The costs hospitals can control: 7 insights from clinical leaders on talent turnover, recruitment and retention

High levels of employee turnover is costly in any industry, but as the demand for talented medical staff increases, issues with employee retention and recruitment can be particularly problematic for hospitals and health systems.

                                    This content is sponsored by B.E. Smith

Hospitals are labor-driven entities dependent on talented frontline providers for fiscal success. In order to keep operations cost-effective, administrators must successfully recruit and retain highly skilled staff members or shoulder the financial burden of high turnover. The cost of turnover for just one experienced registered nurse can reach $88,000, according to a 2017 study published in SAGE Open Nursing. When factoring in the cost of recruitment, onboarding and lost revenue, the cost of physician turnover can reach as much as $1 million per physician, according to a 2012 study published in Recruiting Physicians Today.

High costs associated with turnover are likely to become even more palpable for many hospitals as the percentage of Americans over age 65 continues to increase, driving up provider demand. According to a 2017 projection from the Association of American Medical Colleges, the United States may face a physician shortage as high as 104,900 by 2030.

"The demand for talent, particularly for clinical executive talent, has never been greater," Gail Wurtz, MSN, MBA, RN, vice president and account relationship executive with healthcare leadership solutions company B.E. Smith, told a room of more than 20 clinical healthcare leaders during a May 11 executive roundtable discussion at Becker's Hospital Review Health IT + Clinical Leadership in Chicago. "You and the clinical staff you lead are the key to providing superior patient care, which supports your organization's future success and services."

During the roundtable event, clinical leaders split into groups to discuss issues related to turnover, recruitment and retention. After these mini-discussions, designated leaders relayed the most crucial elements of their group's discourse to the larger group.

Here are seven insights from the roundtable.

"Location, location, location."

1. During the discussion, an administrator from a 300-plus bed hospital in the Midwest described physician recruitment as all about "location, location, location." While the leader's hospital is located in a city of less than 30,000, it is located within driving distance of a major metropolitan area. The hospital tries to market its proximity to the big city when recruiting top talent.

2. The CMO of a Midwestern children's hospital said his organization is not located in what is generally considered a "destination community." The hospital's location proves challenging for physician recruitment. The leader said his organization addresses these issues in a number of ways, including investment in medical residents.

"We've done some innovative things to tap into resident talent," the CMO said. "We invest in them during their training with stipend programs and three-year [employment] guarantees upon residency completion, which have worked out pretty well for us."

The CMO said the three-year mark is a critical turning point for his organization. "Within the first three years, we have a reasonably high turnover rate," the CMO said. "Once they're employed with us for three years, they get really engaged and they stay."

3. Ms. Wurtz said a B.E. Smith survey of 800 hospital leaders published in January reflect executives' comments about the importance of location when recruiting talent. In the survey, 33 percent of respondents identified location as their organization's greatest challenge to staff recruitment, making it the most identified challenge in the survey. Twenty-four percent of respondents said access to high quality talent was their organization's greatest challenge, making it the second-most identified challenge.

Prioritize retention to combat turnover

4. In the B.E. Smith survey, which participants completed in November and December of 2017, 35 percent of respondents said they were contemplating a job change in 2018. Ms. Wurtz said this finding highlights the importance of implementing retention programs within organizations to "foster a culture of continuity" and staff engagement.

5. During the discussion, a nurse leader who heads the intensive care unit at a medical center in the Southwest said her organization is piloting programs to hold onto top nurse talent. "There's been more of an emphasis on new nurse hires at my organization rather than a focus on retaining top nursing talent," the ICU leader said. "We're looking to do more to hold onto leaders that are seasoned."

6. The assistant director of clinical support for an academic health system based in the Midwest said her discussion group believes mentorship programs should receive more attention and resources to help develop leaders from within. Such programs could help mitigate potential overreliance on outside recruitment for leadership positions.

Focus on the nurse-physician relationship

7. During the roundtable, multiple leaders discussed the importance of creating an environment of inclusion and collaboration to facilitate positive relationships between providers — specifically nurses and physicians. As a nurse leader, the ICU director from the Southwest said strong nurse-physician relationships require both provider groups to keep the perspective of the other in mind.

"When we have good relationships, those can help retain talented employees," the ICU director said. "For my part, I know I think very often about, 'Do I like to work with this doctor?' But I don't often think, 'Does this doctor like to work with me?' To be successful, that kind of thinking has to go both ways."

For more insights into hospital workforce recruitment and retention trends, click here.

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