to win

a pumpkin pie sounds ridiculous”.Gregory Smith, Author

The Traditional Workplace

– Security from the institution– Promotions based on longevity– Loyalty to the organization– Wait to be told what to do– Respect based on position/title

The New Generation Workplace

• Security from within

• Promotions based on performance

• Loyalty to the team

• Challenge authority

• You must earn respect

Age Groups

• Nexters – 1975 to 1981 (22-28)

• Gen Xers – 1965-1975 (28-38)

• Cuspers – 1960-1965 (38-43)

• Boomers – 1946 – 1959 (44-56)

• Pre-Boomers – 1939 – 1945 (58-64)

What does healthcare leadership look like?

• We are characterized by:

• Boomer Leadership (44-56)

• Cusper Front line Managers (38-43)

• Gen X staff members (28-38).

– What concerns do you see with this demographic picture?

Thoughts on the “gaps”:

• “Many good employees quit traditional organizations because different age group do not know how to deal with one another”.

• “Many times Gen Xers and Nexters are characterized negatively by other generations”.

Grant Campbell, Director of StarMed Staffing

Nexters and Gen Xers

• These groups do not plan on staying with one job or company for their career.

• They will not sacrifice family or personal time for a job.

• Many have seen parents “downsized”.

• These groups do have a great appetite for technology.

• They learn quickly.• They adapt to change

easily.• They thrive on the

different and new.

Too Old…Too Young?

“In my department I make sure that we feed our young…not eat them”

Danielle Orr, RN, MHA, ONC

North Broward Medical Center

Tips for merging the generations• Be Approachable

– Direct access to a decision maker is important to this group.

• Take time to be personal– Listen to what this employee has to say; follow-up on the

idea or suggestion.

• Encourage employee growth– These employee like learning; encourage additional

learning opportunities.– Find out their interests and involve accordingly.

• Help these employees see a “big picture”.– Ownership is important to this group; they need to see how

they fit into the organizations goals.

• Build Morale– Have fun at work; try something new.

Switching the focus from recruitment to retention…

• “The most important rule to remember in a labor shortage is not to loose the employees you have”.

• Baird/Borline Associates, 2002

Retention Begins with Selection

The Mirror Test

Studer Turnover Studies

• 66% of Turnover occurs in the first year of employment.

• 50% of the above turnover is in the first 90 days.

• Retention focus over the first 90 days is critical.

The Must Haves (Studer)

• Rounding for Outcomes

• Employee Thank you notes

• Employee selection and early retention

• Discharge phone calls

• Key words at key times

• Aligning leadership evaluations with desired outcomes.

Hospital Wide Terminations by Tenure as of April 30, 2004

22%

26%

25%

8%

10%

8%

0% 5% 10% 15% 20% 25% 30%

Introductory Period

Post Introductory Period to 1 Year

Over 1 year to 3 years

Over 3 years to 5 years

Over 5 years to 10 years

Over 10 years

Termination by Tenure (Licensed Professional)as of April 30, 2004

21%

17%

28%

8%

15%

12%

5%

19%

30%

19%

22%

5%

0% 5% 10% 15% 20% 25% 30% 35%

Introductory Period

Post Introductory to 1 Year

Over 1 Year to 3 Years

Over 3 Years to 5 Years

Over 5 Years to 10 Years

Over 10 YearsProfessional -Clinical

Professional -Nursing

Termination by Tenure (Support Positions) as of April 30, 2004

18%

42%

21%

6%

7%

6%

38%

26%

22%

4%

8%

2%

0% 5% 10% 15% 20% 25% 30% 35% 40% 45%

Introductory Period

Post Introductory to 1 Year

Over 1 Year to 3 Years

Over 3 Years to 5 Years

Over 5 Years to 10 Years

Over 10 Years Hospital Support Staff

Nursing Support Staff

How do you feel about this statement..

• You live in a house with your family.

• The head of your house (someone other than you) notifies you that there will be a stranger coming to live with you and your family.

• You have no choice in determining the new person.

• You have never met the new person.

• You will be expected to welcome the new person into your home.

Peer Interviewing…

• Staff represent primary stake holders in the selection process and will determine the candidates success.

• Increase the cultural fit on the “shop floor”• Creates and environment of engagement

with staff.• Gain staff buy-in for hiring of new

employees

Selection and Early Retention…On-boarding the new employee with

Studer’s help.

• Employee selection via peer interviewing.

• Behavioral based questioning.

• 30 and 90 day retention meetings with the direct supervisor.

Why follow-up with new employees?

• Finding out how the perception of the job compares with what was said in the interview process.

• Options for performance improvement.• Have any individuals been helpful to you.• Situations or reasons that are occurring that

would make the new employee look for another opportunity.

Go with your Gut!

• Don’t go against your interviewing instincts.

• Be Critical and Judgmental!

• No warm bodies.

• Involving Staff (peer interviewing).

• The future of Selection at Baptist East – (On-boarding)

Making Your Leadership the Peoples Choice for Worksites

Engagement and Leadership Roles for Managers and Frontline

Supervisors

Fatal Errors for Supervisors• Misunderstand the role or allow different

perceptions of the role to persist.• Be a buddy not a boss.• Refuse to accept accountability.• Fail to set goals, standards, or expectations.• Withhold feedback: condone incompetence.• Try to manipulate people or play games.• Neglect the development of others.• Be inconsistent; treat individuals differently.

Fatal Errors Continued…• Focus on the problems versus objectives.• Neglect to follow up or follow through.• Advertise differences (disagree).• Demonstrate difficulties in working relationships

with others.• Underestimate the importance of selection and

team building.• Over-emphasize technical responsibilities…under

estimate the importance of interpersonal skills, planning and strategy.

Right Management & Associates

Engagement

• Defined as: the employee’s involvement in the workplace.

• Identifying Lack of Engagement:– No connection to the company.– Employment is mostly about“work and gossip”.– No Teamwork; territorial.– Do not look forward to seeing co-workers.

Why is Engagement Important to Retention?

• “It is easy to leave a workplace where no one will miss you. People stay at jobs because they can’t bear leaving their co-workers” Love ‘Em or Loose ‘Em

Understand Your Leadership Style relative to your workgroup

• What is your leadership style?• Wizard – Listen, heed, and succeed.• Comic – Keep them laughing and they will go

away feeling good.• Motivator – You can do anything if you put your

mind to it.• Sergeant – Tell them straight out and keep telling

them.• Partner – You are responsible for your own

learning, I am responsible for supporting, facilitating, and learning with you.

Closing Discussion

Happy Retending!