A new survey says hospitals and health systems don't go nearly far enough when tackling two of healthcare's most nettlesome issuesnursing retention and good governance.
Costly turnover and poor governance have added to healthcare's headaches, particularly among not-for-profit hospitals and health systems, where directors' and trustees' oversight of executive compensation has come under scrutiny. And plagued by a shortage of nurses and other skilled healthcare workers, hospitals have made retention a priority.
Still, healthcare lags behind other major U.S. industries when it comes to keeping workers, according to a March online and fax survey of 110 hospitals, health systems, clinics and health insurers, by Watson Wyatt Worldwide, a consulting firm, and the American Society for Healthcare Human Resources Administration, an American Hospital Association affiliate. Results of the study were released last week. Overall, healthcare employers' median turnover ran higher in 2005, 14.1%, compared with 10.6% across industries surveyed by Watson Wyatt.
Nursing experts say hospitals cannot rely on signing bonuses or perks to permanently plug vacancies. Careful hiring, strong commitments to standards and values and an investment in leadership development create a "safe, healthy, no-secrets'' culture where employees like to work, said Lillee Gelinas, vice president and chief nursing officer of VHA, the Irving, Texas,-based network of not-for-profit health systems.
"The bottom line is it takes a combination of things to attract nurses and retain nurses,'' said Susan Hassmiller, a Robert Wood Johnson Foundation senior program officer. Hassmiller oversees Robert Wood Johnson's pilot program with the Institute for Healthcare Improvement to boost patient safety and nurses' working conditions; turnover dropped to 4% among the 13 pilot hospitals this year. "We did nothing with salaries,'' she said.
Hospitals can do more to improve oversight of executive compensation as well, the survey found. A little more than half of governing boards, or 56%, define the peer group used to select comparable salaries when setting the chief executive's compensation. Even fewer, 46%, reported documenting an executive compensation philosophy.