nurturing & keeping the best staff cccmha executive retreat june 21, 2007 jeanne supin watauga...

Nurturing & Keeping the Best Staff

CCCMHA Executive RetreatJune 21, 2007Jeanne Supin

Watauga Consulting

Workshop Objectives

Revisit why staff retention is importantLearn the best national research on retaining excellent staffExplore a model for retention in behavioral healthPractical Priorities for Enlivening the CA Mental Health Services Act

Workshop “Rules”

INFORMATIVE and INFORMALCONTRIBUTE your thinking, experiences, and expertiseLISTEN & LEARN from each otherCOLLABORATE on solutions

Why Retention Is So Important

Turnover Trends in Behavioral Health

Turnover rates for case management and paraprofessional staff can be as high as 30-50%Turnover rates for clinical staff can be 20-30%Recruitment of specialty clinical staff is difficult, to say the leastPsychiatrist recruitment is extremely difficult

California Vacancies

Certified alcohol & drug abuse counselors – 38.3%Psychiatric nurse practitioners – 27.6%LCSWs – 24.3%Psychiatrists – 23.3%Some consumer positions – 21.8%Particularly acute for children & youth and older adult systems of care

Additional Staff Needs in CA

Bi & multi-lingual staffBi & multi-cultural staffConsumer / family member staffInner city and rural areasPsychiatric physician-extendersThose able to serve special populations

Losing Staff Affects …

Client & family engagementContinuity of careService capacityFinancial bottom line

Calculations

Direct cost to fill a $60,000 job ranges from $9,777 to $49,000Other studies suggest replacing an employee can cost (direct & indirect) more than 3 times the annual salary

Direct Costs

Placement, advertising feesInterview costsHiring, bonus, relocation costsTraining costAdministrative expenses

Indirect Costs

Care discontinuityLost revenue due to vacanciesLost training & experience“Ramp up” time

Learning curveStaff stressOrganizational image

General Turnover Trends

Unemployment rate is only very slightly higher (5.4%) than in the boom years in late 1990’s (4.6 average)Baby Boomers will begin retiring in 2011, with likelihood many will retire early (60% by age 62)Estimate a skilled labor gap crisis began in 2005 Source: John Izzo & Pam Withers, Values Shift: The New Work Ethic and What it Means for Business

Additional Changes in How Employees Perceive Work

Work is no longer considered the primary focus of one’s lifeParadox: employees also want their work to be meaningful and offer real fulfillmentEmployees are more committed to their own work, their own professional growth & development than to an organization

Bottom line: You don’t have enough people

to fill available positions so you can’t afford to lose any

staff!!

Brief Recap about Good Recruitment

Be creative & aggressive Advertising & marketing Encourage & reward existing staff for finding new

staff “Home grown” staff

Push for, expand, take full advantage, & market CA workforce development strategies: High school & community college academies Education stipends Loan forgiveness programs beyond professionals

if possible)

"In these days of talent wars, the best way to keep your stars is to know them better than they know themselves – and then use that information to customize the careers of their dreams”

Timothy Butler and James Waldroop, Job Sulpting – The Art of Retaining Your Best People, Harvard Business Review, Sept/Oct 99

National Research on Retaining Excellent

Staff

Gallup Organization Research

Authors Marcus Buckingham & Curt Coffman25 years worth of interviews1,939 workgroups in 26 organizations, 21 industries around the worldOver 1 million workersFirst Break All the Rules: What the World’s Greatest Managers Do Differently (Simon & Schuster, 1999)Q12

Most Important Variable in Productivity & Retention

Assuming reasonably competitive pay, the most important productivity & retention variables are:NOT pay or benefitsNOT commitment to the missionIt’s the quality of the relationship between employees and direct supervisors

Not Pay & Benefits?

Pay, benefits, senior management & org structure were initially on the list but dwindled under analysisThey are important, but they are equally important to all employees – good, bad, mediocreAccording to the Gallop research, competitive pay & benefits will get you employees but they won’t encourage the great ones to stay

Gallup Organization Q12

1. I know what is expected of me at work.

2. I have the materials & equipment I need to do my work right.

3. At work, I have the opportunity to do what I do best every day.

4. In the last seven days, I have received recognition or praise for doing good work.

5. My supervisor, or someone at work, seems to care about me as a person.

6. There is someone at work who encourages my development.

7. At work, my opinions seem to count.8. The mission or purpose of my

company makes me feel my job is important.

9. My fellow employees are committed to doing quality work.

10. I have a best friend at work.11. In the last six months, someone

at work has talked to me about my progress.

12. This last year, I have had opportunities at work to learn and grow.

High Scores Mean Higher:

ProductivityProfitEmployee retentionCustomer satisfaction

Specific Retention Questions

1. Do I know what is expected of me at work?2. Do I have the materials & equipment I need

to do my work right?3. Do I have the opportunity to do what I do

best every day?5. Does my supervisor, or someone at work,

seem to care about me as a person?7. At work, do my opinions seem to count?

These 5 questions are most directly influenced by managers, not companies.Employees stay with or leave managers, not companiesThey may join your organization because it’s the type of work they love, but they stay because they have a great boss.

McKinsey & Company

“War for Talent 2000”Surveyed 6,900 corporate officers, top executives, midlevel managers56 companies

McKinsey’s 7 Talent Imperatives

1. Talent mindset at all levels2. “Extreme Employee Value

Propositions” – compelling reasons why someone wants to work for you (great organization, leaders, job & attractive compensation)

3. High-performance culture that combines strong performance ethic and open & trusting environment

4. Recruit great talent continuously5. Develop people to their full

potential6. Make room for talent to grow7. Focus on retaining high performers

“War for Talent II: Seven Ways to Win,” Fast Company, January 2001

John Izzo & Pam Withers

Values Shift: The New Work Ethic and What it Means for BusinessStudied 200 companiesNot just typical dissatisfaction, Profound culture shift in which people are asking themselves fundamental questions about what they want from their work

Six Suggestions

1. Proactively offer meaningful ways to improve work / life balance & synergy

2. Actively promote sense of deeper cause3. Promote & support professional growth

& development4. Treat employees like partners5. Create community in the workplace6. Maintain mutual trust

Some Results

Izzo & Withers found staff turnover falls up to 50% when employees are offered benefits like child-care subsidies, elder-care programs, flexible hoursProductivity increases about 20% after organizations implement work/life balance programs

Source: John Izzo & Pam Withers, Values Shift: The New Work Ethic and What it Means for Business

Keeping The Best©

Model for Retaining Excellent Behavioral

Health Staff

Employee Themes:

Reasonable compensationAbility to do excellent workProfessional & personal balance, integration and synergyStrong, healthy relationshipsSense of meaning

Organizational Themes

Demonstrated alignment between vision, mission, values and everything else!Highest qualityPerformance excellenceSuccessful infrastructureStrong, healthy relationshipsSense of meaning

Employee Themes

Reasonable Compensation

Reasonable related to industry and community comparisonsDoes not have to be the highest but has to be within an acceptable rangeAssuming “reasonableness” it really isn’t the most important variable for retention & performance excellenceIs my compensation reasonable compared with other places I could work?

Ability To Do Excellent Work:

Do I get to use my strengths every day?Do I know what’s expected of me?Do I have everything I need to do my best?Can I do my best every day?Can I achieve the best possible results?Can I grow and develop professionally?

Do I feel good about what I accomplished at the

end of each day?

Professional & Personal Balance, Integration and Synergy

Can I match my professional and personal values?Can I take care of both my professional and personal responsibilities, goals, desires?Does someone care about me at work?Do I have a sense of community at work?

Strong, Healthy Relationships

Do I have a great supervisor?Do my opinions count?Can I help make improvements?Do I trust others in the organization?Do I believe the organization has a culture of honesty?Can I be honest and act with integrity?

Sense of Meaning

Does my work feel meaningful? Does my work lift my spirit and fill my soul?

Organizational Themes

Foundation is Critical

Virtually all organizations have a vision, mission, and valuesBut … do we use these as the drivers for key, explicit, measurable indicators of individual, team, and organizational performance?

Foundation as the Driver

Do we directly link our vision, mission, values to all we do?Do we communicate this organization-wide on a regular basis?Do we demonstrate our accountability for this link?Do we continuously strengthen this link?

Highest Quality

Do we set and strive for the highest possible quality and outcomes?Do we embrace and implement best practices, every day, in everything we do?Do we live a culture of real continuous quality improvement?Are we creative, flexible, and nimble?

Excellent Performance

Do we recruit for the best talent?Do we ensure the best fit between employee and job?Do we emphasize individual staff strengths?Are our expectations clear?Do we provide ongoing, meaningful feedback and valuable performance reviews?Do we spend the vast majority of our time, attention, and money on those who do excellent work?

Successful Infrastructure

Do our policies, structures, and practices support excellent work and talent?Do we shower supervisors & managers with training, guidance, mentoring, support, time, and energy toward their success?Do we encourage, allow, and reward managers & supervisors to do the same with their employees?Do we offer meaningful professional growth and development for everyone?

Strong, Healthy Relationships

Do we value & support strong, healthy, collaborative relationships?Do our structures and practices support strong, healthy, collaborative relationships?Can employees actively participate in continuous quality improvement?Do we encourage honesty, integrity trustworthiness?Are the top leaders honest and trustworthy?

Sense of Meaning

Is our vision & mission clear, meaningful, and truly inspiring?Can our employees live our mission & values every day?Can our consumers and families find real meaning in what we do?Can our employees find real meaning in what we do?

Living the Mental Health Services Act

Practical Priorities

Recommended Actions

Administer the Gallup Q12© or the Keeping the Best© employee questionnaireAdminister the Keeping the Best© : Organizational QuestionnaireFocus on the lowest scores. (Remember, questions 1, 2, 3, 5, & 7 on the Q12© relate to retention)

Identify short, medium, and long-term strategies to improve areas with the lowest scores. Focus on the short term first!!!Involve staff!!!Administer the questionnaires routinely so they become part of your ongoing QM/improvement efforts (implementing the medium & long term strategies)

Psychiatrists

Community/Recovery oriented psychiatrists want: Physician extender support Treatment teamwork & collaboration

with psychologists, nurses, social workers, case managers, community support workers, consumers

Adequate administrative support

Alcohol & Drug Abuse Counselors

Build dual-diagnosis capacity (dually trained, integrated services, real support for this model)True strengths, recovery, and resiliency model

Multi Lingual & Cultural Staff

Strong, culturally sensitive managers and supervisors – folks who understand cultural differences with consumers & families and with staffWant other professional identities & career development opportunities besides being “the bilingual staff”Manageable case loads!Encourage & support mentoring if desired

Consumer & Family Staff Members

True strengths, recovery, and resiliency culture & practices throughout the organizationFull support and meaningful work, responsibility & authority; predicated on education, development, culture, and practicesSupport, mentoring & collaboration!!!

Rural Areas

Flexibility!Collaboration among agencies & partnersAccountability with autonomy & trust

Inner Cities

Creativity! Creativity! Creativity!Allow staff to take calculated risks with novel approachesCollaboration among agenciesProtect staff from burn-out

Special Populations

Blend a “specialist” model with increasing skills among “generalists”Use clinical “help-desks”, train the trainer, mentors and other ways for specialists to share certain expertiseDon’t box specialists in!

Novices

Don’t overwhelm or “throw them onto the street”!Strong, thorough orientation and on-the-job training & guidanceStrong, excellent supervisorsEncourage mentoringEncourage & provide structure for peer supportSupport, guidance, mentoring!!!

Final Thought

You know when you have a great job with a great organization …there’s an energy about it, a buzz, a synergy.

Ultimately it’s based on … Knowing what you want to accomplish Nurturing the creativity and the

structures to do it Building on everyone’s individual

strengths Letting it happen

Additional Resources

Marcus Buckingham: First, Break All the Rules Now, Go Find Your Strengths The One Thing You Need to Know Go: Put Your Strengths to Work

12: The Elements of Great Managing, Rodd Wagner & James Harter, Gallup Press (2006)

Jeanne SupinWatauga Consulting

Boone, North Carolinajeanne@supin.com

www.supin.com828.265.0367