UPI Study › Courses › Healthcare Organization and Management › Free lessons › Lesson 13.5 Free with a free account
Employee Development, Retention, and Staffing
Healthcare Organization and Management · Chapter 13: Workforce Training and Development in HealthcareSection 13.5 · lesson 78 of 10511 min · free with a free account
Free preview
Create a free account to keep watching
It takes a minute and costs nothing. Your free account unlocks all of Chapter 1 and 3 more lessons of Healthcare Organization and Management.
Lesson complete
Earn the 3 college credits for Healthcare Organization and Management
Enrolling adds a quiz after each lesson, the graded work and the official transcript. Recommended for credit by NCCRS.
Next lesson: Building a Culture of Continuous Learning →← Coordinating and Evaluating Training EffectivenessNext lesson: Building a Culture of Continuous Learning →
In this lesson
Development plans, turnover math, and the real drivers of retention.
- Describe individual development plans and career lattices, and why development is kept apart from performance reviews
- Calculate a turnover rate and separate avoidable voluntary turnover from other kinds
- Identify the main drivers of turnover and the levers a unit manager controls
- Use stay interviews and engagement follow-through to improve retention
Free study notes
Get this lesson's notes by email
The key points and 4 practice questions with answers, in your inbox. One email, free.
One email. Unsubscribe in one click.
Transcript
Everything said in the video, section by section (1,440 words). Read along, or search it.
Opening Case
Six of Fourteen Technicians Gone
Devon Clarke manages 4 North, a medical-surgical unit. In the past year he has hired fourteen patient care technicians, the aides who bathe, turn and walk patients. Six of them have already left. HR sees a recruiting problem, and wants him to advertise more widely. The exit interviews mostly cite pay. But pay is identical on 4 South, and 4 South keeps its technicians. So why are they really leaving? And what would make them stay?
Development Plans
The Individual Development Plan
Devon takes it to Rosa Delgado, the HR director. She starts with a distinction. Training builds capability for the current job. Development builds it for a future one. Its tool is the individual development plan: a written agreement between a staff member and their manager. It covers where the person wants to go, what capability that takes, the activities that will build it, and when to review progress. Its value isn't the document. It forces the person's real aspiration into the open, which managers often assume rather than ask, and it commits both sides.
Common Mistake
Keep Development Apart From Reviews
Rosa adds one rule. Don't hold the development conversation in the same meeting as the performance review. In an evaluation, a person's rational strategy is to look capable. In development, they need to say where they're weak. Combine the two, and nobody admits needing anything. So hold them at different times, with development visibly unconnected to pay or rating.
Career Lattice
Sideways and Diagonal Routes Count
Next, where can development lead? A career pathway is a defined route upward. A career lattice adds sideways and diagonal moves, and treats them as progress. Hospitals need lattices, because positions narrow sharply with seniority. A purely upward path offers most people no realistic route. Lateral moves into another specialty keep people who want variety. Clinical-to-management moves are common and badly supported. Educator and advanced-practice routes let people progress while staying clinical. For Devon's technicians, a lattice could run from technician to licensed practical nurse, or to registered nurse.
Credentials
Plan the Credential With the Role
Hospitals support credentials with tuition help, study leave and paid time, often tied to a promise to stay for a set period, or repay part of the cost. Those agreements matter most when someone weighs an outside offer, and counts the repayment. But a funded credential with no role to use it creates someone more employable and more frustrated. So plan the credential together with the role it leads to.
Turnover Rate
Calculating 4 North's Turnover
Marcus Bell, the workforce analyst, pulls 4 North's numbers. Turnover is separations, divided by the average number of employees, times one hundred. Last year 4 North averaged twenty-six technicians, and eleven left. That's forty-two percent. For comparison, NSI's twenty twenty-six national retention report, covering twenty twenty-five, put hospital turnover at eighteen and a half percent, and registered nurses at seventeen point six. Nursing assistants and patient care technicians turn over fastest of all, about a third every year. And close to three in ten new hospital hires left within their first year.
Turnover Types
Voluntary, Involuntary, Avoidable, Unavoidable
A single headline rate hides what matters. Voluntary turnover is the employee's choice; involuntary is the employer's. Cutting across that, avoidable turnover could have been prevented, and unavoidable couldn't: retirement, a partner's relocation, illness, a career change. Only avoidable voluntary turnover is a management problem. A high rate driven by retirements is a workforce planning issue. The same rate driven by first-year resignations is a management issue.
Turnover Cost
Vacancy Is the Biggest Cost
Losing someone costs far more than recruiting someone, and the cost falls in four places. Replacement covers advertising, selection and checks. Vacancy coverage pays for overtime and agency staff while the job is empty, and is usually the biggest piece. Onboarding pays for the trainer's time and the new person's extra-staff weeks. And productivity is lost for months while the new person gets up to speed. NSI's same report put the average cost of replacing one bedside registered nurse, at about sixty thousand dollars. Since most of the cost comes from the vacancy, preventing it beats cheaper recruiting.
Turnover Drivers
The Manager Is the Biggest Lever
Rosa lays out the drivers of turnover. The relationship with the immediate manager is the strongest and most consistently found. Workload and its sustainability follow closely. Schedule control matters more in healthcare than most fields, because shifts intrude on life outside work. Development opportunity decides whether staying has a future. Recognition costs nothing, and is chronically scarce. And pay works mainly as a threshold. Pay seen as unfair drives people out, but pay above that line won't hold someone whose manager is poor. The direction of these findings is well established; their size varies by setting. So the biggest retention lever in most units is the manager.
Manager Levers
Actions a Unit Manager Can Take Now
Each driver has a lever a unit manager can pull this month, without waiting for the organization. Regular one-to-ones, and acting on what's raised. Removing low-value work. Posting schedules earlier, and honoring requests where possible. Stretch assignments. Specific, timely thanks. Pay is the exception: the manager can check its accuracy and explain it honestly, but the pay structure itself is an organizational decision.
Quick Check
Three Kinds of ICU Departure
Quick check. In one month the ICU loses three kinds of nurse. One retires after thirty years. One moves abroad to care for a parent. And two first-year nurses resign, citing constant short-notice schedule changes. Which of these is a management problem? Pause, and decide. The two resignations. They're voluntary and avoidable: schedule control is a driver the unit can act on. The retirement is tempting, because thirty years of experience is a real loss. But it's unavoidable, so it's a workforce planning question, not a management failure.
Stay Interviews
What Current Staff Will Say
Devon trusts exit interviews less now. People leaving have nothing to gain from candor and a bridge to protect, so they give safe answers. Pay is the safest. So he holds stay interviews: conversations with people who haven't resigned, about what keeps them and what might make them leave. Tasha Greene, a technician eight months in, is specific in a way no exit interview was. She came off orientation at three weeks, ready or not, because the schedule needed her. She trained with a different technician almost every shift. And nobody checked in on her between week two and month three.
Acting on Answers
Fixes That Need No Budget
None of that is about pay, and none of it needs a budget. Devon ends orientation on a validated sign-off, not a date. He gives each new technician one named trainer, with a backup. And he puts fifteen-minute check-ins at weeks two, six and twelve in his own calendar. One condition: stay interviews only help if something follows. Asking what would improve someone's work, and then doing nothing, is worse than never asking.
Engagement
Closing the Gap Between Survey and Action
Engagement is the involvement and discretionary effort staff bring to work. Measuring it is the easy part. The gap is between measuring and acting. A survey runs, results reach the unit months later, a plan is written, and nothing staff raised changes. Next round, fewer people respond and scores fall, and leaders read it as falling engagement, when it's an accurate review of the last round. The fix: fewer questions, faster feedback to the team, one action the team picks, and visible completion before anything is measured again.
Skill Mix
Role Redesign for Fit, Not Cost
Retention also connects to how work is divided. Skill mix is the team's makeup by role and level. Role redesign changes what a role contains, and delegation hands tasks to the right role. Two cautions. What may be delegated is set by state scope-of-practice law, so it's a legal question first. And changes made to cut cost, rather than to fit work to role, are seen by staff for exactly what they are. Done for fit, role redesign retains people. Done for cost, it drives them out.
Quick Check
Pharmacy Technician Turnover Rate
Quick check. Larkfield's pharmacy averaged forty technicians last year, and ten of them left. Using the turnover formula, what was its rate for the year? Pause, and decide. Twenty-five percent. Ten separations, divided by an average of forty employees, times one hundred. Ten percent is tempting, because ten left. And forty is the headcount. But the formula divides one by the other, then scales to a percent.
Case Resolved
How They Were Brought In
Back on 4 North, six months later. Of the five technicians hired since Devon's changes, one has left. Tasha is still there. She has started tuition-supported prerequisites for a practical nursing program, with a role waiting at the end. They weren't leaving for pay. They were leaving because of how they were brought in, and because no one noticed they were struggling. What keeps them is cheaper than replacing them.
Key Takeaways
Retention Essentials
To recap. Development plans work best held apart from performance reviews. Lattices open real routes, and credentials should lead to a role. Avoidable voluntary turnover is the management problem. Vacancy is the biggest cost, and the manager is the biggest lever. Stay interviews beat exit interviews, as long as something follows.
About Healthcare Organization and Management at UPI Study
Healthcare Organization and Management (Health 302) is a self-paced online course of 105 video lessons in 18 chapters, from health systems and the law to ethics, leadership, teams, strategy, informatics, finance, quality, human resources, marketing and evidence-based practice. It carries a NCCRS credit recommendation for 3 semester credits.
Every lesson transcript is free on pages like this one, and the videos are free with a free UPI Study account. Enrolling adds a practice quiz after each lesson, the graded work and final exam that earn the credit, lifetime access, and an official transcript on completion. UPI Study has helped over 130,000 students with college credits. ACE and NCCRS have over 2,100 cooperating colleges that will consider accepting credits; the final decision is with the universities.
Enroll now → Course details Download the syllabus All Health courses Every course with PRO →
Why take it here
Why students take Healthcare Organization and Management with UPI Study
Where the credit goes
Universities that work with NCCRS
Healthcare Organization and Management carries a NCCRS credit recommendation. These universities work with NCCRS; some are UPI Study's signed partners. ACE and NCCRS have over 2,100 cooperating colleges that will consider accepting credits; the final decision is with the universities.
Thomas Edison State UniversitySigned partner
University of the PeopleSigned partner
Charter Oak State CollegeSigned partner
Strayer UniversitySigned partner
Columbia Southern UniversitySigned partner
Indiana TechSigned partner
Penn StateWorks with NCCRS
Southern New Hampshire UniversityWorks with NCCRS
SUNYWorks with NCCRS
+many more cooperating universitiesFind my college →Find my college → Not listed? Ask Athena in the corner of this page, or book a 15-minute call.
FAQ
Questions students ask us
About Employee Development, Retention, and Staffing
What is an individual development plan for healthcare staff?
How do you calculate employee turnover rate?
What are the main drivers of staff turnover in hospitals?
What is a stay interview, and why can it work better than an exit interview?
About the Healthcare Organization and Management course
How many college credits is Healthcare Organization and Management?
How much does Healthcare Organization and Management cost and what is included?
Which universities accept UPI Study credits?
How long does Healthcare Organization and Management take?
How are the exams done?
How do my credits reach my college?
Ready for the full course? Earn 3 credits in Healthcare Organization and Management.
105 video lessons, a quiz after each one, and the graded work that earns the credit. Recommended for credit by NCCRS.
3 credits · NCCRSEnroll →