Evidence-Based Strategies Reduce Voluntary Turnover and Labor Costs

Caregiver satisfaction and voluntary turnover at Community Health Network (CHNw) were negatively impacted by a lack of standard processes, which resulted in rework and communication gaps regarding procedures and increased labor costs, reducing CHNw’s environmental services (EVS) team’s ability to deliver core services. In an effort to reduce voluntary turnover rates, CHNw convened an improvement team to improve processes, training, and communication related to cleaning requests, which has led to reduced voluntary turnover and labor costs.

VOLUNTARY TURNOVER IMPACTS HEALTHCARE LABOR COSTS

The healthcare industry faces a significant turnover problem, and it negatively impacts customer service, patient safety, employee engagement, and results in higher healthcare labor costs.¹Replacing an employee typically costs at least 33 percent of the position’s annual salary.²

社区健康网络(CHNw)是位于印第安纳州中部的一个非营利组织，在全国最综合的医疗保健系统中排名前列。该公司总部位于印第安纳波利斯，雇佣了超过1.5万名护理人员，在医院、健康馆、医生办公室以及工作场所、学校和家庭，随时随地为患者提供优质的医疗服务。

PROCESS VARIATION CONTRIBUTES TO EMPLOYEE TURNOVER

CHNw认识到这是一个机会来提高照顾者的参与和减少自愿离职的EVS部门。EVS团队缺乏标准的流程，导致返工，以及有关流程的沟通方面的差距，导致团队成员满意度降低和大量的自愿离职。这导致了人力成本的增加，并对EVS团队提供核心服务的能力产生了负面影响。

环境服务伙伴在病人的体验和质量以及影响安全方面发挥着至关重要的作用，迫使CHNw投资于减少EVS部门的自愿离职。

DATA-DRIVEN APPROACH TO DECREASING VOLUNTARY TURNOVER

CHNw的高层领导提供了行政支持和资源，专注于减少EVS自愿离职的改进工作。一个由关键利益相关者组成的改进团队，包括EVS领导层、EVS培训师、房屋主管、护士经理、人力资源人员、卓越绩效顾问和数据架构师。

Enhancing improvement team impact

To enhance the team’s effectiveness, EVS improvement leaders completed the Health Catalyst^®加速实践(AP)计划，一种沉浸式和基于项目的经验课程，融合了现实世界中所需的工具和知识的应用，以实现显著更好的结果。改进团队运用AP项目的经验，减少了EVS的自愿离职。

The improvement team reviewed literature and exit interview data to understand the reasons for employees leaving their jobs. Members of the improvement team performed direct observations of EVS team members while they performed their daily work. Modeling servant leadership, the EVS supervisor sought to understand the existing processes, working with the team to remove barriers that made it difficult for the EVS team to complete their work, and guiding the EVS team to recognize their value as crucial members of the care team.

Using feedback from EVS team members, CHNw concentrated its improvement efforts on systemizing new hire orientation, standardizing and communicating the room cleaning process, improving interdepartmental communication, and training leadership on the processes for direct observation of performance and coaching for improvement.

To ensure consistent messaging on the roles and responsibilities of EVS team members, EVS leadership developed and implemented a standard orientation plan for all new EVS team members. Those members who train new hires receive information about the training plan, and are taught how to best train new hires, preparing both the trainer and new hire for success. Baseline expectations and the standard work for room cleaning upon patient discharge were re-established, with all EVS team members receiving education regarding related expectations and processes.

Streamlining cleaning request communications

CHNw implemented a process for using the EMR bed tracking functionality to communicate room cleaning needs. Nursing enters the room clean request in the EMR, improving communication between nursing and EVS, and reducing re-work. EVS team members receive notification electronically when a room is ready for cleaning and assign responsibility to an EVS team member.

领导观察团队成员的表现以确保遵守标准流程。他们能够审查性能数据，包括清洁要求的时间，完成的时间，以及完成房间清洁的特定团队成员。领导者使用这些数据来识别过程中的差距，并在发现时提供指导。

Multiple department leaders, including EVS, infection prevention, and nursing, have incorporated routine room inspections into their daily work, ensuring EVS team members are able to meet organizational expectations.

RESULTS

CHNw’s data-driven improvement efforts have reduced voluntary turnover and labor costs, while also improving room cleanliness. Results include:

• Four consecutive months without voluntary turnover, and a 28.7 percent relative reduction in voluntary turnover.
• 劳动力成本减少10.4万美元。
• 18.2 percent relative improvement in percentile rank for HCAHPS room cleanliness.

“All the stakeholders participating in the voluntary turnover reduction improvement initiative came together and asked, ‘Are we telling our people what they need to know to get the job done?’ The answer was no, so we implemented and adhered to an accountability process that worked beautifully. Now, we have real-time data and analytics to support the workflow, and managers know what processes to follow to maintain low voluntary turnover and contain labor costs.”

– Tiffany Eddington, PMP, CSM, CSSBB Manager, Performance Excellence

WHAT’S NEXT

CHNw继续监测照顾者的满意度和自愿离职率，并在出现改善机会时采取行动。

REFERENCE

1. Sanborn, B. J. (2017).Cure for healthcare’s high employee turnover is engagement, expert says.Healthcare Finance.
2. Otto, N. (2017).Avoidable turnover costing employers big. Employee Benefit News (EBN).