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Healthcare Employee Retention: Best Practices

April 1, 2021
April 1, 2021

Taken from an Interview with Lori Knowles, Vice President of Human Resources, Memorial Hermann

In 2015, Memorial Hermann staff were working feverishly to keep up with demand for healthcare in their growing Houston service area. To accommodate the growth, Memorial Hermann was undergoing four major expansions and had two brand-new hospitals coming out of the ground. The system’s headcount was growing at 8-9% per year, which translated into a need for nearly 5,500 new employees annually. Although there was a dedicated push to hire new employees, this effort was hindered by the fact that the system had only an 85% organization-wide retention rate, with pockets of turnover at 25% among first-year nurses and in key areas such as the ED, ICU, and OR. Against this backdrop, leadership decided it was imperative that Human Resources (HR) take on the system’s first year retention issues.

Leadership Training Was Key

As part of its solution, HR developed a comprehensive leadership retention program titled “Retention Engine.” “Our biggest ROI came from training our leaders to take specific actions,” says Knowles. HR did a corporate road show to ensure that every leader in the system was trained on actions they could take to improve first year employee retention. Knowles met with leaders in groups of 10-15. Senior leadership at Memorial Hermann showed their support for these efforts by including turnover as a key metric in the corporate bonus program that impacted everyone at Memorial Hermann who was a manager or higher. “The result was that we had champions everywhere,” Knowles reports.

A Portal Full of Tools

To support leaders throughout the system, HR also developed a portal with 15 tools that units could access as needed. Some of the tools included:

  • Hire for Fit: A toolkit for managers on how to evaluate and interview job candidates, including all the legal rules managers needed to follow. The toolkit also contained a how-to guide for job shadowing which allowed candidates, especially those in high turnover areas such as ED, ICU, OR, and patient access call areas, to shadow current employees to obtain a first-hand feel for what the job would entail.
  • What fills your tank: An assimilation tool that is used prior to the employee’s first day on the job. New hires are asked what they are passionate about, their favorite foods and candy, their birthday, etc. This information allows the manager to prepare a customized welcome basket for the employee on their first day of work and provides additional, personal information about the employee that the manager could incorporate in activities throughout the year.
  • Onboarding roadmaps: Guidelines for managing the new employee’s first few months on the job. This toolkit included recommendations on who the employee should meet with on the first day, additional actions that should occur on the first day, what should happen after 10 days, etc. It also contained a primer on “25 ways to help new employees fit in.”
  • Stay interviews: Leaders were encouraged to talk regularly with their new employees to help speed up their journey from “outsider” to “insider.” Leaders helped new employees learn their “solar system” at Memorial Hermann, enabling them to be more organizationally savvy and nimble. Stay interviews provided a structured method for doing this, providing topics of conversation that are appropriate after the first 90 days, after the first 6 months, etc. At 6 months, leaders are coached to ask new employees the hard questions:
  • Are there specific reasons that you can think of that would make you leave Memorial Hermann?
  • What will keep you here?
  • Are we fully using your talents?

In addition to the portal, HR would regularly send reports to managers, reminding them who first year employees were. They would also send reports to remind managers which employees were ready for 6-month stay interviews and other key events. In return, managers were asked to report to leadership on why any 1st-year employee left the organization.

Impressive Results

Memorial Hermann’s program to reduce turnover was launched in the spring of 2015. By the end of 2016, the overall retention rate had jumped from 75% to 88%. This rate equated to 1,064 employees being retained who would have otherwise been lost, saving the health system millions of dollars. Memorial Hermann spent $18 million on the retention program, including benefit enhancements, and, after these expenses, they achieved a net savings of $46 million.

Here are a few additional outcomes the team noted along the way:

  • The system realized its highest retention among employees who participated in Stay Interviews.
  • The system saw a 95% retention rate among employees who participated in the student loan repayment program.