As any practice administrator knows, retaining great employees is no easy feat. Turnover rates in medical practices are often sky-high, especially as the economy gains steam and staff scout for better employment options. Poor staff retention has serious downsides, including the loss of institutional knowledge, the expense associated with additional training, and weakened relationships between patients and staff at a time when patient satisfaction is more important than ever.
So what can practices do to engage and hold on to their high-performers? To find out, I spoke with Tom Ludwig, RN, MBA, FACMPE, president and CEO of Forward Healthcare Solutions, and a consultant with the MGMA Health Care Consulting Group.
Maureen: Tom, why is high turnover such a concern?
Tom: When there’s high turnover, there’s a lack of consistency. Staff don’t get to know patients well, and you lose champions of technology systems and processes. It’s far easier for things to fall through the cracks. For instance, if a patient is discharged from the hospital and misses their follow-up appointment, new staff who aren’t as familiar with the importance of transitions of care might not follow up.
Maureen: What’s the most important thing practices can do to retain star employees?
Tom: Compensation is important, of course, and employees want to paid a fair wage, but without a doubt, the most important thing is to make sure staff feel connected to your organization’s overall mission and goals. They need to understand how their role fits into the larger strategy. Employees—especially high-performing ones—want to feel like they matter and their work is meaningful. If you can help them understand the “why” of what they’re doing, it will go a long way.
I was once part of a consulting team at a small clinic and their front desk staff made a lot of registration errors that resulted in rejected claims. We asked the practice manager about the errors and he said, “We keep telling them they have to be more accurate.” We replied, “Did you tell them why?” There was a blank look on his face like the thought had never occurred to him. My colleague put together data to show staff the rates of claim rejections and the chunk of lost money that those rejections represented. Their eyes got big. They finally understood that what they were doing had a direct impact on the organization and their error rate went way down.
Maureen: What are some other best practices?
Tom: Get to know your staff personally. You don’t have to be everyone’s friend, but pay attention to what’s going on in their lives. Early in my career, I remember my supervisor asking about a sick child or a recent vacation. Those things make a difference.
Recognition of birthdays, employment anniversaries and other milestones are really important, too. And don’t forget celebrating team goals. It can be very deflating when you have clear goals in place for your staff and when they achieve them, you say, “On to the next one” with no recognition. You don’t need to have lavish celebrations. I’ve always found that a simple gesture like a handwritten thank-you card or a mention in the staff newsletter is effective.
Maureen: How important is staff training?
Tom: Training and education are very important because it means your staff is constantly learning new things. Sometimes when funds are tight, it can be hard to send people to formal training events. In that case, consider bringing in a good speaker for your staff meeting or turning an everyday event into a learning opportunity. I really like to promote the use of an incident reporting system as a training tool. An incident might be when a staff person got hurt using a piece of equipment or a transition of care didn’t go well. This process allows everyone to talk through what happened and discuss what we did well, what we didn’t do well, and how we can do better next time.
Maureen: How should practices gauge employee satisfaction? How do they know if the changes they’re putting in place are making a difference?
Tom: I definitely tell organizations I work with to use surveys. I’m in favor of using shorter, more frequent surveys to supplement the longer, more comprehensive ones that practices conduct once a year. A more nimble process is much more beneficial. It’s important to ask about the level of communication within the organization and I also like to ask employees to identify issues they see, like bottlenecks and inefficiencies. A short survey could be as simple as these three questions: What is going well? What isn’t going well? How can we do things differently or better?
You also need to give staff some authority to use their judgement and solve those issues when they spot them. For instance, I worked with a clinic where front-desk staff complained of a bottleneck answering the phones. It turned out they were required to get permission before scheduling same-day appointments. Once they didn’t need to get permission anymore, the problem resolved itself. Another example might be giving staff the authority to hand out coupons for a free cup of coffee if a patient or family member experiences an extended wait. It’s important to let staff address some of those inefficiencies when they see them. They’ll feel more valued, and you’ll solve problems more quickly.
Maureen: Any final thoughts, Tom?
Tom: Treat your staff well and everything else—retention, patient satisfaction, efficiency and quality—will fall into place.
