This document summarizes a webinar discussing reasons for staff turnover in the healthcare system. It identifies four main reasons for turnover: 1) shortage leads to more shortage as burnout increases, 2) the importance of building the right team through proper recruiting and mentoring, 3) lack of clear onboarding practices for new employees, and 4) poorly supported change management when organizations undertake initiatives. The webinar featured a physician speaker who discussed these challenges from her perspective and provided recommendations such as focusing on workforce design, candidate sourcing, emphasizing diversity, maintaining a positive culture, dedicated onboarding processes, and change management essentials like communication and participation. Unified talent management solutions were presented as helping to address these turnover factors through

1. Preventing Turnover: Four
Reasons Staff Are Leaving
Your Health Care System
Steve Dobberowsky, Principal Consultant, Cornerstone OnDemand
Rebecca Parker, MD, Board Chair, American College of Emergency Physicians

2. Today’s Webinar Speaker
Feature Speaker
Dr. Rebecca Parker - MD, FACEP, and Chair of The American
College of Emergency Physicians Board
Moderator:
Steve Dobberowsky - Principal Consultant , Thought
Leadership & Advisory Services at Cornerstone OnDemand

3. Today’s Agenda
1. Overview of Current State of Healthcare
2. Turnover As a Major Challenge
3. Four Reasons Driving Turnover in Healthcare
4. Feature Speaker – Dr. Rebecca Parker
a. Observations & Recommendations from a Physician’s Perspective
5. The Opportunity for Unified Talent Management
6. Q&A

4. 4
The Workforce is Changing
Proportion of the population
aged 60 years+
20202010200019701950
8%
9%
10%
15%
21%
In 2020, half of our workforce
will be Millennials
50%

5. 5
Healthcare is Also Changing
Key Driving Forces:
• ACA & Healthcare Reform
• Rise of ACOs, Shifts to Value-Based Payment, and Population Health
Mgmt.
• ‘Big-Bang’ Changes
• Transition to EMRs & Meaningful Use and ICD-10 Cutover
• Shifts in the U.S Population
• Newly Insured & Retiring Baby Boomers
• Increasing Provider Shortages
• Aging Workforce and Limited New Entry

6. 6
Consequences of High Turnover
Staff Turnover Directly Impacts:
• Ability to Fulfill Mission & Provide Quality Care
• Excess Costs & Missed Revenue
• The Patient Experience
• The Organization’s Reputation

7. 7
Four Reasons for Staff Shortage
1. Shortage Leads to More Shortage
2. Toxic Employees & Importance of Building the Right Team
3. Lack of Clear Onboarding Practices
4. Poorly Supported Change Management

8. Preventing Turnover – From
the Physician’s Perspective
Rebecca Parker, MD, FACEP
Chair, ACEP Board of Directors
8

9. 1. The Physician Shortage
 36% of all physicians in the U.S. are 55 or older
 11% of physicians 50-65 years old suggest they will retire in the
next three years
 17% suggest that they will significantly reduce their practices
Source: American Medical Association
Challenge

10. Physicians Feel the Shortage Squeeze
Merrit Hawkins’ 2014 Physician Survey - Changing of the Guard
 81% physicians feel overextended/full capacity
 Only 19% have more time for patients
 44% take on more step to reducing access to patients
 39% accelerate retirement because of changes
 72% believe there is a physician shortage and more GME funding
is needed
Challenge

11.  Hospitalist Boom
 Surgery and OB Laborists
 Increase in Diversity of the Physician Workforce
 Earlier Recruitment of Residents and Fellows
 Increased Signing Bonuses, Loan Repayment
 Quality of Life Becomes Top Priority
Factors Impacting Recruitment
Challenge

12. Workforce Management
 Maximize Workforce Design
 CRNA/PA/NP
 Scribes
 Technology support
 Tracking of Needs
 Monitor Market Forces
Recommendation

13. Candidate Sourcing
 “How Physicians Search for Jobs”
 347 responses / 2,000 sample
(17%)
 Final year residents and those in
practice 1-3 years
Source: NEJM, “How Physicians Search For Jobs” 2007
 Sources for Job Search – Top 6
 Personal/Prof. Referral 81%
 Physician Recruiters 74%
 E-Mail 72%
 On Line Job Sites 71%
 Classified Ads 70%
 Residency Staff 69%
Recommendation

14. 2. Building the Right Team
Interview with Coach Pat Fitzgerald
Challenge

15. It All Begins with Recruiting
 Academics
 Character
 Leader on and off the field
 Willing to go outside comfort
zone
 Shares vision of striving for
excellence
 “What do they do when no one
is looking”
 Player skills
Recommendation

16. Help Become the Best They Can Be
 Teach about being on a Team
 Servant Leadership
 Prioritize inner character
 Small groups with leadership
council
Recommendation

17. Promote Team Engagement
 Get to Know the Team
 Weekly with nursing leader counterpart
 Monthly departmental meetings
 Monthly c suite meetings
 Quarterly physician/APN/PA dinners
 Provide Structure
 Established regular meetings
 Establish regular communication methods
 Continue rounding
Recommendation

18. Focus on Team Mentoring
 Managing Individual Team Members
 Coaching versus Mentoring
 Understand the role they play and knowledge
 Help discover their talents
 Match abilities and interest to topic
 Understand their diversity
 Gender
 Generational
 Cultural
Recommendation

19. 1/23/2015 Sheryl Sandberg: Why we have too few women leaders | Talk Video | TED.com
Log
Sheryl Sandberg:
Why we have too few women leaders
TEDWomen 2010 · 14:58 · Filmed Dec 2010
Subtitles available in 44 languages
View interactive transcript
Emphasize Diversity
Recommendation

20. Understand Your Workforce
Recommendation
Traditionalist Baby Boomer
Generation X Generation Y

21. Emphasize Diversity
Recommendation

22. Maintain a Positive Atmosphere
 When it doubt, round
 Follow up, follow up, follow up
 Thank you notes work wonders
 Have private conversations
privately
 Honesty goes a long way
 Always do what is right for the
patient and you can never be
wrong
Recommendation

23. 3. Lack of Dedicated Onboarding
 New hires lack healthcare system “culture knowledge”
 Lack of transparency in expectations and measures of success
 Lacking communication from supervisors
 Need dedicated time and resources
Challenge

24. Focus on Onboarding Practices
 Crucial for retention
 Set up process
 Checklist
 Set expectations
 Provide training and resources
Recommendation

25. The 90 Day “Test Drive”
 Engage: Engage the provider and their spouse and peers to increase
the cultural and community fit and connection.
 Mentorship: Assign a mentor to the provider.
 Set Expectations: Set clear expectations for the provider.
 Training: Provide resources for any training needs. Make sure during
“90-day-test-drive” that the provider is getting support.
 Feedback: Get feedback from the Provider to improve the practice.
Provide feedback during the “90-day-test-drive.
Recommendation

26. Goal Setting
 Prioritize Issues
 Rounding logs
 Standardized goals
 Tools to engage (e.g. LEAN)
 Research and identify benchmarks
 Set reasonable expectations
 Develop Action Plans
 Review with Key Players
Recommendation

27.  Many organizations are undertaking major organizational
initiatives (consolidation, ICD-10, EMR conversion)
 Poor change management lead to staff feeling:
 Unprepared to do their job
 Overwhelmed by the change
 “In the Dark” with what is going on
 Unsupported by the organization
27
4. The Need for Change Management
Challenge

28. 28
52% 50%
43%
34% 33%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Developing skills as a
physician
Keeping up with new
technology and info
Continuing education
within specialty
Remaining
comfortable
w/specialty choice
Compliance w/new
healthcare
regulations
Most Pressing Professional Issues
Top 5 Professional Concerns
ACEP 2013 Member Survey

29. 29
Top 5 Personal Concerns
ACEP 2013 Member Survey
75%
59%
33%
24% 23%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Maintaining Work
Life Balanace
Trying to build wealth Being Overwhelmed
w/workload
Upcoming Retirement Unsettled over
personal options
(finances, family, etc.)
Most Pressing Personal Issues

30.  Physicians want to participate
 Tools needed:
 Leadership training
 Leadership Council
 Answer the “Why”
 On the ground approaches: Standard work/LEAN
 Rounding
 Feedback and follow up
30
Change Management Essentials
Recommendation

31. Team Mentoring
 Team goals and mission established
 Recruit your Leadership Council
 Break projects in to teams with
leaders
 Recruit your teams from your
rounding knowledge
 Match skills and interest to
assignment
 Allow these groups to brainstorm
and give input
Recommendation

32. Team Mentoring
 Support your leaders
 Review action plan
 Help them identify the solutions
 Set a timeline and help them be accountable
 Each shift/room is a small group of leaders
 Team leaders: physician/charge nurse
 Goal: taking care of patients
Recommendation

33. Focus on Work-Life Balance9/13/2015 Stanford’s “time banking” program helps emergency room physicians avoid burnout | Scope Blog
Published by
Stanford Medicine
Emergency Medicine, Health and Fitness, Mental Health
Stanford’s “time banking” program helps
emergency room physicians avoid burnout
Holly MacCormick on August 21st, 2015 No Comments
For emergency room doctors, few things are more
important than time. They’re trained to work quickly and efficiently to gain the moments, minutes and hours
that can be the difference between life or death for a patient. Yet, few ER doctors have the luxury of time in
their personal lives.
According to a 2012 study, physicians’ work weeks are roughly ten to 20 hours longer than that of other
professionals. This means that it would take the average professional about a year and a half to accomplish
what a hard-working physician does in a single year. With a schedule like this, it’s no wonder that burnout is
an issue for many physicians.
So, Stanford’s Department of Emergency Medicine adopted a “time banking” program that allows doctors to
log the time they spend doing often under-valued activities, such as mentoring and covering colleagues’ shifts,
to earn credits for the work and home-related services that would normally gobble up their free time.
Recently, the Washington Post highlighted this time-saving initiative in a story featuring emergency
Recommendation

34. Leadership
Leaders are made, they are not born. They are made by hard effort, which is the
price which all of us must pay to achieve any goal that is worthwhile.

35. Thank You!
rparker@acep.com
www.acep.org
Follow me: @BeckyBP
Stay in Touch

36. Unified Talent Management (UTM)

37. How Can UTM Help Healthcare
Challenge Cornerstone Offering
Staff Shortages Recruiting & Onboarding
Building the Right Team Recruiting & Selection
Lack of Clear Onboarding Onboarding
Poor Change Management Learning & Performance
Cornerstone also offers a full range of Advisory Services

38. Questions?
• Q&A Discussion
• Please Enter Your Questions For the Speakers Directly
Into the Chat Box