Table of Contents
- Understanding Turnover in Healthcare
- Factors Affecting Turnover in Healthcare Settings
- The Cost of Turnover in Healthcare Settings
- Elements of a Positive Healthcare Environment
- The Nature of Work and Strategies for Reducing Turnover
- Transforming the Nature of Work: Loma Linda Case Study
- Reducing Employee Turnover in Healthcare with ADN
The COVID-19 pandemic triggered a mass resignation in the healthcare field. It heralded a paradigm shift that revealed numerous problems that only compounded during the crisis. The sudden exodus left administration teams asking, “How do we reduce employment turnover in healthcare?”
In this comprehensive post, we’ll share the causes behind the heightened employee turnover crisis in the healthcare system. We’ll dig into the costs associated with the loss of skilled labor, including its impact on patient health outcomes. Finally, we’ll share actionable strategies for reducing turnover in healthcare settings.
Continue reading to learn effective ways to reduce turnover in healthcare, cultivate stability, and retain your skilled frontline staff.
Understanding Turnover in Healthcare
In general, turnover refers to the rate at which healthcare workers leave their positions over a given period of time.
Both nurse turnover and provider turnover have implications for patient health and safety outcomes. Specifically, voluntary turnover, in which skilled nurses and physicians resign from their positions due to dissatisfaction, is creating a skilled labor gap. Likewise, internal turnover, in which unhappy employees seek a new role within their organization, removes experienced professionals from frontline, patient-facing roles.
Factors Affecting Turnover in Healthcare Settings
Per recent data, both voluntary and internal turnover is exacerbating the staffing crisis in many hospital systems.
According to the National Health Care Retention & RN Staffing Report, over 27% of registered nurses left the medical field in 2021, at the peak of the COVID-19 crisis. A nursing workforce analysis published by Health Affairs suggests that accounts for 100,000 RNs, the majority of whom were under the age of 35 at the time of their resignation. That is the highest workforce reduction in the past four decades.
While the pandemic crisis played a large role, it wasn’t entirely to blame. As of late 2023, only 4.17% of nurses have chosen to return to the field. Their reluctance to resume their roles has created a significant labor gap. As a result, many regions of the country are facing a critical nursing shortage, which the American Journal of Medical Quality expects to last until 2030 or beyond.
Doctors, in contrast, appear to be leaving their positions at a rate consistent with past resignation patterns. This does not denote stability, however. Instead of resigning, physicians are pursuing new positions, with 43% of providers leaving their previous roles in 2021. According to a CHG Health survey, 35.2% of those professionals cited work-life balance as the primary reason for the transition.
A 2022 survey from Human Resources for Health identified several reasons why both registered nurses and doctors left or transitioned within the field:
- Pandemic-related stress and burnout
- Lack of workplace support
- Fear of contracting COVID-19
- Dissatisfaction with compensation
- Low staffing levels
- Lack of sufficient supplies and PPE
- Absence of mental health support
- General lack of equity and respect
At present, there are not enough student nurses studying at the baccalaureate level to address current turnover rates and sufficiently enhance patient safety. As the nation’s aging population has growing care needs, this shortage will only become more critical.
The Cost of Turnover in Healthcare Settings
There are both financial and non-financial costs to the high turnover rates in the healthcare field. The following factors contribute to a marked disruption of services in the hospital setting.
- Training: Every time you hire new frontline staff, they must receive training in an institution’s procedures, technology, and routines. The NSI staffing report suggests recruiting, hiring and training can cost as much as $52,000 per RN. The higher the turnover rate, the more funds must go toward training new staff. Learn how the opportunity cost in healthcare affects resource allocation and impacts hospital quality.
- Cost of Traveling Nurses: When hospital systems are unable to staff enough nurses, they frequently employ travel nurses to address the staffing deficit. Hiring a single RN has the potential to save hospitals as much as $157,000 on supplemental labor costs.
- Longer Wait Times in Hospitals: Reduced staffing levels consistently lead to longer wait times in hospitals. Likewise, patients have less time with healthcare workers and providers. This lowers patient health outcomes and can lead to patient dissatisfaction.
- Increased Shift Length: The less staff there is on the hospital floor, the more responsibility others must take on to compensate. Often, practitioners and nurses must take on increased workloads. Not only does this contribute to employee stress, but often necessitates longer shifts.
This costs financially, as staff will need to be compensated for working overtime. More critically, however, overburdened workers are more likely to resign as a result of stress and burnout. Frequent overtime makes maintaining a work-life balance nearly impossible, especially for healthcare workers with families.
There is a direct link between employee well-being, patient care, and organizational reputation. Thus, hospital administration teams have a responsibility to learn how to reduce turnover in healthcare.
Elements of a Positive Healthcare Environment
Positive patient outcomes begin with decisions made at the top, by hospital administration teams. A 2021 Delphi-method study identified three primary themes contributing to a positive work environment in healthcare settings:
- Positive Social Context: This refers to an overall positive workplace culture and organizational atmosphere. It includes elements such as feelings of respect, utilization of equitable conflict resolution methods, and a supportive team.
- Positive Physical Context: This refers to the safety and comfort of the physical workspace. It includes elements like access to adequate equipment, including appropriate PPE.
- Positive Psychological Context: This refers to cultivating an environment where healthcare workers feel a sense of meaning and purpose in the workplace. It includes elements like appropriate workload management, opportunities for learning and growth, and the ability to maintain a work-life balance.
Strategies intended to reduce the turnover rate in healthcare must address the above elements. Addressing these factors often requires major cultural shifts in the workplace.
Administrators might consider striving to become a High-Reliability Organization. Aligning your hospital’s mission with HRO traits is an evidence-based method for improving patient outcomes and building trust.
The Nature of Work and Strategies for Reducing Turnover
One of the largest considerations is ensuring the nature of the work is both meaningful and challenging.
Improving the nature of work in hospitals requires:
- Task variety
- Staff autonomy
- Fair distribution of tasks
- Thoughtful overtime management
- Alignment of skills with assigned work tasks
- Access to training and development programs
- Clear opportunities for career advancement
- Open, egalitarian pathways to communication
- Opportunities for mutual support
- Implementation of technology and automation to streamline tasks
At the individual level, consider offering self-care support, enhanced professional development opportunities, and implementing employee assistance programs.
At the organization level, prioritize providing positive recognition and feedback to frontline staff. Work-life balance initiatives, such as more flexible schedule options, are another evidence-based approach to burnout reduction. Your staff should always feel like they have both autonomy and a voice, which can improve overall motivation.
Learn about effective strategies for reducing nurse burnout to enhance work-life balance for your staff.
Psychological safety is another major component of creating a more positive culture. Staff must be able to report issues or errors without fear of retribution. Consider implementing a Good Catch or Near Miss campaign, which rewards frontline staff for reporting near-miss safety incidents.
To make improvements, administration teams must first understand how current staff feels about the nature of their work. It can be helpful to implement and administer surveys to better understand your existing workplace culture. Consider working with survey administrators who have experience soliciting high response rates.
Transforming the Nature of Work: Loma Linda Case Study
Another way to improve quality teams in the hospital setting is through “smartsourcing”. The concept behind “smartsourcing” is that competent staff members should be utilizing their core competencies in the workplace.
For example, a registered nurse who is tasked with the burden of data abstraction may not feel as if they are contributing or making meaningful change. Smartsourcing allows teams to outsource tasks to those with the skillset, time, and energy to devote to the task. This frees your staff to work with patients or implement system-wide changes as part of an operations team.
A case study out of Loma Linda University Health notes the effect of smartsourcing data abstraction on job satisfaction and, ultimately, staff retention.
Brenda Bruneau, MBA, RN, the Assistant Vice President of Quality & Patient Safety for Loma Linda, was emphatic about the positive change in her staff.
Bruneau said, “All of my individuals who did abstraction previously are nurses. So for them to see that their knowledge of the data, workflows, and processes and their contribution with the team in making care better for patients, that’s invaluable.”
She continued: “Because they then get to look at what’s happened with our data outcomes, celebrate those things, and move on to the next area of opportunity. It’s very fulfilling to those individuals. It is important to folks to know that the work that they’re doing is positively impacting patient outcomes.”
Reducing Employee Turnover in Healthcare with ADN
Partnering with American Data Network is one way to reduce employee turnover in healthcare. Smartsourcing will help remove the burden from your abstraction staff and transform the workplace environment.
Our team of healthcare data professionals will help your organization meet all data collection and reporting requirements. We will work with your staff to seamlessly integrate into your current system and data abstraction process.
By allowing us to focus on our core competencies, you give your team the freedom to focus on theirs. As a result, morale, job satisfaction, and patient outcomes will improve.
Discover how ADN’s data abstraction services can enhance your hospital’s efficiency and reduce employee burnout.