Turnover crisis aligns with COVID-19 spikes

In the healthcare industry, when a shortage of qualified staff directly affects patient outcomes, controlling turnover is vital. Baptist Health is a mission-driven not-for-profit healthcare organization with more than 23K employees, 1,500+ of whom are providers, and among its healthcare facilities operates nine hospitals, primarily in Kentucky and southern Indiana. In 2021, Baptist Health found itself facing increasing turnover numbers. Much like other healthcare organizations during the height of the pandemic, Baptist Health was losing people and couldn’t recruit fast enough to permanently fill the vacant roles and was forced to rely on costly agency staff to meet patient needs. They needed a way to stem the loss of valuable talent and provide their organization with a break long enough to catch up.

Steve Rudolf, system vice president, Human Resources at Baptist Health, knew they were part of a nationwide crisis when the news reported 4.3 million workers, including healthcare staff, left their jobs in just one month. He looked carefully at his organization’s turnover metrics and noticed that Baptist Health’s turnover aligned very closely with COVID-19 surges. “Based on what we were forecasting, we knew the omicron surge was going to hit in December and January. And, if we continued to turn over staff at our current level, we would not be able to provide the care that we needed to provide to our patients. So, we needed to figure out a way to retain our staff.” He had a conversation with Baptist Health’s CFO and other leaders about options to try. 

Rewarding employees with what they needed most

The organization had already rewarded staff with some success, using various recognition and bonus efforts, such as a “celebrate you” reward program. But these measures were no longer sufficient. With turnover going up fast, a business can’t hire fast enough to do the backfill. 

It was a tough time. Everyone was feeling the crunch, as healthcare staff were not able to take time off as they normally would because they were committed to care for the patients coming through the facilities. Front-line workers had been struggling with the mental and emotional toll of seeing so many patients come through the doors. The pressure to care for patients while dealing with this exhaustion was causing many to feel burnout. Additional paid time off (PTO) was believed to a benefit that everyone could use (once Baptist Health made it through the next projected wave of the virus). While Baptist Health couldn’t promise that the pandemic would end soon, they could provide some assistance for their staff. They decided to offer additional PTO as a retention reward for staff who remained with the organization. This program was designed in two phases, with the first phase starting in mid-October and running for 10 weeks and the second phase running through March 2022 (long enough to get through the next predicted COVID surge). 

“The HOPE PTO retention program was hopefully going to slow exits so we could get the starts to increase. It was a multimillion-dollar effort to find out whether we were going to be able to change our [retention] curve.” Rudolf knew that his team had the analytic capability with Visier and could track its success to know the first phase succeeded before launching the second phase two months later. “We basically told employees, we’re going to try this. We don’t know if this is going to work or not. If it works, if we’re able to change our curve on our turnover, we will do phase two. And, obviously it worked. We saw a great reduction.”

Figure 1: Internal data showed the crisis of resignations and how swiftly the program changed the trend.

People analytics measures success

The analytic capabilities Visier gave the Baptist Health team helped them gauge the success of the HOPE project in multiple ways. First, they were able to monitor the first retention curve in real time and saw it climbing, sounding the alarm to move quickly. Second, they were able to estimate the cost of turnover, which then gave them an estimated return on the investment being made in additional PTO. Average turnover costs Baptist Health millions every month — this program cut that loss in half, with proven savings and a positive return on investment due to reduced turnover. “We’ll have to find out whether we have weathered the storm and been able to get some solid footing to hold onto these people beyond the end of the program. So, we don’t know yet if it is cost delayed or cost avoided, but even the delay provides an inherent cost savings because you’re at least not having to replace staff in that period of time,” Rudolf said. More important, this slowdown in attrition gave Baptist Health’s talent acquisition team a much-needed chance to catch up.

While the analytic capabilities of the Baptist Health team were crucial in averting this crisis, new uses for people data insights were discovered as more teams began to use Visier’s capabilities. Kayla Batts, director of People Analytics and Solutions, came to her role from a background as an HR manager. “People analytics is really a brand-new journey for our entire organization,” Batts said.  Batts has been building personalized guidebooks for teams depending on their roles. While she had been working closely with data on Rudolf’s team for years, when Visier was rolled out to her and the other HR leaders, they originally couldn’t quite wrap their heads around how much it could help them. “And then finally, I sat through some of the executive sessions and listened to their questions, which I think is what really made me understand what [information] I needed to get into the hands of my leaders to drive some conversations.” At that point, the questions were specifically around the key metric of turnover. 

“What we are trying to do with Visier is this, we [already] have the dashboards and the ability to have the rearview mirror to see what was happening retrospectively. What we were seeking [now] is something that would tell us why it’s happening, and then also be able to predict what’s going to happen,” Rudolf said. The ability to perform predictive analytics is why Rudolf’s team chose Visier over other competing products: To identify hotspots that needed intervention, and to forecast–allowing his team to stay on top of what’s coming. Rudolf’s ultimate vision is to take the analytics team to a place where “We are able to predict somebody is thinking about leaving before they know that they’re thinking about leaving.” 

The future of retention

Retention will continue to be an issue in every industry, including healthcare, and Baptist Health is exploring new options to address it, including compensation in a time of wage inflation. “I’m sure you have gone into your local restaurant or your local store and said, wow, grocery store prices have gone up. The prices we charge for patient care have not materially changed, but our wages and labor costs have gone up,” Rudolf said. The organization is squeezed by increased operational costs and its limited ability to raise prices and the limited ability to pass along those increases to government and commercial payers much as a grocery store, restaurant or retail outlet might do to its customers, and they’re struggling with losing employees to positions that pay more. “Travel nurses can earn two or three times more than what you can as a regular employed nurse. And we’re trying to figure out how to manage through that situation as well. We’re trying to make sure that we have a great employment brand and unbeatable work environment where employees want to come work and be part of the Baptist Health family. We want individuals to recognize the value of being part of our organization as opposed to moving around, but the world of travel nurses has changed. In today’s current environment, individuals now have the ability to ‘travel’ within their own city whereas previously, if you traveled, you knew you were packing a suitcase. So, there’s just a lot of dynamics, a lot of variables that are at play.” 

Baptist Health has raised salaries and is taking a data-driven, targeted approach to other employee retention efforts. “One of the things that we were able to use Visier for is when we saw that steep [turnover] curve, we wanted to find out if that curve was systemic, or was it related to certain parts of our organization? And, we were able to quickly dissect the data to say it does affect this area, but it doesn’t affect this other area. We knew that we had high turnover in our acute care hospitals. We thought we had high turnover in our home care organization, but when we peeled the onion back, that did not necessarily prove out; it did not have the same curve. And, so, as a result, when we did the program, we limited it to our acute care facilities,” Rudolf said. Because they were able to dissect the data to make sure that they were careful in where they spent the money, they could apply the program to where it was needed most to address turnover in the exact areas that needed help. 

Limiting the program was a tough decision. “Because everybody’s working hard and everybody has an important role to serve to make sure we provide the care. From that perspective, it doesn’t matter whether you are a nurse or somebody cleaning the floor or somebody who is in our patient services area who’s dealing with patient financing. Everybody has a critical role to play, but because of the large investment that was going to be made in the program and the limited resources that we had to apply to this program, we needed to make sure we were somewhat surgically precise in where we applied those funds.”

The benefit of people analytics is not just to see where the problems lie, but to test solutions. The problem of turnover isn’t going away; Baptist Health’s leaders will continue to seek solutions. With Visier, leaders can see how people are moving in and out of the organization, as well as within the organization. (Figure 2) 

Figure 2: Employee movement summary data reveals insights about retention and career progression planning

“If we’re having more difficulty recruiting nurses and we’re trying to address the nursing shortage, we will likely need to explore changing the nursing model and how nursing care is provided. What that will look like, I don’t know, but that is something that we are exploring. I think we’ll use Visier to help us explore that as well.” When Rudolf jokingly said that the not-for-profit health system had to compete with the academic centers and start “Baptist Health University” so they could offer free tuition, the idea took root. While they don’t necessarily have degree programs, Baptist Health is looking to develop non-degree training programs to train people in house on how to become a certified nurse assistant or other similar level positions. “I think that’s one thing that draws people to our organization,” Rudolf said. “The growth opportunities.” 

While turnover and retention issues will continue to impact all companies, the people analytics expertise Rudolf and Batt’s team is building within their organization will continue to help meet new challenges. People data is essential to measure the organization’s Human Resources vital signs.