7 Strategies for Improving Healthcare Workforce Retention

1. Hire the right people in the first place

Retention starts with recruitment and the ability to identify skilled and talented people likely to fit well into the organization’s culture. Depending on the position, it can cost healthcare providers anywhere from US$3,000 to US$7,000 and take from a few months to nearly a year to fill a vacant position, and those costs don’t factor in the toll on existing staff called on to provide interim coverage. It pays to find people who will produce at a high level and stay for the long term. AI-based HR systems can help organizations identify those people.

2. Onboard your people with purpose

Across all industries, nearly a third of new hires quit within the first six months. Top reasons include feeling neglected, overwhelmed, and underappreciated—feelings employers can head off with structured onboarding programs that give new hires the confidence to succeed out of the gate.

At a minimum, onboarding must make it simple for new hires to fill out forms and get trained on systems, policies, and procedures—which is even more important in the highly regulated healthcare industry. A modern human capital management (HCM) system’s interactive digital assistant can help walk new hires through the basics.

Meanwhile, healthcare organizations need to apply a personal touch to help new hires quickly build lasting relationships. This includes assigning each new hire a mentor early on, organizing a tour of the premises and a team lunch on their first day, introducing new employees to colleagues and senior leaders, formally announcing each new hire and providing some fun background information in an organizationwide email, and regularly asking recent hires for feedback on early challenges and celebrating successes.

3. Offer some scheduling flexibility

Forcing healthcare practitioners to log long hours with insufficient help is a recipe for burning them out and losing them to competitors or other professions. Some doctors, nurses, and supporting staff like a fixed, predictable schedule, but for others, a bit of flexibility and variety in when and where they work is welcome. Everyone wants a healthy work-life balance.

Some hospital groups offer their practitioners and support staff nontraditional schedules, including staggered start times and overlapping shifts to help compensate for shortages. They even allow some people to set their own schedules—an option that appeals to younger professionals, those with family responsibilities, and those who want to earn overtime pay.

Some groups have built internal staffing agencies to share practitioners across locations. Novant Health, for example, runs what it calls a “float pool” of a couple of hundred nurses who travel among the system’s 15 hospitals and 360 physician practices across the Carolinas. A major hospital group in India allows radiology, lab, and other specialists to work remotely while creating a hybrid model for others—a model that’s also attractive to young practitioners and those with families.

Here, too, technology can play a major role. The popularity of Zoom and other videoconferencing software makes it easier for practitioners and patients alike to discuss select health matters virtually; it’s also more cost-effective for hospitals and practices and safer for caregivers and patients when dealing with contagious illnesses.

Some hospital systems are exploring putting “virtual nursing” into practice to allow remote staff to handle more of the patient admission workload. In this model, an on-premises floor nurse can perform a physical assessment of the patient, and a remote nurse can update data on allergies, medications, and medical history. Upon the patient’s discharge, the remote nurse can review orders and documentation, deliver education, and check if a pharmacy is documented.

Meanwhile, AI-based workforce-planning applications can help managers predict surges in patient demand and set practitioner schedules accordingly. Northwell Health, one of the large health systems in New York State, used a dashboard on their cloud HCM system to help their chief nursing officers stay abreast of patient inflows, staff recruitment, and resource requirements during the COVID-19 pandemic.

4. Build a more engaged professional workforce

When HR leaders talk about improving employee engagement, they generally focus on steps employers can take to connect with their people on a more personal level and create a sense of loyalty. Alternatively, they talk about improving the employee experience.

Strategies to foster and manage employer-employee connections include providing practitioners and support staff with personalized career guidance based on their unique backgrounds and circumstances. Healthcare employers are also fielding regular employee surveys and encouraging feedback on ways to improve the organization. And they’re connecting caregivers with mental health services—as well as with communities of their peers for advice and support—to avoid burnout. The goal is to create a culture in which employees engage more regularly with their peers and with management, building appreciation and a sense of belonging.

5. Stay current on pay and other forms of compensation

The healthcare profession may be a higher calling for most practitioners, but everyone still wants to be paid what they’re worth, especially given the rigors of the field and the competitive market. Provider HR organizations need to use external benchmarking data to regularly adjust their compensation plans for both medical staffers and contractors.

Complicating matters for the healthcare industry is the fact that costs of all kinds continue to rise—for systems, supplies, malpractice insurance, heating, electricity, and other goods and services—all while the workforce shortage is putting upward pressure on salaries and wages. For example, the price of traveling nurse services tripled during the pandemic and remains relatively high. There’s only so much money to go around, so healthcare providers need to get creative with how they compensate their people.

Financial incentives—in addition to competitive salaries and benefits—include signing and merit bonuses, tuition reimbursements, subsidies for childcare, and student loan repayment programs. Increasingly popular are relative value unit (RVU) plans that compensate physicians, in part, based on their productivity and quality of service.

6. Hire enough people

In the end, the scarcity of healthcare workers creates a vicious circle: Not having enough doctors, nurses, and other practitioners leads to overwork, stress, and burnout, causing people to leave their professions, which further worsens the worker shortage. Unfortunately, there are no easy solutions.

At the hospital and medical practice level, employers need to form partnerships with high schools, universities, training programs, and other institutions to develop and recruit workers at different professional levels.

In the long term, it will take a cooperative public-private sector healthcare Marshall Plan to educate, train, and make available sufficient numbers of qualified professionals. The American Hospital Association has called on US policymakers to lift the cap on Medicare-funded physician residencies, boost support for nursing schools and faculty, and expedite visas for highly trained foreign healthcare workers, among other measures.

7. Ease the paperwork burden on care providers

Doctors and nurses are burning out and leaving the profession not only because they’re overworked but also because they’re frustrated with the volume of administrative tasks during their days. This paperwork burden has spread more widely across the industry in recent years. In 2018, 70% of physicians said they spend more than 10 hours per week on paperwork and administrative tasks, up from 57% in 2017. In 2014, only one-third of physicians spent 10 hours a week on such tasks.

Part of the problem is that most EHR and other administrative systems don’t communicate with one another. Where possible, healthcare providers need to consolidate systems onto a single provider’s platform and demand interoperability among the systems they buy from different vendors. Meanwhile, AI-based natural language speech recognition software can minimize the time clinicians have to spend completing documentation and other paperwork. “Jumping between disparate platforms—within and outside of clinical workflows—to complete everyday tasks or access information creates friction and negatively impacts provider experiences,” notes Rebecca Laborde, a master principal scientist with Oracle Health.