Four Ways to Improve the Retention Problem across the Care Continuum

April 1, 2021
April 1, 2021

Staff retention has grown to be one of the most significant challenges across the care continuum, affecting the entire healthcare industry. Retention is growing in importance, due not only to the increased size of the care population, but also from the more than 10-year low for unemployment rates (4.3% for May 2017) as well as the possibility of rising minimum wages across the industry. Simultaneously, this growing area of the healthcare industry is experiencing an influx of jobs and increase in benefits, making voluntary turnover prevalent among those employees looking for more pay, less stressful work environments, and more positive company culture. In addition, “It is not just the turnover of direct care staff that plagues this profession— administrators and other managers churn as well” (Salela, 2017).

The bottom line is that turnover is expensive, especially in terms of onboarding costs and the time spent in training new employees. Employee engagement is a key measure for any healthcare organization that is trying to retain competent staff. As one study shares, “It is widely assumed that more-engaged employees stay and contribute [to the organization]. While close to half of disengaged employees will be job hunting in the next 12 months, only one in 10 of those who are highly engaged will be looking for a new job with a different employer. In other words, 90% of highly engaged employees plan to stay with the organization, at least for the near future” (Lowe, 2012). What the research makes clear is that “Improving engagement therefore carries another important advantage for the [healthcare organizations] already competing to find and keep a dwindling supply of people with critical skills, especially in clinical areas” (Sherwood, 2013).

What are some of the tools that organizations across the care continuum can adopt in their efforts to improve retention?

Training and Workforce Development Opportunities

One important tool is training and staff development. In an article from McKnight’s Long-Term Care News, author Alyssa Salela references one industry expert, who states, “Employees feel more rewarded when they have tools to do a great job, which leads to higher retention rates” (Salela, 2017).

Leadership by Example

Another very important component to the retention puzzle is found in how organizations are led. In Provider Magazine, Joanna Smikle offers that “Leadership behavior is a forceful driver of commitment and retention.” In her research, “Employees freely, often emotionally, cited examples of ways in which leaders throughout the organization have impacted their lives” (Smikle, 2015).

Fostering Community and Connectedness

Smikle states that “A sense of connectedness emerged as a central, driving factor in commitment and retention. Whether the connections are to managers, peers, or residents, the human connection is a profound and undeniable theme. The voices shared through the interviews told stories of relationships, bonds, and connections” (Smikle, 2015).

Identification with an Organization’s Mission

Smikle pinpoints the role of identification with the corporate mission as an important contributor to engagement. She suggests that “Crafting a meaningful mission and integrating it into the culture of the organization served the organization in this study well.” In addition, “Employees from all levels and functions mentioned the mission and its impact on their work. Employees repeatedly identified the corporate mission as an important part of how they conduct the business of elder care” (Smikle, 2015).

Learn more about HealthStream solutions for workforce development across the care continuum.


Salela, Alyssa, “Training pays off when looking at retention in LTC, panel members say,” McKnight’s Long-Term Care News, June 13, 2017, Retrieved at

Sherwood, Rick, “Employee Engagement Drives Health Care Quality and Financial Returns,” Harvard Business Review, October 30, 2013, Retrieved at

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