According to a recent report, U.S. industries see first year turnover of 21.5% but in the hospital sector it’s 28.3%. As many as 22.2% of nurses will leave after their first year.
Turnover has a real bottom line impact. Consider a hospital with 2,000 employees of whom 35% (700) are nurses. Average annual base salary is $67,000 and annual turnover is 20%. Assuming turnover cost of 1.5x average annual base salary, cutting turnover in half could save $7M!
This cycle of losing nurses but then throwing more resources at nurse recruiting and staffing efforts costs the organization in other ways: Contingent staffing costs increase; continuity of care is disrupted; training costs increase; process improvement and quality programs suffer; the ability to develop nurses into leaders is impeded; staff workloads, accident rates and absenteeism increase (contributing to staff dissatisfaction and greater turnover). Finally nursing turnover leads to medical staff dissatisfaction as communication and care continuity are disrupted.
On-boarding, training, employee retention and assimilation programs are important to retention but these strategies should follow a more deliberate approach to selection. Studies have looked at why employees leave and, invariably, it has to do with job fit and behavioral performance issues – of staff and managers.
Based on research and hundreds of nursing focus groups, our consultants have identified the most common causes of turnover and the role of selection:
- Involuntary terminations. Nearly always related to personality traits and interpersonal behaviors - dependability, professionalism, a lack of emotional intelligence, or poor decision making.
- Workload. Workloads are going to increase, as are demands to constantly roll out new quality and cost control initiatives. Evaluating a candidate’s ability to adapt and handle stress prior to making a job offer becomes important.
- Relationship with Supervisors. Assess each candidate’s leadership potential so that great nurses do not become poor leaders.
- Relationship with colleagues. The desire and ability to collaborate with others is difficult to train. However, it is possible to assess a nursing candidate’s abilities and propensities in regard to teamwork before the job offer.
The most successful organizations do a better job of selecting nurses. They take a three-pronged approach:
- Define important behavioral competencies.
- Become better at interviewing candidates. It’s amazing how far behind healthcare is when it comes to this basic HR skill. Many hospitals don’t even have a structured interviewing program. If they do, they have no idea how consistently it’s used.
- Use proven behavioral assessments to examine behavioral competencies. Nearly 75% of successful companies in other industries increase their odds of selecting the right candidate, and reducing turnover, with pre-employment behavioral assessments. Healthcare is catching on. Nothing is more effective at evaluating motivational fit factors and behavioral competencies than a well-designed, healthcare-specific assessment designed for selection. The right tool allows the hiring manager to focus their interviewing time on the right candidates.