Recruitment & Retention Strategies

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Recruitment & Retention Strategies. Results from a Survey of Pennsylvania Clinicians Suzanne E. Rossel, CHCANYS, Senior Director of Health Center Support. The Project. Goal: Identify successful recruitment and retention practices Approach relied upon two analyses methods - PowerPoint PPT Presentation

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  • www.chcanys.orgRecruitment & Retention StrategiesResults from a Survey of Pennsylvania Clinicians

    Suzanne E. Rossel, CHCANYS, Senior Director of Health Center Support

  • The Project Goal: Identify successful recruitment and retention practicesApproach relied upon two analyses methodsA literature identify evidenced-based best practices for recruitment and retention of cliniciansA survey of 41 Pennsylvania clinicians working in primary care settings.PACHC conducted this project, funded in part, under a contract with the Pennsylvania Department of Health.

  • Focus Areas Organizational Selection and PreparationPreparation for Hire and First 180 DaysOrganizational Supports and Resources that Contribute to SatisfactionClinicians Motivation, Satisfaction and Long-Term Commitment

  • Interviewee Demographics

    Interviewees% of Total% FemaleYears at HC *Total4185%4.7Physicians1229.3%83%4.6 Dentists717.1%86%3.8 MD/DO512.2%80%5.7Physician Assistants (PAs) & Nurse Practitioners (NPs)1843.9%83%4.0 NPs37.3%67%4.7 PAs1536.6%87%3.6Behavioral Health (BH) Providers922.0%89%7.2 LCSW & Licensed Behavioral Counselors819.5%88%6.9 Psychologist12.4%100%9.5Dental Hygienist24.9%100%4.5

  • Organization Selection78% of respondents indicated that Ties to the Area was the reason they came to the organization.Particularly relevant for Physicians Assistants, Nurse Practitioners (PAs & NPs) and Behavioral Health (BH) Professionals

  • Organization SelectionOverall, 65.9% indicated that they wanted to work for the organization, comparatively:80% of medical physicians identified this as a reason67% of BH professionals and 61% of PAs & NPs said they wanted to work for the organization

    Sought out the organization based on reputation and team culture.The passion and commitment of leadership was contagious.Heard about employee satisfaction and manageable productivity.

  • Organization Selection36.6% selected the organization because of the loan repayment programI was buried by debt, was glad to find the loan repayment program.24.4% indicated the mission brought them.I wanted to give back to my community.I wanted to make a difference.

  • Preparation for Hire: On-Boarding Activities90% of all respondents indicated that they received some on-boarding activities92% of physicians indicated that they had regular communications30% indicated limited on-boarding preparation

  • First Day/WeekOver 68% were introduced to staff, and 66% toured the facility. 51% had some orientation, which usually involved HR related items. 34% received training/shadowing 56% of NPs and PAs had targeted training.30% saw patients on the 1st dayPrimarily physiciansSome noted a lighter or shared schedule

  • Improving Satisfaction in 1st 180 Days44% of interviewees indicated they would have liked more supportSeveral highlighted that the workload in the 1st days/month was challenging34% felt more check ins would have increased their satisfaction.17.1% discussed leadership, particularly physicians, as an important consideration for satisfaction

  • Organizational Support & Resources that Contribute to Satisfaction93% of respondents identified staff support as contributing to their job satisfaction.41.5% felt they had good staff support41.5% felt they had limited/inadequate supportA majority of physicians noted the need for improved/increased staff support.

    The happiness of a provider really depends on who you are working with. This can really make or break your day!

  • Organizational Support & Resources that Contribute to SatisfactionAspects impacting good staff support:Maximized use of clinical support, particularly medical assistants Support staff need to be used to the fullness of their licensureA lack of a career ladder makes retaining quality staff difficultCuts to staff challenges ability of providers to achieve volume targets.

  • Organizational Support & Resources that Contribute to SatisfactionTechnology (IT) was seen as an important resource:71% of respondents discussed technology support, with a focus on electronic health records (EHRs)49% indicated they had good IT support22% indicated that EHR/IT support was inadequate.There was interconnectedness between staffing and IT.

  • Organizational Support & Resources that Contribute to SatisfactionClinicians who felt they had good IT support noted:Shift to EHRs was difficult but well supportedReceived good IT orientation and supportClinicians who did not feel they had good IT support:IT understaffed to cover multiple sitesIT is always in transitionEHR is not maximized.

  • Organizational Support & Resources that Contribute to SatisfactionContinuing Education (CE), support was available to most interviewees.Some indicated that it was challenging getting to trainings because of work loads.Leadership, Creativity, Innovation and InitiativeOver 50% of the respondents indicated they were given opportunities in this area.Nearly 50% of all providers were unsure or felt that these types of opportunities were not available.

  • Organizational Support & Resources that Contribute to SatisfactionLinking with peers.61% of interviewees did not know about opportunities or did not feel supported to link with peers.Nearly 40% felt opportunities were available:Working in the communitySpeaking at conferences, going to meetings, etc.Other resource supports were noted by a small number of respondents.

  • Connection with the OrganizationServing the patients was a primary motivator:85% of the clinicians identified working with the patient population as a significant consideration.The patient-motivation was consistent across provider types interviewed.Co-workers were seen as important for 60% of the interviewees, several mentioned:Building a team cultureWorking with technically competent staffA sense of community, almost family.

  • Connection with the Organization41% of medical physicians and 57% of dentists prioritized their attainment of professional goals.Comparatively, 39% of NPs and PAs and 33% BH professionals identified achieving their professional goals as important. 27% of respondents identified their salary or loan repayment as a motivation.

  • Plans to Stay with the Organization59% said they planned to stay with the organization, 24% said they were unsure, and 17% said they did not plan to stay.

  • Plans to Stay with the OrganizationAmong interviewees planning to stay with the organization 45% identified organizational commitment and support an important consideration41% identified job satisfaction as a primary factor influencing the decision to stay80% of medical physicians identified job satisfaction as a retention consideration.

  • Plans to Stay with the OrganizationAmong those who were unsure or did not plan to stay, the most frequently identified reasons: 29% identified family considerations29% identified career/work17% identified financial/loan repayment.The reasons clinicians said they would leave often related to management of the organization: Concerns about the stability of the organizationCommitment to staff and high quality of care

  • Interview Results & the Literature ReviewOrganization Selection:Both the literature and interview results highlighted the value of opportunities to receive training and/or previous experience with the setting/organization.Rural considerations and communityThe literature highlighted the importance of exposure to rural settings for long-term retention.The interviews results emphasized community and family ties to the area.

  • Interview Results & the Literature ReviewOrganization Selection:Transparency about job responsibilities was noted in the literature but was not specifically mirrored in the interviews Organizational reputation was noted by intervieweesOrganization being a good place to work was importantAs was the mission.

  • Interview Results & the Literature ReviewOn-Boarding and 1st 6 months:The literature emphasized:Nurturing the relationship between clinicians and their colleaguesAllowing the clinician time to ramp up These findings were echoed by the interviewees who identified the value of:Shadowing/mentoring with other cliniciansRegular check-ins to assess integration

  • Organizational Resources & SupportThe interviews highlighted recruitment and retention considerations that have impacted the clinicians workload and need for support:Care integration, meaningful use, data collection and reporting requirements Pressure to become patient centered medical homesImplementation of EHRs.

  • Organizational Resources & SupportThe literature identified professional satisfaction in terms of opportunities for autonomy, especially in rural locations.Comparatively, the interviews identified the opportunity for leadership, creativity, innovation and initiative.This may be an area for further assessment

  • Organizational Resources & SupportContinuing Education Resources:The literature identified CE as part of the benefit package/financial incentive that were important.Most interviewees indicated that CE resources were made available to them, almost a given.Other educational opportunities were limited

  • Organizational Resources & SupportWork with the Community and Peers:Community involvement was noted as important in the literature.Some interviewees noted the importance of community work and peers, but many were unaware of opportunities.

  • Provider SatisfactionService to the population, patients and mission were important considerations for professional satisfaction in the literature and interviewsDifferences noted in the interviews:Physicians noted the importance of realizing their work/career goals in terms of the type of patients, community, and/or system of care.Comparatively, non-physician providers often mentioned the importance or relationships with colleagues as critical to their job satisfaction.Quality of care was noted as an important factor.

  • Provider SatisfactionRelationship with colleagues was underscored in the literature and interviews:The literature identified Poor relationships with colleagues was identified as a factor for a provider to leaveComparatively, many interviewees extolled their collegial relationshipsin many instances this was a reason given for staying.

  • Provider SatisfactionThe relationship with administration/ management was noted by interviewees positively and negatively:Management relationships were described as positive when clinicians felt their professional skills were valued, their opinions sought, and their personal/family life needs considered.The interview results indicated a greater emphasis on this relationship than the literature review would indicate as a retention factor.

  • Provider SatisfactionSalary and loan repayment considerations were identified by a limited number of interviewees as the most important consideration for retention:In some cases when salary and or the loan repayment were seen as inadequate, the interviewees describe dissatisfaction with other aspects of their experience with the organization.

  • Conclusions The literature and interviews highlight approaches to strengthen recruitment and retention activities.Potential areas for further exploration:Differences by provider typesImplications of health care transformationsQuality of care and the impact on professional satisfaction.

  • Conclusions The interviews underscore recruitment and retention considerations:Differences by provider types may be important Health care transformation.As part of this ensuring adequate, trained support staff is a core consideration.The link between clinicians professional goals and the delivery of high quality care.

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