How do retention and motivation affect health outcomes?

What impact does staff engagement have on a hospital account? And on care quality and patients’ satisfaction?

How do retention and motivation affect health outcomes?

High costs, increasingly higher patient expectations, and external conditions influencing the healthcare work environment were some of the challenges that the sector was already facing before the COVID-19 pandemic emerged. The current context not only exalted these issues, but also placed enormous strain on the healthcare sector’s workforce, globally.

The growing international competitiveness for healthcare workers and the consequent rise of salaries is pointed out in Deloitte’s 2021 Global Health Care Outlook as one of the drivers for continued health care spending growth, expected to rise at a 4% compound annual growth rate, considerably faster than what was reported in 2015–2019. [1]

Care providers need not only highly qualified professionals, but also productive and committed teams that are focused on patients’ needs, and, consequently, deliver the best results. However, global data reveals that every year almost a fifth of all healthcare professionals change jobs. [2,3]

More than a matter of concern for human resources departments, health workers retention is all about institutionally wide productivity and efficiency:

  • According to the 2020 National Healthcare Retention & RN Staffing Report, each percent change in registered nurse (RN) turnover will cost/save the average hospital an additional $306,400/year. [4]
  • Considering a 17% turnover rate, hospitals can easily spend $5 million per year on rehiring, retraining, and more. [4]

And what about patients’ outcomes and satisfaction?

Increasing patient safety is a priority for policymakers and health leaders all over the world, and the ability to motivate and retain talent has a meaningful impact. Several studies show that the level of satisfaction of professionals is proportional to the level of satisfaction reported by patients.

  • An analysis, developed by Gallup consulting, involved 200 hospitals and concluded that nurses' engagement has more impact on hospitals outcomes than the relationship between the number of these professionals and the total number of patients. [5]
  • A study published in the Journal of Nursing Scholarship found out that workgroup cohesion and relational coordination had a positive impact on patient satisfaction, and increased workgroup learning led to fewer occurrences of severe medication errors. [6]
  • Another example – published in the Journal of Nursing Administration – was conducted by looking at data from more than 100,000 patients cared for at three hospitals in a US city between 2007 and 2012. This study found that patients on a unit with not enough registered nurses on both the day and night shift were 15% more likely to develop a urinary tract infection, bloodstream infection, or pneumonia two days later, compared to those with adequate nurse staffing. [7]

Back again: health outcomes depend on processes – the recommended set of activities to be performed by clinical and non-clinical teams - and on the people that execute them. Physicians, as well as other health workers, are main champions for quality goals. That been said, management efforts should be oriented to empower these professionals. Ensuring continuing medical education programs is not only a relevant competitive advantage among units – it is associated with retention rates up to four times better. [8]

References:

[1] Deloitte | 2021 global health care outlook Accelerating industry change | [internet] available at https://www2.deloitte.com/global/en/pages/life-sciences-and-healthcare/articles/global-health-care-sector-outlook.html

[2] Eagle's Flight | 5 Effective Employee Retention Strategies in Healthcare | [internet] available at https://www.eaglesflight.com/blog/5-effective-employee-retention-strategies-in-healthcare

[3] ITA Group | 7 Things That Cause Nurse Turnover (and 8 Things That Stop It) | [internet] available at https://www.itagroup.com/insights/7-things-cause-nurse-turnover-8-things-to-stop-it

[4] Nursing Solutions | 2021 NSI National Health Care Retention & RN Staffing Report | [internet] available at https://www.nsinursingsolutions.com/Documents/Library/NSI_National_Health_Care_Retention_Report.pdf

[5] Gallup | Nurse Engagement Key to Reducing Medical Errors - People more important than technology | [internet] available at https://news.gallup.com/poll/20629/nurse-engagement-key-reducing-medical-errors.aspx

[6] Bae, S. H., Mark, B., & Fried, B. (2010). Impact of nursing unit turnover on patient outcomes in hospitals. Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing, 42(1), 40–49. https://doi.org/10.1111/j.1547-5069.2009.01319.x

[7] Shang, Jingjing PhD, RN; Needleman, Jack PhD, FAAN; Liu, Jianfang PhD; Larson, Elaine PhD, RN, FAAN, CIC; Stone, Patricia W. PhD, RN, FAAN Nurse Staffing and Healthcare-Associated Infection, Unit-Level Analysis, JONA: The Journal of Nursing Administration: May 2019 - Volume 49 - Issue 5 - p 260-265 doi: 10.1097/NNA.0000000000000748

[8] Deloitte | Learning in the flow of life - 2019 Global Human Capital Trends | [internet] available at https://www2.deloitte.com/us/en/insights/focus/human-capital-trends/2019/reskilling-upskilling-the-future-of-learning-and-development.html/#endnote-sup-3