Hospices are unearthing new opportunities in the world of clinical workforce retention by taking a deeper examination of workers’ competing priorities.

The pandemic took a tremendous toll on their nursing workforce, according to Cooper Linton, associate vice president of North Carolina-based Duke HomeCare and Hospice. The impact continues to affect hospice providers, Linton said.

However, even in the midst of these challenges, hospices gained valuable insight around nurses’ competing priorities and what served as their biggest clinical retention levers, Linton said during the Hospice News Staffing Summit. The hospice workforce is increasingly placing a higher value on flexible schedules that allow for greater work-life balance, he stated. Responding to this need can open up career growth opportunities in some cases, Linton said.

“We’re seeing people looking for greater flexibility,” Linton told Hospice News during the summit. “COVID was not just an impact on the way people professionally approached work, but it [also] caused people to do some soul searching on their personal priorities. We see this in nursing and other professional roles as well, where staff are looking for ways to maintain work-life balance and use that flexibility to be professionally fulfilled without sacrificing their personal lives. We need to be sensitive to both.”

The complexities of addressing workers’ priorities

Hospice leaders need streamlined processes that help them understand how to provide a workplace environment that supports personal and professional balance, according to Cathy Wozniak, executive director of Massachusetts-based Hospice & Palliative Care of Martha’s Vineyard.

Having open lines of communication and avenues for staff engagement and feedback are important components of retention, Wozniak stated. Consistent staff communication is key to knowing the significant challenges impending greater satisfaction and career development, she added.

Ongoing engagement can provide hospice leaders with insight around the professional priorities and goals among their clinical staff, which can aid in better retention, Wozniak said. Strong communication can also impact a hospice’s recruitment outlook as roles become available and leaders gain a better understanding of their internal staffing resources.

“One of the things that we’ve seen is [that] we have clinicians that really do want to grow, and it’s so important to listen to them and hear that, and then begin to provide them with the education that they need to grow,” Wozniak told Hospice News during the summit. “The identification of staff [who] want to grow is really important because they are our next hospice leaders and we have to support them.”

Fueling a sustainable workforce means ensuring support around their physical, psychosocial, emotional, practical and financial needs, according to Jordan McGuire, director of operations at the human resources service provider Beneration.The Philadelphia-based company’s invoicing and accounting software system is designed to help organizations manage their employee and benefit data.

Back-office administrative staff can play an important role in strong clinical retention rates and develop policies that better address their competing priorities, McGuire stated. 

“These hospice companies can range from 500 to more than 10,000 employees and see a lot of complexities,” McGuire said. “They’re not only addressing employee concerns, but they’re also writing company policies and making sure they’re answering questions related to benefit spending. What we see a lot is that almost everything comes downstream from HR departments that interface with everyone.”

Rising demand and expanding geographic reach can be significant factors in growth, but also pose operational and clinical challenges, said Evan Rakowski, chief strategy officer of Beneration. Hospices’ strategic expansion can bring heavier workloads and organizational shifts that challenge clinical capacity as well as back-office administrative, human resources and accounting teams.

Staff can become overburdened as they manage complex employee benefit systems and billing structures, which can lead to dissatisfaction and higher levels of turnover, according to Rakowski. This trend can lead to insufficient support systems that can impact retention across interdisciplinary clinical teams as well, he added.

“The frontline turnover rate in skilled nursing is about 40% year-over-year, and generally speaking hospice would be somewhat similar,” Rakowski told Hospice News. “As every industry is facing, [hospices] are trying to do more and more with less and less people. There’s a ton of burnout. In health care, clinician licensing adds a whole other layer of HR required that other industries don’t have. It’s much more important.”