Hospices Seek to Maximize Employee Satisfaction Amid Pandemic Turnover

Amid industry-wide staffing shortages, hospices are progressively focusing on strategies to reduce turnover and improve employee satisfaction. Recent research indicates that providers can do more to support hospice staff work/life balance needs and boost morale to mitigate burnout and grow their workforce as they contend with added pressures resulting from the COVID-19 pandemic.

Staffing issues were indicated as a top challenge in 2020 for end-of-life care providers in a Hospice News survey earlier this year. The survey was performed prior to the onset of the pandemic. More than a quarter of respondents identified workforce shortages as a primary concern, outweighing focus on competing in a crowded hospice space.

Many hospices have reevaluated employee paid time off (PTO) policies to help support staff needs during the coronavirus pandemic.


“It’s no secret that working in the healthcare industry amid COVID-19 has been challenging,” said Angela Rhoads, senior vice president of Interim HealthCare’s home health and hospice business lines. “Some Interim HealthCare franchise owners have provided further assistance such as hazard pay, childcare support and additional PTO to staff members to ease their burdens during COVID-19.”

Research published this summer in the International Journal of Environmental Research and Public Health found that providing resources for self-care facilitation and staffing support for balanced workloads could improve quality of life among interdisciplinary hospice teams and the patients and families they serve.

“We asked respondents working in hospice what made them feel valued and supported in the work environment,” said Rebecca Lehto, associate professor at Michigan State University College of Nursing. “From there we talked about challenges on what their experiences were with burnout related to hospice work: how they managed it, what types of recommendations from their perspective that organizations could implement to help with work-related stressors.”


Previously serving as an oncology nurse with clinical experience serving patients with advanced terminal illness at the end of life, Lehto was part of a team of researchers collaborating on the study examining home and community hospice workforce satisfaction. Feedback was initially collected from surveys issued to hospice staff in various organizational and clinical roles and geographical urban and rural settings across the state of Michigan prior to six discussion-based focus groups.

The study found that hospice employees felt both rewarded and challenged in their roles surrounding the end of life, with burnout and heavy workloads driving forces of stress. Respondents cited lack of support staff for time off and the need for organizations to provide increased opportunities for self-care during work hours as strategies for hospice providers to improve employee satisfaction and reduce high turnover.

Hospice providers have ramped up staff appreciation efforts during the coronavirus pandemic under added pressures for staff facing risk of exposure to themselves, patients and their families.

“Our franchise owners have been wonderful since the start of the pandemic in implementing programs to show appreciation for caregivers and other staff members,” said Rhoads. “From drive-thru breakfasts to gift basket deliveries, they have really stepped up to show compassion and to recognize their employees’ great work during this incredibly challenging time.”

Providers forging ahead with strategies could focus on providing staff with opportunities throughout their work day for self-care under the stress of caring for dying patients and supporting their families. With COVID-19 pressures refocusing hospice leadership focus on employee mental health needs, providers incentivizing self-care among staff could cut high burnout and turnover rates.

“Anything that can foster a work-life integration I think is of the essence for hospice providers,” Lehto told Hospice News. “Having built in self-care, that is something that’s just part of what everybody does, and maybe there’s some incentive around people who are doing things so that you’re getting points or earning something, that was one of the things that research participants were pretty clear on. They didn’t just want people to give them a pizza or something like that. Just having that perception in the employees that leadership is listening, and they do really care about how staff is being impacted matters — especially during the pandemic, that’s really magnifying some of these existing workforce problems.”

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