Alvera Mandavia

Employee retention is challenging in the current healthcare environment. Economic shifts and federal policies aimed at curtailing healthcare costs while simultaneously increasing the quality of care has focused the industry in creating a patient-centered culture. Millions of dollars are invested on developing services geared towards creating a memorable and satisfactory patient experience -including state-of-the-art equipment, facilities upgrading, and creating a concierge medical environment -but a major facet of creating a satisfactory patient experience is committing to hiring, developing, and maintaining a dynamic work force. Where most companies are able to invest heavily in hiring and developing a work force, there are still many lags when trying to retain a valuable workforce.

The high cost of turnover should take into account not only the advertisement and fees for recruitment, but also the amount of time it takes to train an employee, and the cost of business lost from the time an employee leaves to the amount of time it takes to hire a new staff member. Additionally, talented employees attribute directly in creating a patient-centered environment, which then attributes to higher satisfaction in the delivery of care. It has been reported that 

“hospitals with high performance scores in patient care are more profitable”

 (Press Ganey 2011). Now we are forced to look at not only the cost of losing an employee, but the cost of possible business lost because we were unable to retain an employee. So how do you retain your most valuable asset?



One of the most important factors in retaining highly driven and valuable employees is keeping them engaged in their work. Open-ended discussions focused on collaboration and team discussion is a powerful way to engage employees. Ask your staff members what their opinions are about a critical process improvement effort. Encourage the discussion by asking questions rather than imposing opinions. Create an environment of mutual respect for opinions. Have employees suggest rewards for meeting goals, and help them help you by providing insight into process improvements in their own area of specialty.



Effective healthcare leaders recognize that an employee’s commitment to the company is in huge part related to their ability to harbor pride in their company and develop a sense of purpose in their role. This is in large part attributable to the management team's ability to nurture and understand an employee’s personal goals and agendas and intertwine it with the company's mission statement. Taking pride in one's company comes from communicating gratitude towards the workforce for accomplishments of large goals. If a hospital has met its quota for meeting Medicare’s PQRS initiative, send a hospital-wide e-mail congratulating the staff for contributing. If your healthcare organization is now profiting directly from increased patient revenues due to an initiative focusing on creating a culture focused on patient care, reward your staff and provide them an opportunity to share in the profits. Allowing your workforce to take part in accomplishments through rewards and recognition will develop an environment of trust, pride, and commitment.



Highly driven employees need to feel their personal goals and development are being recognized and acknowledged by the company. Employees who want to get into management tracks should be given the opportunity by increasing responsibility. Allow your employees to take on more difficult tasks and help them succeed in their goals by providing them structured work plans and routine meetings to monitor their progress. As managers, the responsibility of developing an engaged work force starts by recognizing each individual's personal learning styles and rate of understanding.



Not all companies are able to accommodate a flexible schedule, however, in most cases this can be achieved through simple scheduling changes. A clinic which normally sees patients from 8 a.m to 5 p.m., can accommodate the working mother/father by scattering the schedule. A staff member who needs to leave by 4 p.m. can come in one hour early or work through their lunch so they can accommodate their familial or educational responsibilities as well. In doing so, employees see their employers as caring and attentive to their needs. By being able to provide a small amount of flexibility, not only have you earned the respect and loyalty of the employee, but you have also created a schedule which can accommodate, for example, working patients, who have a difficult time making that last appointment at 4:45 p.m.



Although, as mentioned above, this is one of those tangibles which many companies cannot accommodate, but it is still an important factor in retaining the more valuable and driven employees. Offer more than an annual cost of living adjustment to your more productive employees. Provide them with stock options based on tenure and productivity. It is always advisable to focus your time and money on employees that deliver the highest value.



The nursing/midlevel staff are vital players in the deliverance of healthcare. Training providers to develop and retain positive relationships with the healthcare team is an essential component of creating a positive workplace. Encourage providers to show appreciation to staff members for their hard work and commitment. Buying thank you cards for a job well done with a difficult patient or recognizing someone in front of their peers goes a long way in nurturing trust and self-worth. This attributes directly to employees feeling connected to their company and an increased sense of accomplishment.

 is a practice manager for HCA Healthcare, managing the day-to-day operations and marketing of a family practice clinic in McKinney, Texas. She earned her Master’s degree in healthcare management and is currently working on her FACHE.

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Losing a key member of your medical practice staff not only hurts operations, but it can be costly as well. Here are some tips to retain your top employees.

Author | Alvera Mandavia

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