Staff Retention Strategies

• Staff retention should start while the employee is open to staying

Learning Objectives

• Explain how managers develop staff
• Understand how managers appraise staff performance
• Describe how managers compensate staff
• Explain how managers protect staff
• Understand how onboarding improves staff retention

Staffing at Mass General Brigham (MGB)

• Managers at MGB used the staffing function to obtain and retain workers.
• Compensation was determined for each position, including base pay, incentives, bonuses, and benefits.
• Managers had to understand compensation laws and evaluate staff job performance.
• MGB developed employees through training, coaching, and mentoring.
• Staffing processes helped MGB achieve goals and its mission.

Staffing Overview

• Staffing a healthcare organization (HCO) requires thought by managers.
• Chapter 7 covered obtaining workers, while this chapter focuses on retaining workers through developing, appraising, compensating, and protecting staff.
• Processes overlap, supporting both obtaining and retaining workers.
• The chapter concludes with onboarding for new employee retention.
• Effective staffing processes allow HCOs to obtain and retain the workforce needed to succeed.
• Critical staffing issues include shortages, employee turnover, and retention.
• The COVID-19 pandemic exacerbated these issues.
• Hospital leaders rank personnel shortages as their top concern since 2004.
• Five primary drivers of employee turnover in healthcare:

Drivers of Employee Turnover

• Supervision and management
• Workload and excessive job demands
• Compensation and benefits
• Lack of recognition, appreciation, and respect
• Employee engagement

Employee Engagement

• Employee engagement is the positive or negative emotional attachment employees to the organization and their jobs.
• Engaged employees are energetic, enthusiastic, and immersed in their work, positively affecting organizational outcomes.
• Businesses focus on improving the "employee experience" by increasing training, development, compensation, and well-being.
• Staffing processes aim to engage employees and improve community health.

Developing Staff

• Developing staff involves helping employees acquire new knowledge, skills, attitudes, behaviors, and competencies.
• Staff development methods include training, coaching, mentoring, job rotation, and formal education.
• Managers develop employees to motivate them, build competence, enable success, and foster growth.
• Continuous development is needed due to accreditation, licensure standards, and external changes
• Lack of worker preparation leads to the workers and organization quickly falling behind
• HCOs develop staff for current and future jobs to improve staff retention.

Orientation of New Staff

• New employees need orientation to the department and the HCO.
• Effective orientation shapes perceptions, feelings, and retention and involves both technical and social aspects.
• HCOs handle orientation differently, varying in length, formality, and organization
• Large HCOs might use a months-long onboarding process.
• Remote employees need hardware, software, office supplies, and training on communication tools.
• Top managers orient new employees to the HCO's culture and values.
• Human resources orients them of employee benefits, standards, safety, compliance, and wages.
• Department managers handle the specifics of the department.
• Methods include videos, tutorials, webinars, e-handbooks, manuals, meetings, mobile learning, buddies, mentors, and checklists.
• Employee orientation is spread over days to avoid overwhelming new hires.
• Department orientation includes introductions, tours, workstation setup, and discussion of job expectations.
• Organization orientation includes an overview of the healthcare system's mission, vision, values, goals, and policies.
• Orientation involves multimedia presentations, employee benefits details, and time for socializing and facility tours.
• Quick orientations should be avoided to allow new employees to adjust and feel supported
• Employee orientation improves employee engagement, satisfaction, performance, and retention.

Training Staff

• Employees need training to stay current with rapid changes, due to old knowledge becoming outdated within months
• As jobs change or are eliminated due to automation, additional training becomes a necessity
• Training and development equips employees to evolve with change
• Hospitals trained staff for better patient satisfaction in order to have Medicare better reimburse them
• Training is offered to healthcare staff and workers to prepare for developments: patient engagement, diverse cultures, equity and inclusion, and disaster readiness.
• HCOs invest to remain competitive

Ensuring Trained Staff

• Managers ensure workers are trained in equipment, methods, and processes.
• Experts or education departments provide training, with some HCOs outsourcing specialized training
• Vendors train employees on their equipment, and cross-training is used.
• Cross-training: Team members are trained tasks, duties, and responsibilities of fellow team members
• Cross-training improves teamwork, coordination, communication, and respect.
• HCOs identify areas needing help and develop suitable training programs, while providing well-developed and executed training

Retaining Staff with Development

• Training and development are retention components
• Managers should provide training for current jobs and development for transfers, promotions, and career growth.
• They can support job growth with the aid of internal or external coaches and mentors
• HCOs that offer no career growth opportunities have trouble retaining staff

Training Checklist

• Needs assessment: Ascertain needed training examination of prior planning, appraisals,and available data
• Purpose and objectives: Writing the specific purposes, objectives, and desired outcomes of training
• Content, methods, and instructors: Determining the teaching and learning methods, instructors, and resources
• Implementation: Making training convenient and providing materials
• Evaluation: Evaluating all aspects of training and examine the outcomes

Providing Advancement

• Clinical staff seek career ladders into advanced clinical jobs
• To avoid potential supervisor failure, leadership development and training is useful
• Job development programs prepares workers for supervisory jobs

Manager Development

• HCOs develop potential managers as part of succession planning, with expanded mentoring, coaching to develop competencies.
• Large health systems feature lengthy management development plans to build future leaders.
• Another trend involves HCOs seeking physicians for top management.
• Management development and executive coaching prepares physicians for management.

Appraising Performance

• Appraising performance is evaluating employee job performance and discussing those evaluations with them.
• It is part of performance management using data for improving performance and assessing HR practices.
• The appraisal process will develop HCO's employees to help achieve the HCO's and employee's goals
• Top and HR managers develop the tools to appraise, while supervisors implement them
• These appraisals can achieve many purposes: Enable discussion, remind employees, provide feedback, coaching, and identify future goals

Additional Appraisal Benefits

• Guide and support training and development
• Guide and support decisions about compensation.
• Guide and support decisions about promotion, transfer, and termination.
• Guide and support succession planning for critical jobs
• Support compliance with accreditation and requirements

The Appraisal Process

• Appraisals should be based on up-to-date descriptions, goals, and behaviors
• Objective measures can help remove problems associated with appraisals
• The process may be dreaded by both parties is appraisals are not performed with the employee and employers interest in mind

Improving Appraisals

• In some HCOs, managers formally appraise employees annually or more frequently for new workers, or those transferred in
• Continuous performance management encourages ongoing communication between manager and employee
• The processes can improve employee feedback, assess development needs, and adapt to workplace changes
• Formal appraisals should ensure progress, as well as frequent monitoring and consistent manager talks
• Evaluations can arrive from a multisource of sources

Evaluating Employees

• Managers can give written questions from their employees, while some may implement the employee from the process entirely
• Information can remain flexible on custom appraisals
• Graphic rating scales are another great, standard tool for determining performance
• Performance evaluation with rating scales contains open questions

Graphic Rating Scales

• List job traits to measure job Knowledge, Quality, Quantity, Reliability, Cooperation, and Attendance
• Evaluation should follow up post assessment

Performance Evaluation

• Effective feedback from managers after an assessment steers the focus to the present
• Managers pay attention to the employees

Effective Meeting

• In the final part of a performance appraisal, the manager arrange a meeting to clarify the employees career
• Formal appraisals become more frequent in this method
• Performance becomes more flexible to the changes within the organization and the employees career

Effective Meeting Checklist

• Management fully supporting process.
• Appropriate guidance and assistance the continual year round
• Give a month lead to gather full information and the job description
• Meeting is in a private location with set unperturbed time
• Effective feedback is provided
• Supportive tone is used
• Focus is driven to future performance and the past
• Discuss future goals
• Document plan with proper follow-up

Assessing Daily

• Managers and contributions for future work
• Attentive and active employees giving feedback
• Effective and natural feedback

Assessing Deficiencies

• Expectations and guidance before the assessment
• Manager assessment on the current issues on deficiencies with employee

Effective and Appropriate Action

• Goals are followed correctly with correct manner
• Disciplinary action with effort
• Performance problems are informally discussed first
• Progressed to verbal and then written
• Suspensions and terminations can also be appropriate with the consultation of written consent

The Appraising Process

• Appraisals can uncover issues that can improve future planning involving jobs
• Deficiencies can be addressed now
• Help management develop goals for compensation.

Compensating Staff

• Wages will be given
• Salaries, incentives, and benefits to workers: pay (e.g., wages, salaries, merit increases, cost-of-living increases, bonuses, shift differentials, cash incentives) and benefits (e.g., paid vacation, health insurance, childcare, retirement contribution)
• Pay and benefits will be based upon several variables
• Besides pay, there can be extrinsic and intrinsic rewards

Compensation Affects

• Obtaining and Retaining effective managers
• There must be little error here
• Differences can arise and come off as unfair
• HR and Top are responsible here
• Someone within HR will be a compensation expert

Salary Help

• Some can outsource pay to a consultant
• Can have HCO’s gather info from online resources
• Broad organizational will need to be put for affect
• How do wages affect benefit compensation
• The staffing and retention will need more attention

Three Manager Roles

• Compay with hr
• Compensation method with benefits
• Manager must be effective

Payment Determination

• Managers are set upon how salary is based upon these
• Values can be made on the employee
• Community job positions
• Competitiveness positions and skill rating as assigned by a point based system

How the Factors Determined

• Managers can also plot it to a regression line for all jobs to find the best fit between job value points and job base pay

Internal and External Equality

• Group jobs onto grades
• Can overcomplicate basic pay
• Internal and External must be carefully used

Worker Values

• Hourly wages normally base pay
• Positions and skill ratings can be based on these
• Sign on
• Retention
• Overtime
• Profit sharing
• Differential pay

Pay and Incentives

• Increase incentives for pay
• Productivity increases by these methods
• Compensation benefits should come from experts by:
• Employee and labor security
• There is help online from federal entities to assist with these actions

Protections

• Imagine if there was an inability to help those staff that need on the job
• Safe work conditions and employee health can affect these
• Well mental will be impacted otherwise

OSHA Regulations

• Stipulates the working environment
• Risk based with many other risks needing precautions

Protecting Employees is Good For

• Helping a diverse workforce to better perform
• Cultural improvements.
• Inclusivity and safety.
• Leaders supporting professional development, equity and inclusion

Resources

• The help, guide, and the members from groups to better improve
• Violence increasing in the recent years.

What Leaders Can Do

• Enforcing a zero-tolerance policy
• Ensuring an organizational culture of civility, respect for others, and inclusion
• Carefully assessing and screening job applicants
• Investigating and acting on warnings of violence
• Modifying buildings and work areas to increase security

How to Better De-escalate

• Training staff
• Counseling employees
• Better hotlines
• Understanding and recognizing and accepting burnout

Burnout

• Burnout and de-escalation and the ability to handle a stressed work load
• Addressing needs and conditions with more support
• Assess problems and provide support for human needs
• Use a participative leadership style that improves productivity

Other Considerations

• Removing obstacles that staff have
• Fair with each other with events
• Resourceful help and resilience
• Acknowledge the hard work, team building, and proper time management techniques

Managing in Springfield

• Safe workspace
• Accidents and the proper training for employees

Understanding Employees

Acknowledge their rights

• Balance their efforts with great safety practices

Workplace Bullying

• Workplace bullying defined by Institute
• Often enabled by the culture and coworkers
• Management must create a workspace that keeps workspace safe and their rights
• Due right in a given process

Employee Rights

• Managers will ensure that workers have rights by:
• Communication through suggestions by workers
• Prompt action
• Sensitive and respectful

Employee Issues

• Employees feel ignored and management has mistreated there effort
• Recall lab unions here
• They are meant to help each other
• Gain power collect concerns as a whole

Onboarding

• Adjusting new hires to their company settings with their job duties by familiarization the staff with the company culture and their standards
• Includes meeting, mentoring, training and other useful skill techniques that improve performance

Explore staff retention strategies in healthcare. Learn how managers develop, appraise, compensate, and protect staff to foster retention. Understand the role of onboarding and compensation laws in achieving organizational goals.