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Agencies try different strategies to retain staff
Home care directors and quality managers now must put extra effort into making work a satisfying and even enjoyable experience for staff as it is becoming increasingly clear that the quality of home care is dependent on an agency’s ability to retain its experienced staff.
"You need a qualified staff that are goal-oriented and quality-oriented," says Penny Rhein, BSN, RNC, vice president of United Home Health Ser-vices Inc. in Canton, MI. Rhein also is the immediate past president of the Michigan Home Health Association in Okemos.
"Home care employees have to believe in your mission and leadership and embrace ethical causes," Rhein says.
Focus on retention
So how does an agency maintain a dedicated and qualified work force during these times of health care staffing shortages? Rhein and other home care directors offer these suggestions:
• Eliminate barriers between staff and managers.
At Pro-Care Home Health Services in Sacramento, CA, there are no closed doors between hourly staff and managers, says David Dial, president and CEO of the large agency.
"The nurses can walk in the front door, and no one will see if the boss is available," Dial says. "Our office is their office, and we don’t want any barriers between us and our staff because they’re our lifeblood."
• Create a flexible work environment.
At the Visiting Nurses Association Inc. in New Orleans, the philosophy is if home care nurses can’t take care of their own families first, then they can’t take care of the patients adequately, says Katherine France, RN, MN, executive director.
"I want staff who are family-oriented, and it’s OK if the school calls and they have to run for their child," France says. "It’s OK for them to leave, and my staff do not have to wait for their supervisor’s permission."
Also, staff are not docked pay when they have to leave work to handle a family emergency, France adds. "You can’t take care of your patients if you’re out there worrying about your child; so if your child’s ill, you take care of it."
Susan B. Allen Memorial Hospital Home Health in El Dorado, KS, provides nurses with flexibility in scheduling so they can plan time off to attend school programs or other family events, says Melinda May, RRT, BHS, director.
"We try to foster autonomy and not have nurses on a set schedule as long as the patients are being taken care of," May adds.
• Give staff learning and advancement opportunities.
United Home Health Services has a number of projects that give staff opportunities to learn and grow. They include a cancer pain initiative study, an infectious disease study, developing clinical pathways, and implementing quality improvement projects using OASIS data, Rhein says.
"We have a long-standing retention of staff that’s very good for our agency," Rhein says. "I believe we’ve really tried to address the needs of our staff, and we’re very much motivated to incorporate field staff in our projects."
Susan B. Allen Memorial Hospital Home Health gives home health aides the opportunity to learn additional skills, including phlebotomy, taught on the job by a phlebotomist. Aides also are taught how to set up Lifeline services for patients, which is the alert system that patients can use to seek emergency help, May says.
• Reward, recognize, and celebrate.
Susan B. Allen Memorial Hospital Home Health holds "pat-on-the-back" parties for employees, in which staff are recognized for their success with an accreditation survey or other projects, May says.
St. Elizabeth Home Care Services in Lincoln, NE, places a strong emphasis on recognizing and rewarding employees, says Phyllis Rizzo, RN, BS, CHCE, director of home care services.
The hospital, in which the agency is based, has given employees free movie tickets and coupons for popcorn and beverages as a tangible reward for their loyalty and hard work.
"When we do our annual budget, we are asked to include $17 per employee for recognition and reward, and we’re expected to spend that much," Rizzo says. "I have a number of gift certificates for the mall, bookstores, etc. in a drawer."
Rizzo gives out the gift certificates whenever she learns of an employee doing something extra special. For example, a supervisor might tell her of an employee who usually doesn’t work on the weekend but came in one weekend to help with staffing, and Rizzo will give this worker a gift certificate.
The agency also has a "wooden nickel" program in which employees receive wooden nickels for going above and beyond their call of duty. This recognition can come from supervisors or co-workers. The employee then can save the wooden nickels and trade them in for T-shirts, gift certificates, and other prizes, Rizzo says.
Henry Ford Health System’s home care agency in Detroit has implemented a recruitment and retention task force and an employee recognition committee that is charged with making sure the staff feel appreciated and recognized for their contributions, says Greg Solecki, vice president for home health care.
The agency presents annual awards for nurse of the year, home health aide of the year, therapists, office staff, private duty staff, and volunteers. The honors are presented at an annual employee recognition luncheon that has become a much-anticipated event, Solecki says.
Another strategy for retaining staff is the agency’s annual employee recognition raffle. The agency solicits donations from southeastern Michigan businesses and typically receives more than 100 gifts, including professional sports tickets, theater tickets, restaurant gift certificates, free hotel stays, beauty kits, oil changes, and other items, Solecki says.
Throughout the year, employees receive compliments from patients and staff, and they save these compliments to use as their raffle tickets. The compliments might be the result of any occasion in which an employee did something extra special.
"Everyone walks away with something from the raffle," Solecki says. "We make the agency a nice environment and recognize people for going above and beyond," he adds.