Healthcare
Human Resource
Management
Flynn
Mathis
Jackson
Langan
Chapter 7
Organizational Relations and
Employee Retention in Healthcare
PowerPoint Presentation by
Tonya L. Elliott, PHR
Learning Objectives
After you have read this chapter, you should
be able to:
 Explain the factors affecting the relationship between
employees and healthcare organizations
 Discuss the importance of employee retention for
healthcare organizations
 Identify the common reasons employees voluntarily
leave organizations
 Define the various organizational retention
determinants
 Describe how to compute the cost of organizational
turnover
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Relationships: The Psychological Contract
The Psychological Contract
The unwritten expectations that employees and employers have
about the nature of their work relationships
Psychological Ownership
Individual’s feeling of control and perceived rights
Loyalty has
declined in
recent years
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The New Psychological Contract
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Individual/Organizational Relationship Factors
Economic changes
-- Shift to dot-com and technology sectors
Generational differences
-- Differing expectations between the generational groups
Loyalty
-- Psychological contract changes
Career expectations for women
-- Expansion into other industries other than teaching and
healthcare
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Job Satisfaction and Organizational Commitment
Job Satisfaction
A positive emotional state resulting from evaluating
one’s job experiences
Organizational Commitment
The degree to which employees believe in and accept
organizational goals and desire to remain within the
organization
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Individual /
Organizational
Performance
Figure 7-2
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Retention of Human Resources
Retention
Keeping employees who have been recruited, selected, and
trained
Retention is a growing concern due to:




More patients due to increase in elderly consumers
Healthcare employee shortages
More demanding consumers
More stressful working environments for healthcare
workers
Retention Officer – often an individual in an HR department
who is responsible for retention efforts in the organization
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Figure 7-4
Retention Determinants
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Organizational Components
Organizational culture
A pattern of shared values and beliefs giving
members of an organization meaning and providing
them rules for behavior
Job continuity and security
Downsizing, layoffs,
mergers, acquisitions,
organizational restructuring
Loyalty
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Organizational Career Opportunities
Key component in retention:
“opportunities for personal growth”
Career Development
 Tuition aid may increase retention rates
 Companies must identify ways to use new knowledge
gained --- increases employee’s feeling of “value”
Career Planning
 Managers should discuss and plan career development
with their employees
 Job posting programs have been proven effective
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Rewards & Retention
Key to retention:
Competitive compensation practices
Pay
 Bigger retention issue in lower income groups
Benefits
 Benefits flexibility aids retention
Special benefits and perks
 Day care centers, salons, post offices, dry cleaners, paid
parking, etc.
 Reduces employee time spent after work on personal
chores
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Rewards & Retention (cont’d)
Performance differentiation of compensation
Greater rewards for higher performers
Variable pay programs
Incentive programs
-- Cash bonuses
-- Lump sum payments
Employee recognition
Tangible
– employee of the month, perfect attendance awards
Intangible
– feedback, recognition in newsletters, banquets
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Job Design and Retention
High turnover rates in early employment have been
linked to inadequate selection screening
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Work Flexibility
Work scheduling alternatives
 Telecommuting
Working from home or other locations
 Flextime
Flexible work schedules
 Compressed work weeks
4 days/10 hours; 3 days/12 hours, etc.
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Work Schedule Flexibility Trends
Figure167-6
Balancing Patient Care Needs & Schedule Flexibility
Increased schedule flexibility accomplished with:
Part-time and casual workers
Some full-time employees replaced with greater number
of part-time and casual employees
Patient census prediction & staffing methods
Establish the core staff
+
Supplementing with variable staff
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Supervisory Retention Efforts
Figure 7-7
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Retention Measurement and Assessment
Retention measured objectively vs. subjectively
Turnover
Number of employee separations during the month
X 100
(Total number of employees at midpoint)
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The Cost of Turnover
Hiring costs
Recruiting, advertising, search fees, staff salaries & time,
referral fees, relocation/moving costs, employment testing
costs
Training Costs
Paid orientation time, training staff time & salaries, training
materials costs
Productivity costs
Lost productivity due to “break-in” time of new employees,
lost employee knowledge of customers, organizational
products & services, resources & systems
Separation costs
Staff and supervisory time & salaries, exit interview time,
unemployment expenses, legal fees for challenged
separations
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Simplified Turnover Costing Model
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Employee Surveys
Employee surveys can be used to:
Diagnose specific
problem areas
Identify employee
needs or preferences
Reveal areas where HR activities
are viewed positively or negatively
Attitude survey
Measures employees’ feelings and beliefs about their jobs
Exit interview
Those leaving the organization identify reasons for their departure
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HR Retention Interventions
Recruiting Process
*realistic job previews
Selection Process
*reduce risk of hires that may create “problems”
Compensation
*competitive, fair, equitable pay systems
Career Development & Planning
*opportunity for career advancement
Employee Relations
*fair/nondiscriminatory treatment
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Retention Interventions: Evaluation & Follow-Up
1. Track intervention results
2. Review turnover data
Analysis sorted by
Measure increases
and decreases in
turnover trends
Jobs and job level
Departments/units/location
Reason for leaving
Length of service
Demographic characteristics
Education & training
Skills & abilities
Performance ratings/levels
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