Set the Tone - Advance Your Team

Employee turnover is one of the biggest challenges a health care leader faces every year. Learn how to work with your human resources and recruiting department to introduce a rock-solid program that creates value for your non-degreed employees.

Leaders in health care face many challenges, from budgeting to project management, but one of the biggest challenges for a leader is employee turnover. I have worked in organizations where employees stay for two or three years and leave to find something better; some organizations experience extremely high turnover rates where employees leave within two weeks from starting (or less), and a very small number of people will stay for an entire career – some more than 40 years. Ideally, an organization strives to offer competitive salaries and benefits packages that attract qualified candidates, including what many people look for – an organization that offers growth opportunities. Without a built-in career ladder for non-degreed employees, an organization will continue to experience a higher rate of turnover and spend more money to recruit and retain employees. Implementing a program in your organization that focuses on mentoring, employee development, and career grow this a start to creating the longevity you desire and hiring the quality employees your organization needs.

Questions about Your Positions

If you are considering a program for your employees that includes the creation of career development and advancement, one of the first actions you need to take is answering a few simple questions about your team. This requires that you focus on your current staffing model, how many employees you manage, and your current staffing budget (how many employees are you budgeting for, do you need to request more employees, etc.). To start, answer the following questions, and meet with your manager or director to analyze your answers:

• Do you work in a hospital or private practice?

  • Hospital – inpatient/bedside care, or outpatient clinics?

• How many employees are in your department?

• Does your current staffing model require any new hires in the next budget year (due to department growth, such as adding a new physician/surgeon, or planning to replace someone who is retiring/leaving)?

  • Or will you be required to downsize your department? (Hopefully not!)

• How many degreed employees do you have? List them by role (RN, technicians with degrees, etc.). Make sure you have the job descriptions for each role.

  • What are their pay rates (low/median/high – based on experience when hired)?

  • Do these degreed roles have I / II / III steps, or a “lead” or “management” position available to provide a ladder of advancement?

    • What are the pay rates for these levels?

    • How often are employees in these roles leaving, and how often are you needing to fill vacant positions?

• How many non-degreed employees do you have? List them by role (Certified Medical Assistant, clerks, schedulers, etc.). Make sure you have the job descriptions for each role.

  • What are their pay rates (low/median/high – based on experience when hired)?

  • Do these non-degreed roles have I / II / III steps, or a “lead” or “supervisory” position available to provide a ladder of advancement?

    • What are the pay rates for these levels?

    • How often are employees in these roles leaving, and how often are you needing to fill vacant positions?

More often than not, most leaders will answer “no” to the last question – they have no advancement opportunities for their non-degreed employees. Answering “no” to that last question means you need to move forward with a plan to introduce advancement opportunities for these employees. Now that you have some foundational information about your employees, you are ready to meet with your manager or director and develop a plan of action.

Review the Job Descriptions, Determine Your Needs – and Get Help from HR

You have your job descriptions handy for your CMA, clerk, and scheduler positions, and you have analyzed them word by word. What will this do for your new program? Analyzing the job descriptions allows you to pinpoint any errors, such as tasks or responsibilities that do not apply, or omission of tasks and responsibilities that do apply, and determine what kinds of responsibilities would be appropriate if you added steps, lead positions, or supervisory opportunities to the role. Your partners in the human resources department have team members who specialize in writing job descriptions, so they are going to be a strong advocate for you during this process. Be forthright in what you believe should be in the job description, and what should be removed.

You will need to determine, based on your current staffing model and needs, how you would like to model your advancement ladder. Are you going to add steps to each role? For example:

• Level I: This will be your new employees, with a minimum time required for experience (the level of “I” will not follow their title). You can even introduce this as a “trainee” opportunity for externs from technical schools. Those who perform well during their externship have the chance to interview and get hired with the organization.

• Level II: Employees at this level may require more years of experience or time at the organization, more advanced skillsets, and possibly the opportunity to mentor and train new employees (the level of “II” will follow their title, such as “CMA II”, or “Clerk II”).

• Level III: Employees at this level may require a minimum of three to five years in their role, and/or a minimum amount of time at the organization. Level III employees will have already engaged in mentoring and training others, developing more advanced skillsets, and possibly earning certifications in their field. This can be labeled as a “CMA III” or even a “lead” position.

Your organization’s HR department will also need to conduct a market analysis to ensure they are setting competitive pay rates for each of the positions you are creating within your current roles. This will ensure that your employees are provided with what many organizations do not have – the advancement ladder for the CMAs and other non-degreed individuals to climb.

The Program is Complete– Implement It!

Every organization has its own pace of how it manages new projects and programs. When you present the evidence that this can turn over your turnover rate, and you are diligent in your efforts to create a program that entices candidates to sign with your organization, you will see fast progress and quick implementation.

The key to implementing your program is organization, planning, and a focus on why this program will create value for your employees. Think about your why with every meeting, every conversation, and every hiccup along the way. The why should drive your passion for giving your employees the status and the opportunities they deserve.

When you get ready to implement your new career advancement program, you will have already assigned your current staff with their appropriate levels, based on their years of experience, years of employment with the organization, and any other factors that correlate with their assigned job description. Meet with each employee and review their job description, and how they have the opportunity to advance and earn higher pay based on their longevity and performance with the organization.

You should announce the new program in an all-hands meeting, and follow-up with a department email and encourage your team to seek guidance or ask questions. This is a program that you are creating for people who never had this kind of opportunity, so it is critical to track its success, and focus on areas that may need improvement.

One of the key elements of success with this type of program is timely recognition and evaluation. Implementing the program is the first step; maintaining it takes just as much work, if not more, than the initial creation of the program.

• Recognize your team for their individual and group accomplishments and review your employee’s performance on a regular basis.

  • How will you know if your program is working if you lack engagement with the very people who are benefiting from advancing in your new career ladder?

• Document the success of the program by documenting the success of your team with periodic rounding and performance evaluations

• Survey your team – ask them if they have suggestions about improving or enhancing the program

• Report to your manager or director regularly, and let them know what is working – and what is not working

One Step Further – What Happens When They Reach the Top?

You may have some of these non-degreed employees who latch on to the idea of career advancement and climb to the top of your new ladder. What happens when they reach the top? Can they climb any higher?

This is for you and your HR department to decide. If you want to create more positions, and it is justifiable to do so, create the model that fits your needs. Create a CMA supervisor or Senior Clerk position and go beyond that by encouraging your superstar employees to go to school and earn a degree that will push their career even further!

Remember – Take Care of Your Employees – and Yourself

You may have heard this – when others succeed, you will succeed; or take care of your team, and they will take care of you. These phrases come in all shapes and sizes, but they all point to one realization – when you do take care of the people you manage, you will find success. Remember – you are in a leadership position for a reason. You worked hard, earned a degree (or two), and you are in your position because you have a passion for your work, and for your role in the organization. At some point in your career, you struggled to advance, just like the people you manage. Now – you are leading others, and you advanced to that level because of your efforts. Remember to take care of yourself by taking care of others. Take pride in your accomplishments and encourage others to do the same. Set the example that you want others to follow – and you will see engaged and inspired employees, less turnover, and a higher level of employee satisfaction. Show your team their new path of advancement; plant the seed, watch them grow, celebrate their journey, and take your own journey to advance you.