10 strategies to improve healthcare staff retention for your practice

As a new medical practice owner, here's something really important you should know: Employee turnover is inevitable.

You will spend a significant amount of time and resources recruiting, hiring, and training employees, only to have them hand in their notice when you don't expect it — and, inevitably, when it's least convenient for the practice. 

Like many other industries, healthcare has seen a great exodus in the recent past, and some sources estimate that it has lost as much as 20% of its workforce. The 2023 NSI National Healthcare Retention & RN Staffing Report found that the overall hospital turnover is 22.7%, while the RN-specific turnover rate is 22.5%. While the turnover rate for hospital-based healthcare workers is higher than for those in private practices, it's still cause for concern.

And with good reason. Excessive turnover can be extremely detrimental — and costly — to a medical practice. When too many employees leave too frequently, it can disrupt patient care workflows, negatively impact team dynamics, rack up recruitment and training costs, and impact productivity and morale. Perhaps the most important effect of someone leaving is the loss of belief in the capabilities of the medical practice without that essential player.

On the flip side, when you bring together a cohesive, experienced team, magic happens. A great team works together to improve patient care, increase efficiency, foster a positive work environment, and contribute to the practice's success and reputation in the healthcare community. In other words, low employee turnover is a good indicator of a positive medical practice environment. The work culture in a medical practice can set the mood for both staff and patients. A high employee turnover rate reflects poorly on the medical practice, negatively impacting its reputation in the community.

Members of your team will leave your practice for all sorts of reasons and, as an employer, your response should always be to wish them well in their next endeavor. And while it may not be possible to eliminate turnover entirely, you can (and should) take proactive steps to understand why employees leave and then do everything you can to create an environment that makes them want to stay. 

When analyzing your employee turnover rate, start by determining who is leaving and why they are going. If it is the new hires, perhaps there is a lack of sufficient training or more senior staff are too demanding. Is there a gap between what you expect employees to do and what they actually can do? If it is the senior staff leaving, are there opportunities to expand their skills and offer them incentives?

Consider incorporating the following strategies into your practice management to reduce turnover rates, build and maintain a cohesive and experienced team, and avoid the expenses associated with recruitment, onboarding, and lost productivity.

Follow these steps to retain talent at your practice.

To attract and retain talented healthcare professionals and administrative staff, your practice needs to offer competitive wages and the most comprehensive benefits package that you can afford. At a minimum, you should include plenty of paid time off for vacations, holidays, and sick leave, as well as health insurance.

In addition to healthcare coverage, consider offering life, short- and long-term disability, hospital indemnity, and other types of insurance, and cover malpractice premiums for other providers. Sponsor a retirement plan and match employee contributions up to a certain percentage if possible.

Expect to regularly review and adjust compensation to stay aligned with industry standards and the market in which you operate. Yearly bonus, profit-sharing arrangements, and opportunities for physicians to become partners or shareholders in the practice can also attract talent. 

Many organizations claim to support a healthy work-life balance for employees without putting the mechanisms or systems in place to make it possible. Offering ample paid vacation days so that employees have the chance to rest and recharge is really important, but meaningless if your staff is never able to use their leave because the practice can't function without them. 

Instead, implement meaningful policies that support balance, such as ensuring all staff members work a reasonable number of hours, offering flexible scheduling options, and cultivating an environment where the practice encourages people to stay home when they're ill and to take their vacation days. Have reasonable policies in place for sudden employee emergencies — and if an employee seems to face regular sudden emergencies over time, have a conversation to find out whether there are deeper issues at play. If the practice has more than one location, consider rotating staff since one address may seem more challenging than another for various reasons. This way everyone has a fair work schedule.

Establish generous and supportive time-off policies that enable your staff to take vacations, personal days, and parental leave without feeling guilty or overwhelmed. Encourage individuals to disconnect from work during their time off to ensure proper relaxation and rejuvenation. Lead by example. As the boss, you set the tone, so don't email or call employees outside of work hours.

Creating a well-designed onboarding program ensures that new employees feel welcomed, supported, and equipped with the knowledge and skills they need to excel in their roles. Identify key members of your existing staff who can assist in bringing in the new employee. Don't forget to reward those who show leadership with new staff. Your current staff will learn, too, when the new person comes onboard. Be sensitive to those staff who may feel that the newcomer may threaten their job. Always, try to stress strong team building.

By providing a set, structured introduction to your practice's culture, values, policies, and procedures, you will help staff quickly acclimate and align themselves with your organization's mission and empower them to develop the skills and expertise they need to deliver high-quality patient care. Make sure your office manager provides needed highlights regarding everything from practice policies to issues with compensation or benefits. Many policy manuals are difficult to interpret.

If your employees feel supported and empowered through effective onboarding and ongoing training, they are more likely to be engaged, motivated, and committed to the collective work of your practice. This, in turn, fosters a positive work environment, improves employee satisfaction, and ultimately enhances retention rates, reducing turnover and promoting long-term success. 

Building a culture of continuous learning and professional growth within your practice is a great way to engage your staff and promote retention. Research suggests that 94% of employees would stay at a company longer if they believed that the company had invested in helping them learn. In addition to providing specific professional development opportunities, remember that learning happens daily in a medical practice. Encourage providers to be especially cognizant of their ability to teach and lead.

Most clinical roles have a continuing education requirement for licensure. Therefore, offer ample paid time off and reimbursement for staff to attend conferences, workshops, and training sessions. This will help them enhance their skills and knowledge and stay abreast of developments in your field. Consider making similar opportunities available to non-clinical staff and support career advancement through mentorship programs, tuition reimbursement, or pathways for promotion within your practice. In some instances, both clinical and non-clinical staff may take courses together, like basic life support (BLS) training.

Today's workforce expects access to modern, digital tools, so investing in technology can be a way to increase engagement and retain employees at your practice. Upgrading to modern technology not only makes your clinical processes more efficient and effective, it also improves the overall work experience for the healthcare professionals on your team. 

Cutting-edge tools, such as electronic health records (EHR), telemedicine platforms, advanced diagnostic tools, and analytics, streamline administrative tasks, reduce paperwork, and enable seamless collaboration among your team and the other healthcare professionals caring for your patients. This allows your staff to focus more on patient care and less on administrative burdens, leading to higher job satisfaction and reduced burnout. 

Furthermore, investing in innovative technology demonstrates your practice's commitment to staying at the forefront of the healthcare industry, making it an attractive workplace for forward-thinking professionals. When employees feel supported by modern tools that facilitate their work and enhance patient outcomes, they are more likely to be engaged, fulfilled, and motivated to stay with the practice for the long run.

Be sure to let everyone in the office know that improved technology does not replace human interaction among staff and patients.

As the owner of the practice, it's your job to establish open and transparent internal communication channels.

Clear communication ensures that information is transmitted accurately, efficiently, and transparently among clinical staff, administrative staff, and management. This reduces the likelihood of misunderstandings, errors, and miscommunication that could impact patient care or cause frustration and dissatisfaction to fester among your team.

Open channels for feedback allow employees to share their thoughts, concerns, and suggestions, and so create a culture of empowerment and continuous improvement. Constructive feedback helps identify areas for growth and development, enabling the practice to adapt and excel in an ever-changing healthcare landscape. A robust communication and feedback system fosters collaboration, strengthens teamwork, enhances employee engagement, and ultimately contributes to better patient outcomes and a positive work environment.

Routinely and actively encourage staff members to voice their opinions, ideas, and concerns. Conduct regular performance evaluations and provide constructive feedback to help staff improve and grow in their roles. Encourage 2-way communication to ensure that staff feel heard and valued.

A great way to foster communication is to call impromptu meetings after a challenging day. Another alternative is to encourage everyone to meet for lunch in the break room. 

If you want to retain employees, one of the most important things you can do is find ways to regularly acknowledge and appreciate the hard work and achievements of your staff. 

Acknowledging and appreciating the efforts and achievements of clinical and administrative staff not only boosts morale, but also reinforces a sense of value and purpose in their roles. Meaningful recognition can take various forms, such as verbal praise, public appreciation during team meetings, and written notes of gratitude. This might mean implementing recognition programs, such as employee of the month/year awards or a peer-to-peer recognition system, or celebrating milestones and anniversaries. 

When you let your employees know that you truly value their contributions, it creates an environment where people feel seen, heard, and appreciated for their hard work. It also instills a sense of pride in one's work, fostering a strong sense of loyalty and commitment to the practice. When employees feel valued and respected, they are more likely to be motivated, engaged, and willing to go the extra mile in their duties. Moreover, meaningful recognition establishes a culture of appreciation and camaraderie, leading to higher job satisfaction and a reduced likelihood of turnover. As a result, your practice will have an easier time retaining top talent, ensuring continuity in patient care and building a reputation as an employer of choice in your community. 

While verbal praise may boost egos, when staff feel valued it feeds their souls.

And don't forget we live in a monetary society: bonuses and raises are very important, too.

You've worked hard to get your practice off the ground, so it's only natural to feel protective of the organization you're building. At the same time, finding ways to foster a sense of ownership and engagement among your team can be a powerful way to cultivate a motivated and dedicated team. When you empower your team to take ownership of their roles, decisions, and contributions, they become more invested in the success of the practice.

Remember there is a reason that your staff work in the medical field. There are special rewards when patient care exceeds expectations because of the staff's actions. Simple reminders from the providers about how important the staffs' actions were for a particular patient outcome are very important. 

Finding ways to encourage autonomy, accountability, and involvement in decision-making processes instills a sense of pride and responsibility. Providing opportunities for professional growth and recognizing individual and team achievements further nurtures a culture of engagement. When employees feel valued and connected to the practice's mission, they are more likely to go above and beyond in their work, leading to improved patient care, higher job satisfaction, and reduced staff turnover.

Burnout is one of the biggest causes of staff attrition, so finding ways to help prevent and cope with burnout and help employees achieve a healthy work-life balance is critical to preventing employee attrition. Make sure staff have the necessary support. One person may not be enough for certain tasks, so recognize that and implement changes, if needed.

If possible, provide your team with access to resources such as stress management workshops, mindfulness training, yoga or exercise classes, employee assistance programs, and mental health support. Encouraging a culture of self-care is an important part of achieving work-life balance, and one of the best ways to achieve this is by modeling it yourself. 

Unfortunately, most healthcare professionals don't need a statistic to tell them that they are part of a workforce uniquely and disproportionately at risk of workplace violence. The Bureau of Labor Statistics found that healthcare workers accounted for 73% of all nonfatal workplace injuries and illness due to violence in 2018 — and incidents are on the rise. In 2022, 48% of nurses reported an increase in workplace violence, up from 30.6%. 

Violence from patients toward healthcare staff is complex and multi-faceted. First, healthcare settings can be emotionally charged environments where patients may experience pain, fear, or frustration, which can contribute to heightened emotions and potential aggression. Second, healthcare professionals have a duty to provide care and support to patients, even in challenging situations, which can make it difficult to navigate conflicts and prevent violence. Third, healthcare workers often face time constraints, heavy workloads, and limited resources, which can exacerbate tensions and increase the risk of violent incidents. 

At the same time, your team cannot provide safe, attentive, and high-quality care when they are afraid for their personal safety, distracted by disruptive patients and family members, or traumatized from prior violent interactions. As an employer, you must adopt a comprehensive plan to address disruptive or threatening behavior and enforce a policy of zero tolerance for violence in your practice. Your approach should include training, policies, resources, and a supportive work environment to ensure the safety and security of both patients and healthcare professionals.

Policy development: Develop a comprehensive policy that clearly outlines the practice's commitment to zero violence against healthcare workers. The policy should define what constitutes violence, including physical, verbal, or psychological abuse; threats; and harassment, and should apply to both staff and patients. It might also outline parameters around patient interactions and the populations for whom the practice is equipped to care. For example, some patients may be better served in a hospital setting rather than the medical office.

Training and education: Provide regular training sessions to all staff members to raise awareness about the zero-violence policy. This training should include identifying signs of potential violence, non-violent communication and de-escalation techniques, and appropriate response protocols. Consider providing training on self-defense and personal safety if deemed necessary.

Security measures: Implement security measures to enhance the safety of healthcare workers. This may include controlled access to certain areas, surveillance systems, panic buttons, and security personnel presence where needed. Adequate lighting, clear signage, and secure parking facilities can also contribute to a safer environment.

Reporting and response procedures: Establish clear reporting procedures for incidents of violence. Encourage staff members to report any instances of violence they experience or witness, and ensure that the reporting process is confidential, accessible, and free from fear of retaliation. Develop protocols for responding to reported incidents promptly, including involving appropriate authorities and providing support to the affected healthcare professionals.

Staff support and debriefing: Provide support and debriefing services to healthcare professionals who have experienced violence. This may include access to counseling, psychological support, or employee assistance programs. Encourage open communication and create a safe space for healthcare professionals to share their experiences and seek support.

By implementing a zero violence policy and taking proactive measures, your medical practices can create a culture that prioritizes the safety of your staff and demonstrates your commitment to their physical, mental, and emotional health.

Navigating the complexities of employee retention in the medical field can be a daunting task for any new practice owner. The healthcare industry's high turnover rates underline the multifaceted challenges that medical professionals face daily. However, the solutions to these challenges are not insurmountable. 

As highlighted throughout the article, a combination of competitive compensation, a healthy work environment, continuous professional development, modern technology, open communication, meaningful recognition, and an unwavering commitment to safety can significantly reduce employee attrition.