Can't get no satisfaction? How to minimize staff turnover (Proceedings)

Whether an employee leaves by choice or at your request, turnover costs your practice. There's the obvious cost of advertising for a replacement and the time spent interviewing the various candidates. But there's also the cost of lost productivity during the interim when you're short-staffed. Remaining staff members pick up the slack and morale may suffer. And if they simply can't get the work done, practice appearance and service suffer. Then there's the cost of inefficiencies when training the new hire, since even the most qualified individual has a learning curve. So how can your practice improve employee retention while avoiding turnover?

According to Benchmarks 2010, owners, associates, and staff members all agreed that the change that would have the single largest impact on reducing practice turnover is enhancing internal communication, followed by the termination of one or two problem employees, and an attitude change on the part of the owner(s). (See Figure 1.) Changes to your existing communication structure can certainly help minimize staff turnover, but there are other ways. Well-Managed PracticesSM focus on creating an environment where people are the top priority and staff retention is an integral part of the culture. Retention starts when you begin the hiring process, so hire with the intent of having happy employees. Then ensure that your staff development program maximizes employee satisfaction so you keep the best and brightest talent.

Figure 1– Factors Leading to Employee Turnover

Hire right – Even if you're short-staffed, the worst thing you can do is hire the first person you interview. Make sure to hire individuals who fit with your practice's culture. Even the most qualified person may not succeed if their expectations of work differ from the reality at your practice. Be sure you give enough information, and ask enough questions, during the interview to ascertain how the potential team member would function in your hospital.

     Know what you want – To find efficient, effective, and productive staff members who are a good fit with your practice, you must have a clear picture of what you're seeking and what the potential employee wants. Determine your "must have" skills and personality traits. These are characteristics you want the employee to bring to the table. You'll need to decide the skills you're willing and able to teach. Develop position descriptions and then hire based on them. A position description allows you to evaluate candidates' previous experience so you can place them at the appropriate skill level.

     Advertise – Consider the population to which you're advertising. Increasingly job seekers are turning away from print in favor of the internet. Advertise in the print and online versions of your local newspaper. Advertise on websites such as veterinarycareer.com, dvm360.com, linkedin.com, jobs.avma.org, or monster.com. Consider your personal contacts. If you were impressed with a receptionist or sales-person at a local restaurant, ask if he or she is interested in working in the veterinary field.

Figure 2 – Associate Salaries

     Interview – After screening the resumes you receive, decide which candidates to contact and schedule a phone interview with. This preliminary conversation will cover technical training, prior job experience, and professional goals. If you are suitably impressed with individuals after the initial interview, invite them to the practice for an in-person interview. Discuss the duties the candidate would be expected to perform, and use a standard list of questions to interview each applicant (you'll be better able to compare applicants this way). Explain the hospital's medical philosophy, code of conduct, and the desire to train, invest in, and ultimately retain staff members long term. Invite top applicants back for a working interview, and if the staff and doctors agree that the candidates would fit into the position and the hospital culture, make an offer to your top choice.

Figure 3 – Median Wage by Years with Practice (Benchmarks 2010)

     Offer fair compensation and benefits – Although high salary or wages were not the top priority in terms of employees' job satisfaction, they weren't the bottom priority either. Associates ranked compensation 5 out of 10 (1 = most important), and staff members ranked it 4 out of 10. Make sure you're paying what your staff members are worth, and they'll feel appreciated for their efforts. (See Figures 2-4.)

Figure 4 – Benefits

Communicate – Employee satisfaction comes from a sense of achievement and the feeling of a job well done. If a staff member is struggling, don't wait until the next performance evaluation; provide assistance and feedback immediately. Communicate a staff member's advancements and successes to the entire team, and acknowledge your employee's dedication.

     Regular feedback – Forms of feedback include daily positive reinforcement and constructive correction, regular doctor and staff meetings, and timely evaluations. Catch employees doing things right and thank them publicly for their contributions. Offer a verbal evaluation for new hires after 30 days of employment and provide written evaluations after 90 and 180 days. Conduct semiannual evaluations thereafter.

     Conduct performance evaluations – Evaluations are a valuable tool to help team members realize their potential. The meeting itself is a rare chance for you to engage in scheduled, direct, and open communication with one individual. It's an opportunity for you to show how much you value the employee and how excited you are about his or her learning and growth. Use specific examples and quantifiable terms when you address areas that need improvement.

Delegate – You can't do it all, so don't try! Give your team members ownership of the various tasks they do each day. If you're looking over their shoulders they'll never step into the responsibilities you hired them for. When in doubt they'll ask you what to do (and if you're hovering they'll always be in doubt). James A. Belasco and Ralph C. Stayer offer some excellent ideas for how to overcome micromanaging in Flight of the Buffalo (Business Plus, 1993). The following example has been adapted from their book.

The opportunity – Don't abdicate your job as owner and/or manager. Rather, help staff members accept ownership of their jobs. Say your receptionist knows she's supposed to cross check the travel sheet with the invoice before she prints the invoice for the client, but she habitually forgets. You can handle this several ways. You could double check her every time she prints off the invoice or you could remind her every time you hand her the travel sheet. If you do either you've added another item to your list of things to do, and the receptionist will only ever see her job as a checklist of tasks to mark off before she heads home.

The solution – On the other hand, you could ask the receptionist if she feels she's doing her job well. Ask her how she would define a job well done. Ask her what obstacles are preventing her, or distracting her, from accomplishing her goals. Don't fill in your interpretation of her job description and her obstacles; let her explain these to you. At the end of the conversation you will understand her perception of her job, and she will see that the responsibilities included in her job make doing a good job much more rewarding. That checklist she had in her mind isn't her job; the care of every client and pet that comes through the door is.

Ah-ha! – Once the receptionist sees for herself that cross-checking the travel sheet and invoice ensure the practice is paid for the services provided, she'll make sure to catch missed charges. A job poorly done by her will short-change the practice, and it will eventually not be able to provide quality patient care. She's in the business of keeping pets healthy too, and once she owns the responsibilities for her job, she'll improve her performance.

Train and educate – Training programs and continuing education send the message that you value employees' talents and want to invest in them for the long-term. Demonstrate your willingness to invest in your staff by creating an effective orientation and training program that encourages mentorship and teaches leadership and technical skills. Employees tell us that appreciation of the work they do is most important to them in terms of personal job satisfaction, followed closely by job security, good working conditions, and a pleasant work environment. Happily, a high percentage of associates and staff in Well-Managed PracticesSM report that they feel appreciated for their work and are satisfied with their feedback. However, an equally high percentage report that there's room for improvement, particularly with their employer's feedback.

     Develop training protocols – Get employees off to a great start at your practice by creating a balanced orientation program that develops the skills they need for their positions in your practice. Designate trainers who will ensure that all new employees in their departments receive proper training. In your training guidelines, provide each employee with the opportunity to learn, assume additional responsibilities, and advance his or her career. During an employee's first few weeks, be sure to assign him or her specific tasks to complete in addition to training. This provides a break from training and allows team members to start using their new skills – an important step in the learning process.

     Provide internal and external continuing education (CE) – Design an annual CE schedule for all positions and hold regular in-house CE meetings. Assign one topic for each CE meeting and assign a discussion leader with extensive knowledge or a special interest in the subject to head the training session. Request feedback from staff members about the session and future topics they want to explore. Meeting new people and hearing other perspectives at conferences and other external CE events provides new insights and can reaffirm employees' commitment to your patients and clients. Investing in your staff now will result in large rewards for your practice in the future.

Encourage mentoring – Mentoring is more than just a buzzword. Mentoring is a one-on-one initiative that brings together colleagues with different levels of experience within a practice, industry, or specialty to work together to improve job performance and create and recognize prospects for advancement. Encouraging your staff to develop a relationship with a more experienced member of their field is an excellent way to show them you value their commitment to the practice.

     How to mentor – Generally, a mentor answers a new employee's questions, provides a friendly ear to listen to the challenges the employee faces, offers advice, and shares his or her own experiences. Sometimes an employee needs a mentor with skills different from his or her own, and other times the employee needs a mentor with similar skills but more experience. The key is for the team member to identify where the gaps lie and what his or her goals are, and then to choose people who have the knowledge and influence to help strengthen those areas. Mentoring is a fluid process that will change over time given the needs of the employee being mentored.

     Why mentor? – To begin with, your mentee will have knowledge you don't have and you'll learn from the experience as well as teach. Also, mentoring will give you a chance to expand your people-development skills and allow you to give back to the profession. Mentoring can energize you, give your practice a recruitment edge, shorten employee learning curves, increase employees' job satisfaction and loyalty, and improve productivity and work quality. If the relationship is properly managed, both sides will benefit and the practice can merge past and present into a better future.

Your practice can improve employee retention while avoiding turnover, though there's no quick fix. Minimizing turnover requires a dedicated commitment from the entire team. The process to strengthen retention isn't flashy or glamorous, but the results are worth the effort. When staff enjoy coming to work both you and they benefit, the bottom line benefits, and most importantly, your clients and patients benefit.