Retention Strategies for the Care Continuum: Leadership by Example

April 1, 2021
April 1, 2021

Staff retention has become a major challenge across the care continuum, affecting the entire healthcare industry in terms of care quality and outcomes, not to mention patient and family experiences. This blog post is the first of four excerpting the HealthStream article, “Solving the Retention Problem across the Care Continuum.”

The growth in retention’s importance is 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) and the possibility of rising minimum wages across the industry. This growing 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 Cost of Retention

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).

The Importance of Leadership to Retention

Another very important component of the retention puzzle is found in how organizations are led. In “Why They Stay: Retention Strategies For Long Term Care,” Joanne Smikle offers that “Leadership behavior is a forceful driver of commitment and retention.” Smikle shares that in her research, “Employees freely, often emotionally, cited examples of ways in which leaders throughout the organization have impacted their lives.” She adds, “One such story was shared by a CNA, who detailed a practice that is commonplace in her facility. In her own words: ‘When your bosses come around and they know what section you work in, every morning they walk in and they look and they tell you, “You know, your section looks good, you’re doing a good job,” it motivates you to do a good job and try to do better. It means a lot to that staff member because you know that they recognize your work, and especially when they call you by your name. It makes a lot of difference when they call you by your name’” (Smikle, 2015).


Lowe, Graham, “How Employee Engagement Matters for Hospital Performance,” Healthcare Quarterly, 15(2):29-39 (April 2012, Retrieved at

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

Smikle, Joanne, “Why They Stay: Retention Strategies For Long Term Care,” Provider Magazine, November 2015, Retrieved at http://www.provider­

Download the full article here.