The State of Employee Retention in U.S. Healthcare

Senior care organizations are struggling to fill the numerous open positions across the care continuum. This includes nursing, direct support professional (DSP), certified nursing assistant (CNA), home health aide, administrative, and educational instructor positions. The U.S. Bureau of Labor Statistics has reported that approximately 531,000 positions went unfilled in U.S. healthcare and social assistance.

To combat the severity of the problem, senior care organizations are directing their focus on retaining their current employees and reducing turnover. But, exactly how bad is the retention problem?

The University of New Mexico reports that the turnover rate remains high among nurses providing bedside care across different healthcare settings. The report indicates that the turnover rate was 17.2% while frontline staff, such as CNAs and DSPs, had the highest turnover rates of all professionals at 23.8%.

What’s Driving High Turnover Rates Among Healthcare Providers?
High turnover rates among healthcare professionals reflect three pain points in the industry:

• Employees have a high workload. This varies between specific positions. A study conducted by the Texas Center for Nursing Workforce Studies found that increased workload was a common reason for high turnover. When workloads are not fairly distributed among similar positions, the likelihood of resignation increases.

• A lack of leadership leaves employees without a sense of support. Management and administrative officials should have a strong leadership role in your company. Health care professionals need to see the bigger picture beyond their respective assignments to be successful, which translates into better treatment outcomes and service offerings in your organization. Furthermore, your company needs to lead your team toward better care standards. More than 50% of surveyed healthcare professionals in a Gallup Poll cited a previous “bad boss” as the reason for resignation. Although this goes back to the need for strong leadership, it indicates a possible miscommunication or disruption along the chain of command.

• Employees may not have the ability to grow and expand their careers in a company. Regardless of their current designation and skillset, every employee needs an opportunity for growth. An interview-based study conducted with employees from Opis Management Resources found that offering additional training or the opportunity to receive a promotion or new position increased satisfaction levels. Implementing wage or hiring freezes, or stopping employees with appropriate credentials and experience from being promoted in your organization, will increase turnover rates.

What Does It Mean For At-Risk Individuals?
In behavioral health, high employee turnover can be detrimental to treatment quality and deadly. Yet, a study, published by the U.S. National Library of Medicine, found that there was “no significant association between staff turnover and [overall] quality of treatment.” However, the chances of successful treatment during periods of high staff turnover among those served were dramatically lowered.

This association exists as daily activities and operations continue with current employees trying to manage training new professionals, handle responsibilities and assess current physical and mental states of people receiving care. Unfortunately, this creates problems with staff density.

Depending on the budget of your organization, additional personnel being trained may result in the removal of one or more people from the evening or weekend shift roster. While this may not be an issue at first, an increase in services rendered may cause staff density to drop even further. Consequently, risk in the facility increases.

For example, a person experiencing a behavioral health crisis may engage in behaviors that threaten his or her security and safety or the well-being of others currently receiving treatment. This may lead to suicidal or homicidal attempts, which can undermine the integrity and effectiveness of your facility.

A Quick Recap
High employee turnover leads to worse treatment outcomes and distrust among those you serve, and it is a major problem in U.S. healthcare delivery across centers that provide behavioral health services, senior care services, services for the health of children, youth and families and other people in need. To help your organization grow and continue to serve others in the coming years, you need to understand the causes and effects of high employee turnover rates. Ultimately, you can change the tone by acting to stop the causes now.