December 10, 2012
Increased Retention Leads To Better Care
A number of different studies have shown that lower turnover and higher retention of staff, particularly skilled staff, increases the quality of care. The increase in the quality of care may result, in part, because patients feel more comfortable with staff they know. Additionally, members of the staff that become familiar with patients will notice subtle signs that a new employee would likely miss. If skilled nursing staff spend a considerable amount of time with patients, they will also begin to understand the personal preferences of each patient, which can increase the patient’s satisfaction.
The decreasing of turnover and the increasing of retention can have significant positive effects for skilled nursing facilities as well, including:
- Reduction in time and cost of hiring, including advertising, interviewing and training
- Reduction in the use, and therefore cost, of temporary workers
- Improvement in staff satisfaction and happiness, resulting in staff recruiting more good staff
- Improvement in cooperation and planning between disciplines
- Improvement of communications between caregivers
In short, skilled nursing facilities that create a good working environment for their employees, create happy employees who will recruit more happy employees, and with happy employees come happy patients.
A 2012 American Health Care Association Quality Report indicated that turnover decreased by 9 percent overall for all nursing roles from 2008 to 2010. The turnover rate for certified nursing assistants decreased from 53.5 percent in 2008 to 43 percent in 2010. Turnover also decreased in the food services and housekeeping areas since 2008 as well. The American Health Care Association, as part of its Quality Initiative Plan, is setting a goal of a 15 percent reduction in nursing staff turnover by march 2015. Such a reduction would mean more than 615,000 nursing staff members would remain in their jobs each year instead of moving. The Quality Report indicated that skilled nursing facilities improved in twelve of the fifteen areas that the Report measured. In addition, resident satisfaction levels have increased. Long-stay residents have a satisfaction rate close to 90 percent. Short-stay patients report an 87 percent satisfaction rating, an increase of 9 percentage points from 2008.
The American Health Care Association’s Quality Initiative Plan also includes improvements in customer satisfaction, reductions of hospital readmissions and stopping off-label use of antipsychotics. While many are happy with the progress to date, the upcoming “fiscal cliff” is causing some concern. Medicare cuts or reductions in funding related to changes in the provider tax assessment may affect the ability of skilled nursing facilities to keep up the progress with retention and customer satisfaction.