Go? No Go? The Answer Affects Your Life.

Who actually provides our health care? Not the regulators, legislators, hospital administrators and insurance executives, but the nurses, doctors and allied health personnel. They are the people we really need.

When keeping track of their employees, most medical organizations behave like any other business: they measure turnover. However, we now know this is the wrong measure. We should track what we want – retention – not what we do not want – turnover.

While turnover is worrisome, those few who measure retention find truly frightening data. For instance, net five-year retention of nurses was 17%! This means that 83% of the nurses hired in 2000 had left by 2005. As a result, you either don’t have a nurse at all; the nurse you have must cover too many patients; or your nurse is inexperienced.

You can use your imagination for what low retention means but the facts are probably worse than your nightmares. If your nurse is new to your hospital, she does not know whom to call for what; how to get an unusual medication; or even if your lab result is dangerous. The inexperienced nurse is more likely to make an error and you “pay” for that mistake. .

Low retention is not only dangerous for the individual patient, but bad for all of us in aggregate. It produces a huge but hidden cost. When carefully measured, the cost was 5% of a hospital’s total yearly budget. Since hospitals do not measure retention, they do not know this!

To put this cost in perspective, most hospitals realize a profit of about 2% per year. Low retention is costing hospitals more than double their profit margin and what do they get for it: nothing, nothing except errors and lawsuits.

The title was “Go? No Go?” referring to a provider’s decision to stay or leave. When the majority is leaving, when most decide to Go, we all suffer as patients.

Every study reported in the past ten years shows a nursing shortage, one that is getting worse. The same is now happening with doctors. When a hospital cannot keep the nurses or doctors they have, when their retention is low and getting lower, the likelihood that we will have good care providers when we need them is grim.

Low retention of medical care providers is a problem that must be addressed. Before we start talking about solutions, like signing bonuses, please first diagnose the reasons for low retention. Otherwise, we will be treating symptoms not causes, just like we have done in other areas of our healthcare system. You can see where that has gotten us.

Low retention produces bad healthcare outcomes. Its cause must be cured.

System MD

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#1 Anthony on 07.28.14 at 5:27 am

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