Identifying and Reducing Employee Turnover

by Andrea C. Santiago, Health Careers Guide at

Every employer experiences turnover. But how do you determine if your attrition is “normal” or average, or if there is something more serious going on with the staff or work environment?

Turnover can be very costly to a practice. With each employee who leaves, much time and money go out the door with that person. Being short-staffed can be particularly challenging in a medical practice environment, because patients don’t stop getting sick or stop scheduling appointments just because your key staff member(s) quit today.

Sometimes turnover can even have a “snowball” effect – once one or two people leave, others will follow, and then you’re left scrambling to put the staff back together.

Below are a few ways you can assess and engage your staff to help prevent or reduce high turnover in your practice.

Review your hiring/firing history for at least the past year, or few years, if possible. To calculate a more precise turnover rate, there are numerous turnover calculators to help you determine turnover rate, such as this one at

If your rate is much higher than 12-15%, there may be an issue. You probably don’t need to be seriously concerned unless your turnover rate is significantly higher, in the 25%-plus range.

Then you need to determine which turnover was due to external factors beyond your control, and which turnover was prompted by internal factors that you could control, prevent, or reduce.

If you are not sure why your people leave their jobs at your office, that’s one place to start – by asking detailed questions when people resign – and then read between the lines! Often, departing employees will not tell you the real reason they are leaving. Professionals are usually (and rightfully) advised to prevent “burning bridges” with contacts at former places of employment, which is a diplomatic and professional way to exit. Therefore, you may need to have some other more formal measures in place to determine causes of turnover.

Review your hiring and on-boarding processes. Perhaps it’s not the workplace that is the issue – you could simply be hiring the wrong people. This could be true especially if you have high turnover due to external factors vs. internal factors. Review your interview questions and hiring decisions as well as the people who are making the hiring decisions. The hiring process should help find candidates who not only are capable and qualified for the job, but also those who will fit into the work environment and want to stay there long term.

Additionally, the first 90 days are a critical time period for any new hire. Review your training and orientation procedures, and look for ways to help make the new employee feel more confident and comfortable in his or her new role.

Administer employee satisfaction surveys. There are many online tools you can use to administer confidential surveys that will auto-score and are user-friendly.

Conduct exit interviews for every departure. These should be formal and standardized (the same questions for everyone) if possible.

Follow-up on the survey/interview findings. The key to utilizing these surveys are to follow up on the results – meet with the management of your office and develop strategies to address the issues that are expressed in the satisfaction surveys and exit interviews. You don’t need to be overly concerned with every single grievance that is expressed in these interviews and surveys. However, look for patterns in the results, such as several complaints about the same issue, then it’s probably time to make some changes.

Once you’ve assessed your turnover rate and the staff feedback, some of the ways you can improve the work environment include:

Employee Recognition – increased opportunity for recognition helps your employees feel more valued and important which may help them feel more loyalty for the employer.

Improve incentives and perks – add more ways to earn additional vacation, bonuses, etc.

Remove negative influences – if you have a “rotten apple” in the bunch, it can spoil the entire team. You may think that it’s “just one person” – but one negative team member can truly impact your entire team.

Reduce Stress in the Workplace – any way that you can improve efficiencies, or simplify the processes in the workplace may help reduce the stress on your employees. Also there are more direct ways to reduce stress, such as offering therapeutic support both for mental and physical health.

© 2011 Efficiency in Practice

For more ways to reduce turnover and retain your employees, register for the “Retaining Your Talent – How to Reduce and Prevent Employee Turnover” tele-class with Andrea on July 21, 2011 at 12:00 noon est.  Register Here - your first tele-class with us is on the house!

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