Increasing hospital attrition and how to combat it

Exploring the trend

The healthcare sector has been experiencing increasingly high turnover and attrition rates for years, and this unfavourable trajectory doesn’t seem to be slowing down.

A study conducted across the United States of America of 11 000 healthcare employers with more than 11 million employees found that the average turnover in healthcare jobs in 2017 was 20.6%, up from 15.6% in 2010.

The only industry with a higher turnover rate in America currently is the seasonal-staff-dependent hospitality industry!

Leaders for Today (LFT), a hospital management staffing firm, similarly conducted a survey across the nation with more than 850 responses from healthcare professionals in 2017.

The survey report found that increasing turnover isn’t limited to certain healthcare jobs – it affects every role, from top management to the front desk and the front lines.

The survey also uncovered an alarming trend: the average healthcare employee does not intend to stay at their current job for longer than two to five years, and two thirds of the respondents indicated that they had been in their current job for less than five years.

In many industries, keeping turnover to a minimum is vital. The longer employees work for a company, the better they know the business, and the more valuable their contributions.

The high level of change taking place in hospitals could be attributed to:

  • the lack of continuity in hospital staff, ultimately widening the knowledge gap;
  • the continuing trend of mergers and partnerships of organizations;
  • the emergence of new models of care accompanied by the current hospital environment fostering job dissatisfaction;
  • the retirement of leaders from the baby boomer era; and
  • the movement of CEOs within health systems.

According to a survey by NSI Nursing Solutions, the turnover rate for bedside registered nurses (RNs) in 2017 was 16.8%, up from 14.6% in 2016.

This trend is an expensive problem for the healthcare industry.

A study in the Journal of Nursing Administration found that it may cost anywhere from $97,216 to $104,440 in today’s dollars to replace a nurse, whose work directly impacts a hospital’s safety, quality and patient satisfaction.

The cost calculation includes pre-hire recruitment and aspects such as unstaffed beds, overtime and losses in productivity but does not account for the negative effect that it has on the hospital’s work environment and its care givers.

Deborah J. Bowen, American College of Healthcare Executives (ACHE)’s president and CEO, stresses the importance of organizations having well-developed succession plans to manage changes in senior leadership roles and ensure success in today’s environment.

But how do we navigate that change, not just manage it? How does one ensure that the widening gap between job satisfaction and work environment is reduced?

Job satisfaction

Ron Friedman, Ph.D., author of “The Best Place to Work: The Art and Science of Creating an Extraordinary Workplace,” delves into the attraction and retention of top performers in his book.

He states that pride in one’s workplace is a high motivator and contributor to job satisfaction. “Research indicates that pride is associated with greater employee loyalty and reduced interest in looking for other jobs.”

Friedman goes on to explain that employees should, ideally, view their membership of an organization as an investment – one in which their status level will be elevated and in which they can contribute to the greater good.

“Helping others is intrinsically rewarding and makes us feel good about ourselves. It also lends the work we do greater value by allowing us to see that our sacrifices have meaning.”

Working in the healthcare sector automatically ensures that employees are contributing to a greater good by helping others. The difference here is that they no longer feel that they are doing so.

The novelty has worn off – as with all jobs, one can become accustomed to, and therefore numbed to, a daily work routine.

In order to feel pride and, consequently, satisfied in a job, employees need to be reminded of the good that they do.

This can be done through recognition of achievement, increased responsibility, opportunities for growth, and other matters associated with the motivation of the individual in his/her job.

An employee’s ethic derives from his/her own values and the actual conditions encountered on the job. The degree of compatibility between an employee’s work ethic and the values for which the hospital stands determines how satisfied each individual will be in the position.

Positive work environment

An organization’s values derive from societal norms, formal decisions by the board of directors, and the policies and procedures of the managing group.

The degree of comfort an individual employee feels within an organization’s work environment is influenced by environmental pressures.

Internal pressures include work rules, facilities, coffee breaks, benefits and wages etc. and external pressures include outside job opportunities, community relations, financial obligations and family ties, among others.

The provision of a work environment that is broadly compatible with an employee’s personal goals and their values for working and living is essential to retaining them.

Friedman encourages the integration of family and work life as he believes that it improves the quality of both.

Offering paternity leave to a new dad; providing an onsite crèche or vouchers to help pay for nursery furniture, diapers and onesies; or even allocating a wall in the hospital dedicated to the artwork of employees’ children can all play an important role in creating a positive work environment for family-oriented employees.

Personnel programs, policies, and procedures that are responsive to the different values of employees need to be developed in order to cultivate strategies and reinforcements for retention that is right for both the employee and the organization.


In the midst of change, hospitals can no longer afford to be passive bystanders.

Leaders in the industry need to navigate the unchartered waters by taking an active role in creating and guiding an exceptional workplace, closing the gap between job satisfaction and work environment.

At vi by Aderant, we realise that creating an exceptional workplace requires keeping employees on a constant integration and retention path.

Follow the below link and we’ll provide you with best-practice integration strategies comprising diversity and inclusion activities, alignment with stakeholders, performance management and more.

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