This document discusses strategies for retaining excellent staff in behavioral health organizations. It begins by outlining some key objectives: to learn what research says about staff retention, explore how this relates to one's own organization, and develop concrete strategies. Several retention studies and frameworks are then reviewed. Research shows that turnover rates can be high in behavioral health, and replacing staff is very costly. The most important factors for retention and productivity are the quality of relationships between staff and supervisors, and staff having opportunities to do meaningful work. Specific strategies are proposed, such as focusing on work-life balance, professional growth, strong relationships, and giving staff a sense that their work has purpose. The document emphasizes applying a retention mindset at all levels of an

1. Building & Keeping the Best Staff
Retention Strategies for the Real World
Jeanne Supin, MA, NCCBH
Consultant & Watauga Consulting
Terry Haru,PhD, Heritage Behavioral
Health Center

2. Session Objectives
Learn what the best research says about
retaining excellent staff
Explore how this relates directly to your
staff and your organization
Develop concrete strategies to apply back
home

3. World Café
World Café is a method for creating
dynamic conversations, sharing
knowledge, and exploring
strategies around questions that
matter to you and your work.

4. World Café Etiquette
FOCUS on what matters
CONTRIBUTE your thinking
SPEAK from your mind & heart
LISTEN to understand
LISTEN TOGETHER for insights, patterns &
deeper questions
PLAY, DOODLE, DRAW – write on the tables
HAVE FUN!
The World Café Resource Guide, by Juanita Brown (2002)

5. Discussion
Introduce Yourselves.
Why Are You Here?

6. Turnover Trends in Behavioral
Health
Turnover rates for case management and
paraprofessional staff can be as high as 30-50%
Turnover rates for clinical staff can be 20-30%
Recruitment of specialty clinical staff is difficult,
to say the least
Psychiatrist recruitment is extremely difficult

7. Losing Staff Affects …
Client & family engagement
Continuity of care
Service capacity
Financial bottom line

8. Calculations
Direct cost to fill a $60,000 job ranges from
$9,777 to $49,000
Other studies suggest replacing an
employee can cost (direct & indirect) more
than 3 times the annual salary

9. Direct Costs
Placement, advertising fees
Interview costs
Hiring, bonus, relocation costs
Training cost
Administrative expenses

10. Indirect Costs
Care discontinuity Learning curve
Lost revenue due to Staff stress
vacancies Organizational image
Lost training &
experience
“Ramp up” time

11. General Turnover Trends
Unemployment rate is only very slightly higher
(5.4%) than in the boom years in late 1990’s (4.6
average)
Baby Boomers will begin retiring in 2011, with
likelihood many will retire early (60% by age 62)
Estimate a skilled labor gap crisis will begin 2005
Source: John Izzo & Pam Withers, Values Shift: The New Work Ethic and
What it Means for Business

12. Additional Changes in How
Employees Perceive Work
Work is no longer considered the primary
focus of one’s life
Paradox: employees also want their work to
be meaningful and offer real fulfillment
Employees are more committed to their
own work, their own professional growth &
development than to an organization

13. "In these days of talent wars, the best
way to keep your stars is to know them
better than they know themselves – and
then use that information to customize
the careers of their dreams”
Timothy Butler and James Waldroop, Job Sulpting – The Art
of Retaining Your Best People, Harvard Business Review,
Sept/Oct 99

14. Change Tables!
1. Three people from each table find new,
different tables to join.
2. A host remains at the original table to
share the table’s history with its new
participants.
3. Once settled, please …
Introduce yourselves
Briefly share your thoughts, insights, learnings
from your previous group

15. Discussion
Why do staff leave your
organization?
Why do they stay?

16. Gallup Organization Research
Authors Marcus Buckingham & Curt Coffman
25 years worth of interviews
1,939 workgroups in 26 organizations, 21
industries around the world
Over 1 million workers
First Break All the Rules: What the World’s
Greatest Managers Do Differently (Simon &
Schuster, 1999)
Q12

17. Most Important Variable in
Productivity & Retention
Assuming reasonably competitive pay, the
most important productivity & retention
variables is:
NOT pay or benefits
NOT commitment to the mission
It’s the quality of the relationship between
employees and direct supervisors

18. Not Pay & Benefits?
Pay, benefits, senior management & org structure
were initially on the list but dwindled under
analysis
They are important, but they are equally important
to all employees – good, bad, mediocre
According to the Gallop research, competitive
pay & benefits will get you employees but they
won’t encourage the great ones to stay

19. Gallup Organization Q12
1. I know what is expected of me at work.
2. I have the materials & equipment I need to
do my work right.
3. At work, I have the opportunity to do what
I do best every day.
4. In the last seven days, I have received
recognition or praise for doing good work.

20. 5. My supervisor, or someone at work, seems
to care about me as a person.
6. There is someone at work who encourages
my development.
7. At work, my opinions seem to count.
8. The mission or purpose of my company
makes me feel my job is important.

21. 9. My fellow employees are committed to
doing quality work.
10. I have a best friend at work.
11. In the last six months, someone at work
has talked to me about my progress.
12. This last year, I have had opportunities at
work to learn and grow.

22. High Scores Mean Higher:
Productivity
Profit
Employee retention
Customer satisfaction

23. Specific Retention Questions
1. Do I know what is expected of me at work?
2. Do I have the materials & equipment I need to do
my work right?
3. Do I have the opportunity to do what I do best
every day?
5. Does my supervisor, or someone at work, seem to
care about me as a person?
7. At work, do my opinions seem to count?

24. These 5 questions are most directly
influenced by managers, not companies.
Employees stay with or leave managers, not
companies
They may join your organization because
it’s the type of work they love, but they stay
because they have a great boss.

25. McKinsey & Company
“War for Talent 2000”
Surveyed 6,900 corporate officers, top
executives, midlevel managers
56 companies

26. McKinsey’s 7 Talent Imperatives
1. Talent mindset at all levels
2. “Extreme Employee Value Propositions”
– compelling reasons why someone wants
to work for you (great organization,
leaders, job & attractive compensation)
3. High-performance culture that combines
strong performance ethic and open &
trusting environment

27. 4. Recruit great talent continuously
5. Develop people to their full potential
6. Make room for talent to grow
7. Focus on retaining high performers
“War for Talent II: Seven Ways to Win,” Fast Company, January 2001

28. John Izzo & Pam Withers
Values Shift: The New Work Ethic and What
it Means for Business
Studied 200 companies
Not just typical dissatisfaction,
Profound culture shift in which people are
asking themselves fundamental questions
about what they want from their work

29. Six Suggestions
1. Proactively offer meaningful ways to
improve work / life balance & synergy
2. Actively promote sense of deeper cause
3. Promote & support professional growth &
development
4. Treat employees like partners
5. Create community in the workplace
6. Maintain mutual trust

30. Some Results
Izzo & Withers found staff turnover falls up to
50% when employees are offered benefits like
child-care subsidies, elder-care programs, flexible
hours
Productivity increases about 20% after
organizations implement work/life balance
programs
Source: John Izzo & Pam Withers, Values Shift: The New Work Ethic
and What it Means for Business

31. Discussion
Now that you’ve heard the
research, how might your
answers be different about why
your staff stay
and
why they leave?

32. Discussion
Based on the research, list all the
things about your organization
(your structure, your practices,
your leadership, your managers,
your culture, your pay …) that
might cause staff to leave.

33. Most research about
employee retention and
excellent performance
shares the following
common themes.

34. Employee Themes:
Reasonable compensation
Ability to do excellent work
Professional & personal integration and
synergy
Strong relationships
Sense of meaning

35. Organizational Themes
Demonstrated alignment between vision,
mission, values and everything else!
Highest quality
Performance excellence
Successful infrastructure
Strong relationships
Sense of meaning

36. Employee Themes

37. Reasonable Compensation
Reasonable related to industry and
community comparisons
Does not have to be the highest but has to
be within an acceptable range
Assuming “reasonableness” it really isn’t
the most important variable for retention &
performance excellence

38. Ability To Do Excellent Work:
Am I the best fit for my job?
Do I know what’s expected of me?
Do I have everything I need?
Can I do my best every day?
Can I achieve the best possible results?
Can I grow and develop professionally?

39. Professional & Personal
Integration and Synergy
Can I align my professional and personal
values?
Can I take care of both my professional and
personal responsibilities, goals, desires?
Does someone care about me at work?
Can I find a sense of community at work?

40. Strong Relationships
Do I have a great supervisor?
Do my opinions seem to count?
Can I help make improvements?
Do I trust others in the organization?
Do I believe the organization has a culture
of honesty?
Can I be honest and trustworthy?

41. Sense of Meaning
Does my work feel meaningful?
Does my work lift my spirit and fill my
soul?

42. Change Tables!
1. Three people from each table find
new, different tables to join.
2. A host remains at the original table
to share the table’s history with its
new participants.
3. Once settled, please …
Introduce yourselves
Briefly share your thoughts, insights,
learnings from your previous group

43. Discussion
Considering employee themes from
your own perspective as an employee …
To which questions can you answer the most
resounding YES!
Which questions generate less enthusiasm?
How do your answers affect your
performance & commitment?

44. Discussion
Now consider these questions from your
employees’ perspectives …
Where might their resounding YES! be?
Where might you get less enthusiastic
answers?
How might their experiences affect excellent
performance & retention?

45. Organizational Themes

46. Foundation is Critical
Virtually all organizations have a vision,
mission, and values
But … few really use these as the drivers
for key, explicit, measurable indicators of
individual, team, and organizational
performance

47. Foundation as the Driver
How do we directly link our vision,
mission, values to all we do and
communicate this organization-wide on a
regular basis?
How do we demonstrate our accountability
for this link?
How do we continuously strengthen this
link?

48. Highest Quality
Do we set and strive for the highest possible
quality and outcomes?
Do we embrace and implement best
practices in all we do?
Do we live a culture of real continuous
quality improvement?

49. Excellent Performance
Do we recruit for the best talent?
Do we ensure the best fit between employee and
job?
Are our expectations clear?
Do we provide ongoing, meaningful feedback and
valuable performance reviews?
Do we spend the vast majority of our time,
attention, and money on those who do excellent
work?

50. Successful Infrastructure
Do our policies, structures, and practices support
excellent work and talent?
Are we flexible, emphasizing individual strengths
and quality outcomes?
Do we lavish managers & supervisors with
training, guidance, mentoring, support, time, and
energy toward their success?
Do we encourage, allow, and reward managers &
supervisors to do the same with their employees?

51. Strong Relationships
Do we value strong, healthy, collaborative
relationships?
Do our structures and practices support strong,
healthy, collaborative relationships?
Can employees actively participate in continuous
quality improvement?
Do we encourage honesty and trustworthiness?
Are the top leaders honest and trustworthy?

52. Sense of Meaning
Is our vision & mission clear, meaningful,
and truly inspiring?
Does everyone know, understand, support,
and embody our vision & mission?
Can our consumers, families, and
employees find real meaning in what we
do?

53. Change Tables!
1. Three people from each table find new,
different tables to join.
2. A host remains at the original table to
share the table’s history with its new
participants.
3. Once settled, please …
Introduce yourselves
Briefly share your thoughts, insights, learnings
from your previous group

54. Discussion
Relating to organizational themes,
where is your organization most
successful? Why?
Where are your organization’s most
significant challenges? Why?

55. “Recipe” Review
We have distributed several “recipes” that
describe what some organizations have
done to retain excellent employees.
These are just a few examples to use as you
wish.
We know all of you have implemented
many different strategies and there are
many other examples out in the field.

56. Discussion
If you could cut your turnover
rate in half what would that
mean for your organization?

57. Discussion
What are the most challenging
themes (employee or
organizational) for your
organization?
What might you & your
organization do to improve those
areas?

58. Discussion – All Participants
What are your improvement
ideas?

59. Discussion
What can you do in the next
three months to initiate these
strategies to improve your
organization’s retention of
excellent employees?

60. Discussion – All Participants
Share some of the initiatives you identified at
your table?
What else might you take home with you?
What might you need – from all of us here
and/or others – to help you put these ideas
in action once you get home?

61. World Café
World Café is a method for creating
dynamic conversations, sharing
knowledge, and exploring
strategies around questions that
matter to you and your work.

62. Use the World Café …
With groups sized 12-1200
When you have 1 ½ or more hours available
If you want to get input, share knowledge, explore
possibilities
When you want to encourage authentic,
meaningful conversations about things that matter
When exploring in-depth, strategic possibilities

63. World Café Design Principles
Clarify the Context
Create hospitable space
Explore questions that matter
Encourage everyone’s contribution
Cross-pollinate diverse perspectives
Listen together for insights and deeper questions
Harvest & share collective discoveries
Have fun!

64. World Café
Created by Juanita Brown & David Isaacs
www.theworldcafe.com
Whole Systems Associates
166 Homestead Blvd.
Mill Valley, CA 94941

65. Presenters
Jeanne Supin, NCCBH consultant
Watauga Consulting
Boone, North Carolina
jeanne@supin.com
828.265.0367
Terry Haru
Heritage Behavioral Healthcare
Decatur, Illinois
tharu@heritagenet.org
217-420-4706