Hospices have sought various ways to build supportive organizational cultures that fortify their retention strongholds amid widespread staffing shortages.

Understanding the competing professional and personal priorities of hospice workforces is key to ensuring sustainable career pathways, according to Priscila Feijó Mattingly, chief people officer at the home-based care provider Compassus.

Workers need a culture that recognizes and respects their individual differences, values and beliefs alongside their personal needs and career aspirations, Feijó Mattingly said during the Hospice News ELEVATE conference in Florida. Developing this type of environment requires consideration and multifaceted approaches to staff engagement and professional development, she stated.

“Culture creation of retention is a marathon. It’s not a sprint,” Feijó Mattingly told Hospice News at the conference. “There’s not one magic bullet. You have to create your own roadmap and work on things over time. There’s not a single solution for creating a culture of retention.”

Compassus is more than 50% owned by nonprofit health systems, with minority ownership by TowerBrook Capital Partners. The Tennessee-based company’s 7,500 employees provide home health, home infusion, palliative and hospice care across more than 270 locations in 32 states, among other home-based services.

Compassus has been closely monitoring nurse retention rates and turnover patterns. The company noticed that more than half of attrition among this workforce occurred during the first six months of hiring. In response, Compassus has honed its onboarding process to better support nursing teams within the first year of employment in an effort to improve retention, Feijó Mattingly said. This approach has led to actionable progress and “paid off big time” in terms of improved retention rates, she indicated.

Hospice News photo by TBAR Productions

How a hospice onboards its staff can speak volumes about its organizational culture and in turn impact retention, according to Amy Scheu, associate vice president hospice and palliative care at Advocate Health Care. The Illinois-based health system offers hospice, palliative, pediatric and primary care, among other services.

Employers need a firm finger on the pulse of the individual and commonly experienced challenges that staff encounter at the start of their hospice careers, Scheu stated. This involves providing staff with several touch points for leadership engagement and support, she added.

Advocate Health leverages preceptor training to ensure that new employees receive peer-based support and guidance. Mentorship can also help foster a strong organizational culture that understands and addresses staff challenges, which fuels stronger retention, she said. Additionally, newly hired employees are paired with one another to help navigate the onboarding process, which can lead to collaborative relationships as career trajectories progress, according to Scheu. 

“It’s really trying to be aggressive about connecting with our new team members,” Scheu said at ELEVATE. “What we found is that our labor pool has a lot more people that are new to hospice, so [that is] a major adjustment. The ways that we found to be successful with that is really engaging them on a lot of different levels. It’s checking in with them, making sure we understand exactly where they’re at in the process.”

Hospice News photo by TBAR Productions

Sustainable retention takes meaningful communication and an approach that focuses on continuous process improvement, said Florida-based Community Hospice & Palliative Care CEO Phillip Ward.

Community Hospice & Palliative Care’s more than 1,000 employees care for roughly 1,500 patients daily in the home, at hospitals and at long-term care or assisted living facilities. Established in 1979, the nonprofit is an affiliate of Alivia Care Inc., and serves adult and pediatric patients across northern Florida and two locations in Georgia.

Hospices need a person-centered approach to retention that mirrors their interdisciplinary care models, Ward stated. Workers should have access to physical, emotional and psychosocial support that help them to thrive in their roles. Also paramount to a culture of retention is having a direct line of communication with leadership, he stated.

Hospice leadership should be accessible and create ample opportunities for individualized staff engagement to ensure that they understand their most significant pain points, Ward said. Strong communication avenues are central to learning what workers value most about a hospice’s organizational culture versus what areas may need an overhaul, he indicated.

“Keeping it personable reinforces our intentional culture, which also has that compassionate approach,” Ward told Hospice News at ELEVATE. “With patient care we transform every critical touch point into a meaningful experience. We want to do the same thing for our staff … that ongoing support. You want to hear who they are, where they come from, what attracted them to your organization and make it very personable. There’s the feedback loop [that] we’re constantly improving on what we’re doing with employee orientation. That intentional process really prepares people for the work they’re doing and inculturates them to your mission.”

Hospice News photo by TBAR Productions