RESEARCH TO PRACTICE
Strategies for Reduction of Staff Turnover
Bullock, C. (2008). Consistent staffing benefits resident, staff. Caring for the Ages, 9 (1), p.6.
Consistent staffing is the hallmark of person-centered care, as it promotes meaningful relationships between all-level staff members and nursing home residents. When staff members are consistently assigned to the same small group of residents, it promotes formation of good relationships and improvement in quality of life. Both residents and their families identified relationships with caregivers as the most significant aspect affecting residents’ quality of life and care.
Advancing Excellence in America’s Nursing Homes campaign identified consistent staffing as an important element for improving residents’ quality of care and life. The campaign’s tracking system and additional research has identified some of the results in this area. Residents living in nursing homes with consistent staffing score higher in personal appearance and hygiene in comparison to residents who get services from rotating staff. Because the same staff members provide care to the same residents every day, they are more likely to notice subtle clinical changes before they develop more serious problems. Early problem detection contributes to a higher quality of care for residents.
The cost of long-term care staff turnover is estimated at $2.5 billion annually and this does not account for those costs that cannot be measured financially. Every time a staff member leaves a nursing home the caregiving relationships and quality of care of residents is interrupted. Consistent staffing may provide a solution to these problems. Staff members who are consistently assigned to the same group of elders gain a sense of commitment and this reduces staff turnover. Strong relationships with residents help staff to more effectively provide appropriate care, increase their self-esteem and enhance the feeling of importance of their work.
Studies identified 10 strategies to reduce staff turnover and implement consistent assignment:
- Allow staff to trade work days, even at the last moment. The only priority should be that each shift is adequately staffed. Flexibility with shift changes/exchanges helps to build trust among staff.
- Empower staff with the necessary knowledge and skills to improve work processes and systems of care. Staff should know what is expected of them and where to find resources and supplies.
- Have an Employee Assistance Program in place. A few nursing homes in Kansas provide quick loans to staff members in need. This assistance demonstrates appreciation of their work, and strengthens loyalty to their employer.
- Help staff resolve problems in their lives to prevent them from quitting. There are programs available that offer a-24 hour hot line to help staff deal with their problems and identify workable solutions.
- Indicate staff assignments on the master schedule in order to clarify, from the beginning of each shift, the person responsible for each task.
- Reward and educate staffing coordinators through regular meetings, constant support and a consistent reward system to prevent understaffed shifts.
- Focus on increasing full-time workers while decreasing staff hired on a part-time basis.
- Provide a strong work/life program to attract and retain good workers. For example, a wellness center built primarily for residents which is also available to staff and their families.
- Recognize good behavior rather than focusing only on negative behaviors.
- Establish eye contact, smile, and greet employees, residents and any visitor coming to the nursing home.
Implications: The person-centered model of care is dependent on consistent staff assignment. Recruitment of great direct care staff is only one factor that contributes to residents’ higher quality of care and life. Strategies related to job satisfaction are worth studying and using, considering that consistent and long-term staff assignment is the key to a successful person-centered model of care.