2014 alfa conference reducing turnover by Argentum

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Will They Stay Or Will They Go? Reducing Turnover through Improved Hiring Practices in Long-Term Care Frederick P. Morgeson, Ph.D. Morgeson Consulting and Michigan State University Scientific Advisor, HealthcareSource www.morgeson.com fred@morgeson.com 20 – May – 2014 #ALFA2014  2014 Frederick P. Morgeson. All rights reserved.

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The turnover problem

Why people leave

The hiring process as a key solution – Recruitment – Selection – Onboarding

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The Turnover Problem

ClickTurnover to edit Master is Highâ&#x20AC;Ś title style

ClickTurnover to edit Master is High… title style • • • • •

Median Registered Nurse Tenure Rates Offices of Physicians = 1.57 years General Medical and Surgical Hospitals = 1.50 years Specialty Hospitals = 1.20 years Home Health Care Services = 1.17 years Nursing Care Facilities = .97 years

National Median: 4.40 years

Click to …Is edit Master Costly…title style • Nurse turnover costs – $42,000-64,000 per nurse – 150 nurses and 20% turnover • Yearly estimated cost of $1.25-2 million a year

– Average facility loses $300,000 per year for each percentage increase in annual nurse turnover

Click …Is to Costly edit Master Because… title style • Financial costs

• Training costs

– HR staff time – Manager’s time – Contingent/ temporary staff

•

– Formal and on-the-job training – Mentoring – Socialization – Productivity loss

Replacement costs

• Organizational costs – – – –

– New hire’s compensation – Hiring inducements – Orientation program time

Quality of care Accidents/errors Teamwork Loss of patients

â&#x20AC;ŚAnd Click toLikely edit Master to Be Increasing title style Top 10 Occupations with the Largest Projected Employment Growth Occupation 1. Personal care aides 2. Home health aides 3. Medical secretaries 4. Medical assistants 5. Registered nurses 6. Physicians and surgeons 7. Receptionists and information clerks 8. Licensed practical and licensed vocational nurses 9. Construction laborers 10. Landscaping and grounds keeping workers

Employment 2010 2020 861 1,468 1,018 1,724 509 719 528 690 2,737 3,449 691 859 1,049 1,297 752 921 999 1,211 1,152 1,392

Change Number % 607 71 706 69 210 41 163 31 712 26 168 24 249 24 169 22 212 21 241 21

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Why People Leave

Click What to editIsMaster Turnover? title style • Turnover – The departure of employees for any reason

• Involuntary turnover – Departure initiated by the organization (often including those who prefer to stay)

ClickClassifying to edit Master Turnover title style Turnover

Voluntary

Functional

Involuntary

Dysfunctional

Unavoidable

Avoidable

False Positives

ClickWhy to edit People Master Leave title style Shocks/Scripts

Withdrawal Process

Turnover Drivers • • • • •

Work Design Leadership Relationships Work Environment Individual Characteristics

Key Attitudes • Job Satisfaction • Organizational Commitment

• • • •

Thinking of Quitting Job Search Alternatives Turnover Intentions

Turnover

ClickWhy to edit People Master Leave title style Nurses are four times more dissatisfied than workforce in general… 0%

10%

Shocks/Scripts

20%

30%

40%

50%

60%

Lack of advancement opportunities

Work overload Poor salary Too few staff Poor organizational culture

Withdrawal Process

Key Attitudes • Job Satisfaction • Organizational Commitment

Lack of mentoring • Thinking of Quitting Poor personal fit with boss • Job Search Turnover • Alternatives Limited or not enough access to technology • Turnover Intentions Lack of training Not enough time with patients Too many administrative tasks Lack of interesting assignments Poor shift availability Poor personal fit with coworkers

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The Hiring Process as a Key Solution Recruitment

Selection

Onboarding

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Big Applicant Pool

Recruitment

Small Applicant Pool Job Candidates

Selection

Hires

Onboarding New Employees

Click to edit Recruitment Master title style • Traditional purpose of recruitment – Develop an appropriate number of applicants – Meet goals regarding workforce composition – Increase the success rate of the selection process

• But, could also focus on turnover… – Potential implications for • Recruitment messages, sources, and activities

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Recruitment forMaster Retention: Click to edit titleSources style • Sources vary in retention rates • Focus on sources that produce higher levels of retention – Employee referrals – Previous employees

Recruitment forMaster Retention: Activities Click to edit title style • Realistic job previews (RJPs) – Provide important and candid information about the job and the organization to the candidate

• They work… – Reduce initial job expectations – Self-selection based on fit – Honesty builds commitment

Click to edit RJPMaster – Liststitle style Negative • Work around people with contagious diseases; bodily fluids and blood • Work holidays, evenings, or weekends • Work 10+ hour shifts

• • • • •

Positive Help your community Make a difference in people’s lives Develop relationships with residents Develop and learn Never boring; always changing #ALFA2014

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Click to edit Selection Master title style • The procedures employers use to determine which candidates to choose for particular jobs within the organization • Basic principles – More applicants than open positions – Variability in capabilities OR tendencies that can be measured before hiring – Use this information to hire “better” people

Click Selection to edit Master for Retention title style • What constitutes “better” people? – Traditional approach is to focus on job performance – Yet, applicants possess characteristics and tendencies that are predictive of turnover

• Can measure these prior to hiring to predict turnover likelihood

Will they stay or leave?

Selection Retention: Three Click toforedit Master titleDomains style Biographical Data (Biodata) • Information on past behavior, life experiences, feelings about specific situations • Indication of embeddedness and habitual commitment

Work Attitudes

Personality

• The positive or negative evaluations made about people, issues, or objects • Confidence and employment motivation

• Stable individual characteristics • Conscientiousness and emotional stability

ClickSelection to edit Master Examples title style Biodata

• How many of your close personal friends work for this organization? (EMBED) • How many months did you work at your last job? (HabComit)

Attitude

• I expect to do well at this organization. (SC) • Once I make a decision, I feel fairly confident that it is a good one. (DEC) • I feel very committed to this organization. (MOT)

Personality

• I put a great deal of effort into my work. (C) • I become irritated when others criticize me. (ES)

Click Selection to editfor Master Retention: title style Fit Focus on the fit between workers and the job/team/organization

Person

Job Team Org.

The Varieties of Fit Needs-Supplies Match between individual needs and what the job or organization provides

Demands-Abilities Match between individual abilities and the job or organizational demands

Values Match between worker values and organizational values

Click toAedit Focus Master on Fit title style Mary Swartz, Vice President of Human Resources, Ebenezer Society

"We aren't just looking for people with a certain certification or degree. We also are looking for people with the passion and intrinsic motivation that makes them view their work as more than simply a job." Ryan Ellis, Director of Organizational Development, EMA Communities

Click What to edit is Onboarding? Master title style • The process of helping new hires adjust to social and performance aspects of their new jobs quickly and smoothly – How the new hire will fit in with what the organization does

• Why it is important – Employees get about 90 days to prove themselves in a new job – The faster new hires feel welcome and prepared for their jobs, the faster they will be able to contribute to the organization #ALFA2014

Click Outcomes to edit Master of Onboarding title style

• Jump start relationships

Increase Performance

• Clarify expectations and objectives

Increase Job Satisfaction

• Provide support via feedback, coaching, and follow-up Inoculate Against Turnover

Click Approaches to edit Master to Onboarding title style Structured and Systematic Highly Formal

“Sink or Swim” Highly Informal

• Set of written policies and procedures that assist an employee in adjusting to his/her new job in terms of both tasks and socialization

• Process by which an employee learns about his/her new job on their own without an explicit organizational plan

Click to Onboarding edit MasterTips title style • Formalize program – – – –

Develop a written onboarding plan Have clear goals Use formal orientation programs Consistently implement program

• Program components – Clarify new employee • Objectives, timelines, roles, responsibilities

– Make onboarding participatory – Use technology to facilitate process – Periodically check up on employee progress

Click Concluding to edit Master Thoughts title style • A key underlying principle – Standardization in HR practices

• A slightly different focus – Driving down turnover and enhancing retention

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