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June 09, 2003 01:00 AM

Web-exclusive: Make them want to stay

Healthcare organizations would benefit from devoting more energy and resources to employee retention

Erin Wilkins
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    It's no secret that the healthcare field is having a difficult time recruiting and retaining nurses. Numerous studies have attempted to dissect the causes and effects of this shortage. Although the nursing shortage is certainly troubling, it's critical to note that staffing in other job categories also is suffering. From radiology and laboratory technicians to pharmacists and coders, far too many jobs are going unfilled.

    A September 2002 American Society of Radiologic Technologists study shows that the number of technologists entering radiography will not be sufficient to fill the Bureau of Labor Statistics projection of 75,000 more job openings in 2010 than in 2000. Pharmacy is also facing challenges. A recent report by the Pharmacy Manpower Project anticipates a shortage of 157,000 pharmacists nationwide by 2020. As of July 2002, the National Association of Chain Drug Stores reported about 5,500 unfilled pharmacy positions.

    These numbers are revealing. Recognizing the critical nature of the staffing problem, healthcare organizations are scrambling to recruit workers for all key positions. They are using tactics such as job fairs, salary increases and flextime. In short, they're trying it all. But will this solve the problem? It's a start, but much more can be done.

    One strategy often forgotten is workforce retention. Employers may spend significant amounts on bonuses and incentives to hire new workers, with much less attention given to current employees. That's certainly a poor message to give in an era when retention is every bit as critical as recruitment.

    Recognizing the value of employees is a first step toward maintaining a stable workforce. Other approaches deserve attention, especially manager development. Supervisors and middle managers play an integral role in the development and growth of employees, and they contribute to building long-term employee commitment. Effective supervisors are key to making employees want to stay. That saves the organization significant dollars, since hiring and training a new employee costs one to two times the expense of retaining an existing one. This is a significant savings given that nearly 60% of hospital costs go to the wages and benefits of caregivers and other staffers.

    Unfortunately, the reality of today's healthcare marketplace is that front-line managers are not always up to the challenge of effectively leading their teams. In fact, in far too many instances, middle managers and supervisors are promoted based on seniority and job knowledge, not on the skills necessary to develop satisfied, competent staff members.

    For the past three years, Aon Consulting has teamed with the American Society for Healthcare Human Resources Administration, a personal membership group of the American Hospital Association, to investigate the employer/employee relationship in healthcare. The [email protected] studies examine the attitudes and perceptions of thousands of healthcare workers, representing a broad range of sectors nationwide. The results from the most recent study are troubling, showing that despite the vital role supervisors play in workforce retention, many of their subordinates view them as lacking in key competency areas such as communication, team-building and overall management skills.

    Although such findings can't be ignored, steps can be taken to reverse the trend, particularly if healthcare organizations begin to focus on the critical players involved in retaining employees: middle managers.

    The majority of study areas employees rated as lacking can readily be addressed through additional training, mentoring and other educational programs. A study published by the AHA's Commission on Workforce for Hospitals and Health Systems, titled In Our Hands, outlines steps organizations can take to foster better leaders in healthcare. The study identified 11 key middle-management competencies that healthcare organizations can use to assess and hire managers. Those include: results orientation, communication and team building skills, ability to be an agent for change, commitment to service, ability to build collaborative relationships, resource management and analytical thinking skills and personal integrity.

    To develop those attributes, there are a number of steps healthcare organizations can take. Some examples:

    * Encourage managers to attend management courses and seminars. Provide them with the resources to do so, including reimbursement and time off to attend relevant courses.

    * Reward effective leadership on a periodic basis whether it is through a "manager of the month" award or other meaningful incentives.

    * Develop an approach to hire and assess managers based on the key middle-management competencies identified in the AHA's In Our Hands report * Ensure job descriptions and performance objectives are clearly articulated and integrated with the organization's mission and vision. Managers should participate in a performance review every six months to ensure goals and objectives are set and being met.

    * Get creative with training. For example, managers with similar levels of authority could meet once a month to discuss challenges in managing people, dealing with organizational politics and managing resources. Discussions should be confidential. Sharing such experiences and exchanging advice will yield valuable lessons for all involved.

    * Create mentoring programs where junior-level managers are paired with successful senior managers. This helps younger workers learn from those who have developed effective strategies and gain support and encouragement from those who have "been there and done that."

    As important as these ideas are in developing first-class front-line managers, it is equally important to have outstanding executive leadership. Leading by example is not simply the "feel good" mantra of the new millennium. Just as employees need to look to their managers for guidance and direction, those managers must be able to look at the president, chief executive officer and other leaders to have integrity, communication skills and a commitment to the organization.

    Hospitals and healthcare systems that find ways to improve the skills of front-line managers will retain valued employees, enabling them to better respond to their patients' needs. These organizations will meet and exceed the high-pressure demands of today's healthcare workplace.

    Erin Wilkins is an assistant vice president at Aon Consulting and the [email protected] study director.

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