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Retain your staff-and keep turnover away from your bottom line

Rehab Regs, April 1, 2003

Retain your staff-and keep turnover away from your bottom line

As the director of an outpatient rehab clinic, your financial success hinges upon many things, including hiring just the right staff.

For example, you may employ Mike-a crackerjack therapist whose productivity levels remain high and who receives high scores from patients on satisfaction surveys.

But the clinic across town just offered Mike $2 more per hour, and the possibility of his departure worries you. How much time will you need to hire a new PT, get him or her up to speed, and keep your productivity levels high?

Can you avoid this? Certainly, no one can fault staff for making the best financial decisions for themselves. But industry experts say there are certain steps you can take to improve employee satisfaction within the workplace and make them think twice when it comes to searching for a new job. If you're troubled by high turnover rates, consider the following:

Look at your staffing bottom line. First, it's helpful to consider the necessary threshold your facility needs to rise to when it comes to employment, says Dick Hillyer, PT, MBA, MSM, consultant and owner of Hillyer Associates in Cape Coral, FL.

In some locations, for example, new therapists likely make an estimated $22-$23 per hour if they find employment within a salaried health care system. If one considers that therapists can provide services equal to three to four 15-minute therapy sessions per hour, at a rate of $27-$29 per session, it's likely that they bring in two to three times their cost, which ensures that your facility has a profitable bottom line. Once the necessary threshold is reached, it tends to revolve more around non-salary issues, such as employee-related benefits, including paid time-off, health insurance coverage, subsidized wellness plans, and child-care opportunities.

Consider auxiliary benefits. Once you've reached a suitable threshold, any staffing study should examine issues that address loyalty and job enrichment. Consider, for example, the benefits of retaining a loyal PT. This has been a subject of many studies and books that the wise manager may want to research, Hillyer says.

"Employees who have some longevity within their position-and know how to do their job well and serve the customer well-provide superior value to that customer, whether it be a patient, doctor, or insurance company," Hillyer says. "It's less costly to keep that person than to go out and attract someone new."

How do you keep those employees? Many rehab directors may question the steps they need to take to foster employee loyalty. There are a number of concepts one can consider to promote this, Hillyer says. For example, he cites studies that show strong employee bonding to the workplace as a key concept-one that is modeled upon the military structure. The military encourages unit integrity, in which soldiers are trained to protect not only themselves, but their entire unit. Rehab directors should also encourage this sense of cohesiveness.

"People who have a best friend at work-those people for whom work becomes an important part of their lives, will have tenure and more longevity, and will do their jobs better," Hillyer says. "It's incumbent upon managers to build loyalty and pride within the workplace."

Any discussion of pride within the workplace should take into account the need for integrity, as well. For example, one of your therapists may be lured to work across town for another practice-but once he or she discovers that it's not complying with Medicare regulations in that it's charging individual rates for group therapy.

Chances are good that therapist wants a position that makes him or her feel good-and employment at a non-compliant organization is likely not the answer, Hillyer says.

Promote professional enrichment. Successful rehab directors know that therapists will want to consider educational opportunities-issues pertaining to development of professional skills. Hillyer's organization maintains several settings within Florida, and therapists are allowed to rotate among these institutional settings.

For example, a therapist may work for a few months in a dedicated rehab hospital, switch to an outpatient orthopedic clinic, transfer back to an inpatient neurological unit, and then travel to a sports clinic. At each of these stops, the therapist encounters different challenges and gets to expand upon his or her skills.

Manage in the same way you'd like to be managed. Develop policies and procedures that adhere to your vision, but remember to empower your employees, notes Sally Jones McNamara, a health care and rehabilitation consultant from Falls Church, VA.

When McNamara was employed as a manager for larger rehab organizations and her duties included oversight of several sites, she found it helpful to give some responsibility to individual sites.

"After I get to know people, I push all the decisions as low as they can go," McNamara says. "I empower my people to run their own offices. While I want it done my way-and I've established policies and procedures that outline this-I let them know that I will back up their decisions." A successful manager also keeps the communication lines with employees open -and does not hesitate to deliver news promptly.

"If you have a have a reduction in work force-or you have a staff change-this is something that's likely causing turmoil to the therapists," McNamara says.

"If you know an answer on Friday night at 5 p.m., don't hesitate to tell them then, rather than on Monday morning. Let them know what's going on. Many people may hesitate to deliver bad news on Monday morning, but that's not necessary. Even when it comes to good news, you should reach out to tell them immediately."



Think outside the box to keep your staff happy

Directors of rehab and managers should not hesitate to let employees know how valuable they are, says Sally Jones McNamara, a health care and rehabilitation consultant from Falls Church, VA. Use these tips to reward employees, which will boost morale, increase loyalty, and improve productivity:

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