How to maximize CM staff retention
Explore reasons for staff turnover
By Patrice Spath, RHIT
Brown-Spath & Associates
Forest Grove, OR
Finding, motivating, and retaining qualified case managers and support staff can be a challenge. The reasons for employee turnover are many — low unemployment, a more mobile work force, promises of higher wage and benefit levels, and feelings of not being recognized or appreciated. While managers often cannot control the monetary issues that cause staff to seek employment elsewhere, there are many factors that managers do have power over. Staff turnover rates can be decreased through proper recognition, rewards, and motivation.
Do staff feel a part of what's going on at work? Employees want to have a say in what work will be done, the sequence of the work, and how it will be accomplished. They want input into changes in their work environment, scheduling, and perhaps even the hiring of new employees. When staff are not allowed the opportunity to get involved, they become alienated toward management and the organization. This is a common reason case managers seek employment somewhere else. Having a meaningful role on the job and being included in work management decisions is particularly important to the better employees. These are the employees who are often eager to participant in department decision making — and these are the employees you'll miss the most when they decide to go to work for another facility.
Soliciting staff member opinions does not necessarily mean that the advice or preference must be followed. The ultimate decisions still rest with the manager. However, by asking for input, the manager is reinforcing the value of employee viewpoints and the importance of taking those opinions into consideration.
Does everyone in the case management department feel appreciated? Are they periodically recognized for the work they do? Often staff are recognized only when they do something extraordinary that gets attention. It seems people are only noticed when they do something exceptionally good or exceptionally bad. Yet, the performance of routine work is vital to departmental operations — if it were not done, things would not go smoothly.
The most valuable staff in the department are those that come in every day, don't bother anyone, and get their work done in a reliable, routine manner. Every once in a while, the manager should take time out to thank those people who usually don't get thanked. Show some appreciation for the routine work done by employees in addition to the more exceptional accomplishments.
Do staff receive detailed performance feedback? Good employees want to know specifically how they are doing and how they can improve. When talking with staff about their performance, include explicit examples to illustrate both good and unacceptable performance. When staff have a better understanding of what is needed to fulfill their job responsibilities, they can make definitive modifications to meet expectations. Simply saying, "Gee, you're doing great" doesn't provide people with the information they need to be successful in their job. Staff should understand what tasks are to be done, how they are to be accomplished, and when work is to be finished.
Do people have fun at work? The job of case management must be taken seriously, and everyone has a significant amount of work to do. However, staff also should have some fun while they work. People working in an environment that promotes camaraderie will be more relaxed and happy — which translates into higher productivity. Celebrate birthdays, promotions, and other special events with short parties. The celebrations do not have to be long at all; just a short period of fun together can go a long way toward building teamwork and positive feelings about work. You can't take stress out of the job of case management, but you can reduce the cognitive overload on staff by providing time for some relaxation.
Do people have the tools they need to get their jobs done? Waiting in line to use a photocopy machine can inhibit productivity and create staff dissatisfaction. Not having the right information to make timely discharge planning or utilization decisions can be costly in terms of staff time and stress. People in the case management department want to do a good job, and it is important to give them what they need to achieve peak performance. If work is made too difficult because of inadequate resources, staff soon may look for employment elsewhere.
Are some tasks unnecessary? Rules, regulations, and procedures that people view as unnecessary can be frustrating. Take a good look at all aspects of the case management process to identify anything that might call for extra paperwork, needless steps, superfluous approvals, or similar nuisances. Whenever possible, slash red tape and eliminate burdensome requirements. Do whatever is needed to make it easier for case managers to get things done. Good employees can quickly become frustrated by nonsensical or redundant tasks.
Is professional and personal development a priority? Employees should be encouraged to participate in ongoing education and training that updates and expands their skill level and personal development. Don't limit this encouragement to the clinical staff in the case management department. Clerical and technical support staff, also valuable employees, can benefit from continuing their education and training. The department may offer a stronger degree of financial assistance for job-related courses than it does for courses that don't relate directly to the employee's work. Be careful about being too focused, however. While employees are learning about subjects that are not specifically job-related, they also are strengthening their self-discipline and self-esteem.
Unnecessary turnover is expensive in terms of recruitment costs, service inefficiencies, and lower staff morale. For this reason, understanding why employees leave is important.
One way to explore the issue is to ask departing employees specific questions about ways in which the department could improve (see Figure 1). These questions could be part of an informal exit interview with the manager or be incorporated into a post-exit written survey. To reduce defensiveness, be sure the employee knows that anything they say will not be held against them or influence references. The employee's answers may not tell the whole story, but they can be useful for formulating strategies that can help prevent other employees from leaving the department.
Staff retention certainly is a high priority for the case management department, and by responding to the needs to employees, turnover can be reduced. Employees need an environment where they are respected as valuable members of the department and the health care team. They must be recognized for their accomplishments and given the opportunity to do their best every day. Employees need to understand how they are making a difference and are encouraged to grow both professionally and personally. A case management department lacking in these qualities often has high staff turnover as well as stressed-out employees who, for whatever reason, choose to stay working in that department.
Finding, motivating, and retaining qualified case managers and support staff can be a challenge. The reasons for employee turnover are many low unemployment, a more mobile work force, promises of higher wage and benefit levels, and feelings of not being recognized or appreciated.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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