Learn how to reduce costly staff turnover
By Patrice Spath, RHIT
Brown-Spath & Associates
Forest Grove, OR
In today’s tight nursing labor market, case management directors must find ways to keep staff from seeking greener pastures. The cost of hiring and training new employees is significant. That’s why it is important for directors to motivate and retain quality staff whenever possible. Not only is the labor market tight, but budgets are even tighter. However, there are many nonmonetary ways managers can help department staff feel understood and valued. Think about how staff in your department would answer these questions:
- Would you like clear and specific goals so you always know exactly what’s expected?
- Would you like to know just how well you’re doing?
- Would you like your boss or the medical staff to be aware of the most valuable contributions you’ve made?
- Would you like to know where you’re doing a great job and where you need to shape up a little?
- Would you like a pat on the back when you’ve done a great job?
Improving the work environment for case managers can cost very little if the manager just cares, communicates, and celebrates accomplishments. Here are some tips for retaining valued employees:
Staff in the case management department need to feel a part of what’s going on. Many want to have a say in what work is done and how it will be accomplished. Staff input should be sought when changes are made to their work environment and scheduling. Some may want to be involved in the hiring of new employees. Often, the best employees (and the ones you’d most like to retain) are eager to participate in decisions that affect case management activities. For staff who want to be directly involved in the management of their work, not being given the opportunity may cause them to look for another job that allows more participation.
Whenever possible, provide financial support to those employees interested in continuing their formal education. While some hospitals limit support to what is considered to be job-related courses, it can be important not to be too narrow in providing financial aid. While staff are learning about subjects that are not specifically related to case management, they may be strengthening their self-discipline and self-esteem. The organization can keep the loyalty of employees by supporting the achievement of their career goals.
Like everyone, case managers want to be appreciated for their work. Unfortunately, members of the health care team only seem to notice case managers’ work when they do something exceptionally good or extremely bad. Some of the most valuable employees are those who come in every day, don’t bother anyone, and get their work done in a reliable, routine way. These staff can be depended on to be productive and efficient, yet they often are overlooked when the thanks are handed out. Every once in a while, take time out to thank those who are not the usual recipients of appreciation. By showing some gratitude for the routine work done by people in the case management department, job satisfaction will go up.
Good employees want to know specifically how they are doing and how they can improve. Often, the performance appraisal instruments used in hospitals contain only generalized feedback and numeric evaluations. During the employee’s performance evaluation, be sure to discuss specific examples to illustrate what you like or dislike about what the person does. Everyone working in the case management department should understand what tasks are to be done and how they are to be accomplished.
Excellent employees often can become frustrated by nonsensical rules, regulations, and procedures. Not much can be done to change the requirements imposed by external agencies; however, a lot could be done to simplify things internally by taking a good look at the case management department’s policies and procedures.
Look for anything that might call for extra paperwork, unnecessary steps, superfluous approvals, or similar nuisances. Where can you slash red tape, eliminate burdensome bureaucracy, or remove clutter? Eliminate anything that may be an obstacle to the effective and efficient operation of case management services. Do whatever possible to make it easier for case managers to get things done.
It’s important that people have the tools they need to get their jobs done. Waiting in line to send a fax can decrease efficiency and build staff dissatisfaction. Not having necessary resources can cost time and cause turnover. Good employees want to do a good job. Communicate job expectations and give them what they need to achieve peak performance, and case managers will get the results the hospital wants. Make their work more difficult, and you soon may be replacing them.
Case managers have serious job responsibilities, but that doesn’t mean they have to take themselves too seriously. With the lean staffing in most departments, everyone has a significant amount of important work to do. However, employees also should have fun while they work. Celebrate birthdays, promotions, and special events with short parties. The celebrations do not have to be long; just a short period of fun together can go a long way to adding humor in the workplace.
Don’t think that once employees turn in a resignation, all is lost. Managers overlook an important tool for discovering what keeps employees happy: the exit interview. By interviewing departing employees, the director can discover key information regarding satisfaction with position, working environment, pay, benefits, co-workers, etc. — information that can be used to help prevent other staff from leaving the department. Ask departing employees to fill out a pre-interview form as a springboard to a more productive exit interview. The answers won’t tell the whole story, but they will be useful for preparing specific follow-up questions for the exit interview. The form should cover basic questions like these:
- What are the primary reasons you decided to leave your position?
- What did you like most about your job? Least?
- How did you feel about working with other employees in the department?
- In what way did this job fail to meet your career objectives?
- What would you have done differently if you’d been the manager?
- How would you evaluate your performance?
- What part of dealing with other people did you find most frustrating?
- How would you rate your pay and benefits?
- How would you rate the training you received?
- If you could have made any job changes, what would they have been?
- Do you feel you were given ample opportunities for advancement?
- How would you rate your overall working conditions?
During the interview, it’s important to make departing employees feel comfortable enough to answer your questions openly and honestly. Do this by telling them how much you regret losing them. Also, be sure to tell employees what the interview is meant to accomplish: You want to find ways in which the department can improve. At times, conducting the exit interview while the employee still is on the payroll limits the productiveness of the discussions. To solve this problem, try waiting until one or two months after employees leave before conducting the interview. This way, they may find it easier to be honest.
Remember, no amount of exit interviewing will make things better for those people still working in the department unless the issues raised are investigated and acted on. Share your findings with the appropriate people and make changes to policies or processes when necessary. Understanding why people leave can be an important step toward reducing turnover in the case management department.
In todays tight nursing labor market, case management directors must find ways to keep staff from seeking greener pastures. The cost of hiring and training new employees is significant. Thats why it is important for directors to motivate and retain quality staff whenever possible.
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