Powerful Influence on a Hospital’s Success


In healthcare, as in any organization, one of the major keys to success is the ability to retain qualified staff. Not only do engaged and capable employees deliver more discretionary effort to the business, but they also present a positive image of the organization to patients and their families and friends.  

In the very competitive healthcare field, keeping trained staff members is crucial to avoiding employee overwork and burnout as well as the high costs of sourcing, hiring, and onboarding new employees. At year-end 2016, average hospital turnover rate was 16.2% as reported in the annual NSI Nursing Solutions, Inc. survey. Financial impact to the organization adds up quickly when “the average cost of turnover for a bedside RN ranges from $38,900 to $59,700 resulting in the average hospital losing $5.13M to $7.86M, annually.”

Some amount of attrition is always going to happen, but measuring retention and comparing your facility to other benchmark organizations is valuable. Knowing whether your healthcare facility is doing significantly better or worse than others can be helpful in planning long-term HR strategies.

However, retention is a lagging metric. By the time you learn that any individual employee is thinking about leaving, it’s pretty much a fait accompli; that staff member is not likely to change his or her mind and stay on. For this reason, it’s important to analyze a key leading indicator of turnover...staff satisfaction. As satisfaction dips, you may expect to see retention decline as well. Even better, as satisfaction grows, you may see turnover numbers and associated costs decline.


SEE ALSO: Creating an Operational Excellence Strategy for Hospitals

Do you know if your employees are satisfied?

As a leader in your organization, you wield power over your employees. That unbalanced situation can often mean that individual employees are reluctant or even afraid to tell you that they are not satisfied. The smiling faces and head nods that you see as you walk through various departments might make you think your employees are quite happy. However, they may actually be miserable, complaining to each other at work or with their families at home.

You may need to create a safe channel for employees to share any dissatisfaction with you before it is so overwhelming that they want to leave. A staff satisfaction survey with anonymous submissions is a good starting point.


What keeps employees satisfied in their jobs?

Asking the right questions through your satisfaction survey will help provide the answers to tell you where to focus efforts. Consider categories such as these:


  • Job role and responsibilities.
  • Compensation and benefits.
  • Career advancement opportunities.
  • Supervisor qualities.
  • Manager qualities.
  • Relationship with coworkers.
  • Understanding and connection to organizational goals.
  • Local workplace conditions.

You can even ask employees if they plan to stay with the organization. If participants trust the anonymity of the survey, they may provide early indications that they’re thinking about looking elsewhere long before they turn in two-week notices.

The survey should have both qualitative and quantitative components. Responses to “yes/no” and “to what degree do you agree/disagree” questions can provide relative numerical comparisons between questions and can be used from year to year to look for improvements or declines in specific areas. “Please explain” qualitative answers provide information in the employees’ own words that will help explain why people answered as they did.

Equitable compensation and career opportunities generally top the list of drivers of employee attraction and retention. According to Willis Towers Watson’s 2014 Global Workforce Study, trust and confidence in senior leadership is also very high on the list to keep employees in their jobs. This is as important as or possibly more important than the employee’s relationship with the immediate supervisor.


SEE ALSO: 4 Simple Steps for Setting Your Operational Excellence Vision

The survey is just the start

The HR department or an outside firm will often compile the survey information. Once this happens, it’s important not to assume people in the HR function will do all the follow-up. This accountability belongs to organizational leadership. Assemble a team of cross-functional staff leaders and HR folks. Study the survey information and pick just a few of the top areas to focus. Establish an action plan and monitor progress. Many organizations administer the survey yearly or even quarterly to a rotating subset of the staff, enabling the leadership team to track not just project actions but also results, as measured by satisfaction and retention.

Hospital leaders often have strong medical backgrounds; they know how to address medical issues using science and technical skills. Somewhat different problem-solving and leadership skills are needed to address staff retention. Successful efforts can often lead to a shift in the organization’s culture, with improved retention, satisfaction, patient care, and ultimately the bottom line.

Learn how to get a start on your team’s path toward improved staff retention and satisfaction by contacting EON.  


Talk with an EON Opex expert to learn more

About the author

Nancy Bach

Nancy Bach has spent more than 20 years in the industry as a quality and operational excellence practitioner and manager. In private consulting, she creates and delivers a Lean Certification course, provides Green Belt training and works with multi-functional organizations to develop strategy and implement process improvement.