Based on an article by Kate Rockwood, RMA(AMT), MS (HealthEd) from the AMT Pulse, Winter 2022.
“Things have changed considerably in the past year or two of the pandemic,” says Bianca Frogner, PhD, Director of the Center for Health Workforce Studies at the University of Washington. “Society no longer praises our healthcare heroes, and morale has declined. Many healthcare workers feel forgotten or invisible as they continue to put their lives at risk and face an increasingly angry public with the politicization of the pandemic.”
As a result, many in the industry are on the move. Nearly one-third (31%) of healthcare workers said they expect to leave their current role in the next three years, according to Elsevier’s 2022 report, “Clinician of the Future.”
However, that doesn’t mean that most healthcare workers are leaving the field altogether. Instead, many are seeking jobs with better pay and benefits, more flexibility, and less stress. The end result, though, is that some organizations are struggling to retain employees. By 2025, the United States is expected to face several healthcare worker shortages, including 446,000 home health aides, 95,000 nursing assistants, and 98,700 medical and lab scientists and technicians, according to a Mercer report.
Healthcare leaders are well aware that retaining staff is critical to organizational survival. To help hang on to valuable staff and compete with other organizations, many employers are boosting pay, offering signing or retention bonuses, and finding ways to support burned-out workers.
Now that some of the initial chaos of the pandemic has retreated, more companies are also focusing on company culture again. That’s important given that 30% of healthcare clinical workers say they consider a company’s values and culture when deciding to accept or reject a job, according to Employ’s “2022 Job Seeker Nation Report.”
“When the pandemic hit, uncertainty was very high, and we saw many organizations freeze,” says Dustin Stanley, Managing Director of Healthcare at Culture Partners, A consultancy firm that helps organizations improve their workplace culture. “They didn’t know what tomorrow would mean, and all efforts to intentionally manage culture and gauge morale at the organization took a pause because higher-priority items were taking their attention. Now that people have settled
into new realities, including constant uncertainty, they’ve become open and willing to increase their efforts to manage culture.”
Taking the Pulse
One of the most powerful resources that healthcare leaders have to improve workplace culture is employee feedback. Instead of playing a guessing game, organizations can simply ask how employees are feeling and what they want.
That was the thinking at Luminis Health, a regional health system headquartered in Annapolis, Maryland. Last year, the organization resumed its practice of surveying staff about the overall health of the company’s culture, asking everything from employees’ thoughts on safety practices to how they want to be recognized for their work.
Based on the results, Luminis Health began making changes, both big and small. That included adding storytelling at the start of every major meeting to “emphasize the importance of the work we do and to share the stories of the things we have done well as well as those we can do better,” says Luminis Health Chief Human Resources Officer Manny Ocasio.
Gathering feedback is just the first step, though. Organizations need to act on that feedback, too, Stanley says. Doing so signals to employees that their voices are being heard. When “employees feel like they are a part of driving the change, they will embrace it,” he adds.
For the best results, organizations should use a combination of anonymous feedback and live conversations, Stanley says. Anonymous feedback, such as surveys, helps employees share their honest opinions. Those live conversations are a good time for managers to ask about workload, barriers, and drivers to success, development and their ideas on how things can improve.
“We see that when these conversations happen regularly, the relationship between employees and the employer can improve, which in turn improves retention and eliminates surprises,” Stanley says.
Just like employees in any other industry, healthcare workers rank benefits highly when it comes to job satisfaction. The benefits that healthcare employers say are most useful in retaining employees are better pay, flexible schedules, and career development offerings, Dr. Frogner says.
That’s not to say it’s easy to make those improvements. Small organizations can sometimes struggle to compete against larger organizations on pay and benefits. Additionally, career development benefits can be expensive and difficult for time-challenged healthcare workers to fit into their schedule, Dr. Frogner says. But the healthcare organizations that pull it off may be more competitive in attracting and retaining employees.
Luminis Health, for one, decided to invest $29 million in its workforce last fiscal year. That expense included appreciation and retention bonuses and “a commitment to a living wage of no less than $17 per hour for all of our workforce regardless of status or location,” Ocasio says.
The organization also increased its tuition assistance for all staff and changed the way it handles reimbursement. Instead of reimbursing employees at the end of their classes, Luminis provided tuition money as an advance. Tweaking that process greatly increased staff participation. “We have doubled our tuition assistance payouts compared to the prior year,” Ocasio says.
But a benefit that may have the biggest impact on retention is one that sometimes flies under the radar: childcare. In fact, healthcare employers in a Washington State Health Sentinel Network survey said that, of all benefits, subsidized childcare would have the biggest impact on employee retention.
Not only is childcare expensive, but it has become even more competitive and complicated since the pandemic. Many healthcare employers are now weighing offering childcare, both on-site and off, or expanding their existing offerings. For example, Ballad Health, a hospital system with facilities in Tennessee, Virginia,and North Carolina, plans to invest $37 million in the next three years to build 11 childcare centers on top of the three it currently operates.
Considering that women account for 75% of the health and social assistance industry, and childcare responsibilities often fall more heavily on women, it’s a critical benefit for healthcare organizations to consider. “It’s important that we see burnout and turnover in healthcare in ways that recognize the gendered nature of our industry and the disproportionate way in which certain family and social activities are structured that make it more difficult for women to remain in the workforce,” Ocasio says.
Making Mental Health Matter
The mental toll facing healthcare workers can’t be overstated. Many healthcare employees are working longer, more jam-packed days. With that in mind, many healthcare leaders have boosted their attention to and investment in mental health resources for their staff. That’s an important cultural shift and one piece in the puzzle to help avoid burnout.
Mount Sinai Health System in New York, for example, offers 14 free counseling sessions for its employees. Many other organizations are expanding and more heavily promoting their employee assistance programs (EAPs) with mental healthcare offerings. “In acknowledging that it’s OK to not be OK, we continue to look for ways to meet people where they are and offer mental health support,” Ocasio says.
Luminis Health has also focused on small ways to show employees that their mental and emotional health is a priority. For example, the company’s well-being manager recently introduced short video clips called “Got-A-Minutes” that highlight burnout prevention tips and techniques, Ocasio says.
Healthcare organizations need to create a culture that destigmatizes mental health. In part, that’s because many professionals worry that seeking out mental health services could result in losing their license, Dr. Frogner says. “This is where the employer and health professional organizations need to step in to normalize self-care and the discussion of mental health,” she says.
That means regularly discussing mental health issues in the workplace and offering access to mental healthcare services that are confidential and easily accessible (telehealth can be a major win). When working to improve workplace culture, particularly around mental health, it’s important that the burden doesn’t fall on the individual employee, Dr. Frogner says. The employers whose staff will truly benefit are those who don’t just offer more choices but make changes to pay, benefits, and schedules to make those choices attainable.
“Too often organizations have focused on how the individual worker can address their own feelings of burnout rather than exploring how the organization itself can change to improve the working conditions that lead to burnout,” Dr. Frogner says.
In other words, to feel more supported, healthcare employees need to know they’re truly not in it alone.