Turnover Trouble? Hospital CEO Shares Retention Strategies

Written by Chris Westfall and originally featured in Forbes

In 2022, turnover rates for segments of the healthcare industry ranged from 19.5% at hospitals to 65% for at-home care providers to 94% at nursing homes. According to a new report from software company Oracle, this level of turnover puts a huge financial and logistical burden on healthcare providers. Turnover in hospitals can cost up to $85,000 per clinician – and this number does not factor in future revenue for lost replacements, lost productivity, and other intangibles that hit the bottom line. While COVID-19 put additional stress on the healthcare labor force, the healthcare staffing crisis existed long before the pandemic. “There is an urgent need for healthcare organizations to proactively address the root causes of turnover, develop retention strategies, and invest in creating a supportive and engaging work environment,” explains Brian White, the CRO and Co-founder of software provider, Doorspace

Healthcare jobs are notorious for long hours and erratic schedules, and many are considered “deskless” jobs, meaning workers spend much of their time on the move. In fact, it’s estimated that nurses in hospitals walk about five miles a day. Hospitals operate at the intersection of high tech and high touch, when it comes to retention. “We focus on initiatives that are proven to be effective rather than continuing to invest in solutions that look good on paper but provide little, if any, real-world impact,” White says, referencing his company’s employee relationship management (ERM) software. But tech isn’t the only tool in the box, when it comes to keeping hospitals humming.

Focusing on impact and retention is David Schreiner’s business. Schreiner, a PhD, is the CEO of Katherine Shaw Bethea (KSB) Hospital in Dixon, Illinois. With nearly 1,000 employees, Schreiner leads an 80-bed rural facility 100 miles west of Chicago. While overall industry turnover stands at approximately 18%, Schreiner says his numbers hover around 11%. How is he tackling the challenge of retention in his hospital?

“Before our conversation today,” Schreiner shares from his office, overlooking the Rock River at sunrise, “I sent out six emails: three for work anniversaries, three for birthdays. We have an integrated reminder system so that we can stay connected with our team.” From high tech to high-touch, connection is the key, Schreiner says. “We have to earn the right for people to stay here. That means connecting with employees where they are, and recognizing their journey and their milestones,” he says. Here’s how Schreiner is making sure that those connections create better patient care:

  1. Maintaining Gratitude: how well are you doing, as a leader, when it comes to expressing your appreciation? Schreiner is writing a book, published by Forbes, called Be the Best Part of Their Day. Launching in early 2024, the book identifies 15 leadership pillars (based on both his doctoral research and personal experience)According to Schreiner, it all starts with gratitude. “Leaders need to talk about [appreciation] every single time we get in front of our teams.” In healthcare, as in any business where caring and service are front and center, the key theme is the meaning of the work. That focus on individual impact is key to avoiding platitudes, when expressing gratitude. On a human level, we all see the value of appreciating others. Schreiner explains, “We have a local community college that pumps out 20 x-ray techs every year. It used to be a case that 15 of those would have to take part-time jobs until something opened up. Now they’re placed before they graduate.” It’s no secret that the current job market When employees understand that they have more options, leaders need to understand how to value the employees that choose your organization over others.
  2. Transparency: With nearly 1,000 employees, the hospital doesn’t always lend itself to personal interaction with the CEO – but Schreiner goes out of his way to create a personal touch, inside a promise delivered. “When I get to meet with employees in the first hour of their first day at KSB Hospital, I give them my cell phone number. And I say, if within six months, KSB hospital isn’t the best place you’ve ever worked, please call me and talk to me about it.” When asked how often his phone rings, he replies, “Never. But I wish it would.” More than just a folksy offer, or a bold claim of an informal employee engagement survey, Schreiner means what he says. Walking the walk – and taking the tough calls – is part of transparency. What can you do, as a leader, to let people know that you possess that most valuable and rare leadership ability: the willingness to listen? For extra credit, consider how you might personalize your answer – and show that you mean what you say.
  3. Do the Do-Able: If you improve just 1% per day, in 73 days you will double your results. Leadership, according to Schreiner, happens one step – and one conversation – at a time. “My journey started at a place where I felt like I was underdelivering. I was not engaging in the way that I wanted to with the people that matter the most.” The impulse led him to his doctoral research into advanced leadership, as a means to identify what was missing. In his journey, he recognized the importance of adding one thing at a time, instead of trying to arm wrestle the known universe. Can you relate? Does your leadership style feel like a scene from Everything, Everywhere, All at Once? Inside the frenzy of meetings and obligations, take the win for what you’re already doing right. From a place of encouragement, expand your possibilities. Schreiner calls his approach “Appreciative Inquiry” – offering a new kind of AI that doesn’t cause all of Hollywood to go on strike. “I wanna celebrate what’s already good, and from there: What are one or two or three of the things that are still outstanding that you might be willing to try?”

At its core, leadership is about humanity: connecting with people in a way that drives results. For effective leaders, those results come from appreciation, transparency and process. Leaders, and employees, have to realize that profitability and humanity must co-exist – one supports the other. When turnover can cost as much as 200% of a single workers’ salary, retention in healthcare is a profit-sucking obstacle for everyone – driving up healthcare costs, and reducing the quality of care. More than perhaps any other arena, healthcare is a people business. But hospitals are just one example among many, where people are making a difference. Maybe you’re not healing the sick or bringing babies into the world at your office, but anything of any value happens with the input of other human beings. At least, for now anyway. When you get right down to it, business exists for people, and with people, and because of (wait for it) people. In an era where the entire knowledge of the human race is just one prompt away, the information that leaders need isn’t coming from a ‘bot. We are already well-equipped to be better human beings. And in that regard, leadership is simply putting humanity into practice.