Employee Retention Strategies for Healthcare

and let's go ahead and get started first

I'd like to again welcome everybody

thank you for taking the time today

we're going to hopefully have a very

lively dialogue here with our guest

Brian parodies Brian is a is really a

healthcare expert he has he's been

around the block he's he's learned more

and done more than I will probably ever

hope to achieve

but he's the former president and CEO of

Florida Health Central Region it was a

really huge Enterprise 4 billion dollar

enterprise and obviously it's still

growing and under Brian's leadership

they had 25,000 employees thousands of

physicians he has since moved on he's a

senior partner at C sweet solutions you

can look them up on the web and what I

love about Brian is he's a healthcare

innovator and he really believes that

people are your number one asset hmm

it's not something that that he sort of

pays lip service to but we've had a lot

of really exciting discussions and he's

he's really about people he's really

about culture and I think that's a

really interesting dynamic when you

think about that from a health care

leader especially someone like Brian who

has deep domain expertise in a CFO and

in the financial world so Brian welcome

thank you for being with us today

My name is Matthew Goss I'm the chief

echo Vater at Echo bait we are a

retention solution for hospitals health

care organizations as well as other

larger companies around the United


I look at myself as a bit of an HR tech

innovator and I had the good fortune to

run a couple of HR technology companies

and really like to keep my eat my sort

of pulse on what's going on to help

recoup improve retention and again back

to back to health care specifically so

one question I want to pose out there to

everybody and you can think about this

and and sort of answer out loud at your

desk or wherever you are today but why

is it that people leave an organization

they go through all of this process to

get interviewed and go through and

they're really excited about the

opportunity and they start their first

day and their spouse is excited for them

but why do they leave and there's

there's a really big myth

inception that it's about money but it's

not for money people actually use that

as an excuse to say I'm leaving I'm

going to another organization because

I'm going to make an extra fifty cents

an hour or a dollar 15 hour or whatever

it might be and on top of that if you go

and say no we really want you to stay

we're going to give you another five

thousand dollars or whatever you know a

raise would be typically they're not

going to stay more than twelve months I

think the average is they leave after

another seven months so it's not about


people are searching for more the number

one reason that people leave as you

would guess it it's around their manager

or their team that they're working in

and that ties back to a lot of research

that's been done around something called

psychological safety and that's really

just a sense of you know do I feel

valued by my team do I feel that I can

express my thoughts and ideas without

fear of repercussion or losing my job or

sort of being quarantined over in the

corner and we hear this from time to

time again from our existing customers

it's the number one reason that nurses

turnover it's because their manager

dynamics their team dynamics in that

sense of psychological safety and so I

want to explore that a little bit with

our guest Brian today and you know I'm

hoping Brian that you can maybe share a

story something something real that's

happened when you know when you were

leader at a large organization and what

was that and and and how did you deal

with it oh thanks thanks man and welcome

everybody you know I probably go back

before I was the leader of a large

organization when I was in my first

department you know as a controller of a

smaller Hospital trying to run run that

that just one operating unit and I'll

never forget after about three or four

months in that role I just kept getting

this feeling something was wrong and

people were just kind of fussing at each

other us not as much to me but you just

feel something not quite right and so

one day I just had it and so I called

the entire team downstairs to the

conference room and told them none of no

one was leaving until we got to the

bottom of whatever was wrong and my

assumption was that there was something

going on with

what I learned after quite a bit of time

to get everyone to really talk was that

the problem was was more me and there

were two really interesting dynamics

that I missed one was the way our

offices were organized with an l-shape

and when I came in the door I made a

right to my office past part of the L

but the other part of the L was not in

my normal line of walk and so you know

just being polite I would mention

something say hello they would stop for

a second along my way towards my office

but rarely made the extra trip back into

the other part of that L and the second

thing that happened was we were a

department when I inherited in quite

disarray and so I was spending majority

of my time out of the department trying

to rebuild credibility of the finance

function and and turns out as much as

they appreciated that the the guy who I

replaced who who rarely was able to

execute outside the department would

spend a lot of time asking questions and

I never forget this one part of it when

I had one lady who was pregnant who who

said well you know you've never asked me

if the baby kicked over the weekend and

I remember just half of me just being

kind of frustrated that they were they

were behaving this way because I hadn't

asked about if the baby kick because

what does that have to do with with the

work we're trying to get done and yet I

still this day it's one of those things

I keep very much present as I'm walking

and talking through any size

organization to try to find that

personal connect where they get this

feeling that you care so so that I know

that yeah that's it that's a great

that's a great story and I think what

you know what rings true to me on that

is that sense of caring right and when

you think about why people are leaving

an organization and again it's that

manager of that team it's that lack of

caring and we sort of you know Brian you

and I have joked around a little bit

about just the notion of human capital

our human capital management but I kind

of really don't like that word because

immediately it's taken the

personalization out right these are

people John or Jane that you know are


Thanksgiving dinner and they're leaving

their families every day to go to work

and it's a sort of personalization and

while it may seem you know simple to you

to say hey you know did the baby kick

this weekend it's very important because

that's a big life event that is that's

happening it's really it's really

interesting so the second reason that

people leave is it's a sense of

community that sense of belonging and

you know Brian part of your story there

it's the same thing it's feeling like

you know we're on this journey together

but what we've seen in our research and

speaking with our customers people are

leaving because they don't have that

sense of belonging that sense of

community I mean it's cliche and

everybody's heard this but you spend

more time at work and with your

coworkers then you do at home with your

family and so if you don't have this

connection in the sense of community and

if it's just a sort of punch in punch

out mentality then you know that really

doesn't go very far and eventually that

person is going to get burnt out

especially in the healthcare space

because it can be so dynamic and

sometimes volatile it's important to

have that network that you can go back

to so Brian jump in I'm not sure if you

have any any sort of thoughts around

that as well yeah I come a couple to

quickly jump out one is that again I

find all of these things kind of overlap

and interconnect so you know it's always

a little difficult at least from my view

to how to separate community from from

the manager because it's all all

intertwine but one of the other aspects

of them once you learn how to ask about

the baby kicking

then it's amazing how we forget

sometimes to bring that same question

asking into the work environment and

particularly most of you are in some

form of health care you know I find a

health care a very stressful environment

in the sense of you know unlike many

places there's some life-and-death

things going on I've been placed will

risk at risk and exposed just for what

could happen on their watch or you know

if they're if it's not paying attention

and so so I think the next thing when

things happen or as you're trying to

prevent those things asking people what

they think and what they might do and my

experience has been a lot you know sit

in a room with a meeting asking the

question and that maybe there's ten

people in the room and only three or

four of them speak everyone else learns

to be quiet

and measure their words or kind of wait

sit back and wait and there's always one

or two in every group that are only too

willing to talk and what I learned was

it as a leader you have to take the time

to go around that room almost every

meeting I had I would go around the room

and ask every single person what they

thought and I was never disappointed

because the quiet people often had

unbelievably good thoughts but they just

needed someone to ask and and often we

don't take the time or think to do that

or we're eager to get the meeting over

and so we don't do that I think that's

one thing that and the other thing I

found is this issue of humor and it

sounds again back to her people and I

never forget we had a big physician

dinner we'd have about a thousand

physicians come to this dinner

I was around Christmastime you know and

we had a little bit of a budget so we

would buy some entertainment and for the

budget we had it usually wasn't that

they ranked you know entertainment and

every time after dinner about a third of

the physicians would get up and leave

because they didn't like this music or

that music and one year and bug me so

much I decided not to get music we

bought it we bought a comedian and

nobody laughed and so I think that

lesson of everyone likes to laugh a host

and how do you bring that into your work

environment and even I've joked many of

my leaders look if I were you I'd go

take an improv class because it teaches

you to observe it teaches you to see

what's funny and that humor is an

interesting thing of creating community

because I've noticed when people laugh

together they retell those stories they

reel a fat the same joke and they have a

shared kind of experience where that

humor sort of Bond's them together and

so I think that's one of those other

things almost never here talked about in

a work environment you know I think this

issue of humor is an incredible asset an

incredible gift to be used in our inner

work life and work work environments

that we're creating I love it so

everybody on the webinar today is going

to go back and ask their boss for a

budget so they can go higher median yeah

there you go so so to dig a little bit

deeper on that because to push back I

guess in some ways like

you know you read articles you join

webinars whatever else and it's like hey

these are great ideas how do you execute

on them and things like that but the

reality is like everybody is usually so

busy in their day they're always a week

behind they always feel a bit

overwhelmed so how do you or how have

you sort of empowered your managers your

team to go wait let's stop and take a

break for a second and let's spend the

time that we need to be with our people

and be with our team because it's gonna

have some really long lasting impact I

mean how do you you know a lot of people

today that are in health care and

specifically NH are you know what can

they do and how can they go to say those

line managers and say hey listen we want

to empower you with this but again they

have a busy day I thought you promised

me no hard questions today that's not

right sorry

that's a really hard hard one mad at

least my my experience but I you know -

two quick things one is I think as I

looked at the list there's a lot of kind

of HR people on the list and blessings

too because I think you have a unique

double challenge you've got to make sure

your areas function well and are really

a role model often for the rest of the

organization and then you've got to

figure out how to influence the rest of

the organization to create a culture

where where if you're recruiting or if

you're trying to service employees or

support them you know there's something

in place but there's a phrase that I've

often used called slow down to speed up

and and that's about all I know to do is

you know it's a constant battle and you

know I always keep trying to say how can

we slow down here to speed up and when

people are getting fragmented and and

you know disconnected and there's you

can feel that they're not thinking well

they're not innovating and there's

tension between departments that what's

often to me a sign that we're going too

fast and while it may feel fast it's

really not and so I think you just have

to be discipline to keep coming back to

that notion of ya know that that makes

that makes a lot of sense and some of

the sort of best corporate cultures that

I've seen and some of the you know

lowest turnover rates and most

successful organizations it's they're

taking the

Longview right there's you know there's

that saying of you know you which you

can accomplish in a year you tend to

greatly you know sort of over exaggerate

right but what you can accomplish in

three years or five years is significant

and I think that ties back to that sort

of number one around psychological

safety of listen we're going to do these

things and it may not be a grand slam

tomorrow but we're going to

fundamentally move the organization in

the right direction and it may be over a

two or three year period and you can

measure that over time and and then

you're really gonna actually make sort

of a meaningful difference so the move

yeah go ahead was it and there's a

fountain as a choral he just triggered

is that you know at one point we were

working on our strategic plan and we

were having a debate about how to

incorporate our people into that plan

and and honestly I was probably

defaulting then a little bit too much

too well they're an asset and a resource

you know and it's all geared towards the

customers so so one thing if you're if

you're people are stressed and pushing

too fast you're always placing your core

business and your customers probably at

risk and and I was leaning more towards

them as seeing them more as an asset or

a resource underneath the strategic plan

they were support of the plan they

weren't really part in the plan and and

I was at home one night and just you

know don't watch a lot of TV but that

night for some reason I flipped on the

TV and it was on I think a History

Channel or something and it was a

documentary about herb Keller of

Southwest they're right right right

those guys are famous for further people

and for culture yeah and I never forget

he did it was a jolt like when I heard

him say people and only language herb

could could use probably that you know

people you know think that the customer

is always right he goes the hell they

are he goes it's my it's my employees

that are right and so I just shocked us

so I went in the next morning told

called the team together and said we're

changing the plan and that you know our

paper going into the plan because unless

though they're really cared for and

taken care of I get it they can't

service the customer I think the other

way to slow down

that your customers at the other end of

that speed and if you get that that's

that's yeah that's a really important

point right there they're feeling that

impact right in yes and obviously in the

healthcare space that comes to you know

patient safety patient satisfaction you

know sort of all these all these

empowers all the important drivers so so

again talking about why people leave and

again retention strategies one has to do

with manager and teamwork

two is that sense of community three has

to do with impact and and that's closely

tied to that sense of community but you

know when that person shows up at work

every day do they feel a sense of

purpose and is it you know do they are

they driven for it for something greater

than just showing up to work every day

and that doesn't have to be hey we're

changing the world it could be as simple

as I'm providing you know a paycheck or

I'm able to pay my mortgage you take my

kids to Disney or whatever else but it's

that purpose and I think it's

understanding that and again we've seen

this in talking you know especially in

the in the world of HR around if

somebody doesn't really have that sense

of fulfillment when they're going to

work then overtime when those stressors

do come in then they say okay you know

why am I staying here and I think the

interesting piece about impact and Brian

I know you're going to have some really

strong thoughts on this as well but it's

that whole notion of this person is an

individual right again we talked about

calling people human capital and they're

they're real people right and they're

showing up to this job every day for a

multitude of reasons and what I've seen

a lot is either the managers or HR they

don't really take the time to understand

the motivators behind why that person is

there and I think if you can understand

those motivators then all of a sudden

you can have a whole different

interaction and it's not you know you're

you're a tool in the toolbox to make

this machine run it's know you're a

human being that has family and dreams

and hopes and aspirations and how can we

help to empower those and you can't do

that if you don't know what the impact

that they want to have that they're

currently having in that in that

environment so Brian else you have a

comment or thought on that as well

you know it when it comes to people you

know I used to like like many believe

that you know keep your personal life at

home and right just bring yourself to

work and some point I realized I'm not

very good at that

so why would I expect other people to be

good at it and the other thing I've

experienced and probably many of our

guests of experience that people are

broken you know just as a rule you know

we put on a really good front most of

the time when we learn how to kind of

play our masks but but people are broken

and and many people suffer from all kind

of forms of self-esteem issues and so

what I found was that if it can create

an environment where people feel

successful and therefore valued you know

it's an it's amazing to me that they

don't feel valued at home or wherever

they're there else functioning but they

come to work and they suddenly expect

you to make them feel valued and I think

I should say reality I mean it may not

be fair but there's just a reality so so

just some of those little things I used

to write handwritten cards still do

handwritten cards right too many

employees and I literally would have the

office in tears saying nobody's ever

written me a handwritten note and you

just kind of go wow that isn't that

amazing though I'll say isn't that

amazing because it's in some ways I

think and maybe this is you know

directly proportionate technology and

everything else but sort of that human

touch in that again come back to using

your word around caring and somebody

feeling valued in an organization the

funny thing is those things don't cost

any money no you don't need a big budget

you actually care about somebody right

and you know it's an interesting I think

word to use and thought-provoking in

that in that regard

what's it is you've got yeah good was

this double win because most of the time

when I've done it I feel just as good as

I think they do receiving it and I think

that's that piece for you where it

really is a win-win to take that few

seconds it takes your minutes to write

something or say something or do

something unexpected

I think the key there is to keep it

something a little bit unexpected for

people yeah I would agree um just a

quick housekeeping item for everybody

that's on the webinar today if you have

questions you can write them into the

chat window we're going to towards the

tail end of this we're going to do a

brief Q&A session so as we're going

through writing some questions and we'll

feel those questions here in in a couple

of minutes so let's move on to the

number four and that has to do with

outlook and again this is one that I

love that I think it's something free

that people can do but again these four

items are sort of research driven why

employees are leaving organizations and

the fourth is around outlook and that

has to do with a couple of different

things one is around clarity of their

role do they really fundamentally

understand what they should be doing

what they should not be doing what are

the sort of rules to follow regulations

and things like that and if somebody

doesn't have a clear understanding of

their role and maybe other wines that

they have to sort of play in then what

happens is back to Brian you use you're

worried about self esteem or self doubt

they they sort of hesitate and they

don't maybe put in as much effort

because they're confused they're not

sure where or what they should be doing

so that's the first part of outlook the

second part is the general outlook of

the organization do you fundamentally

know you know what are those values of

the organization what does it stand for

and what is the next two or three years

look like for their role and their role

in the organization where the

organization is going right and so we've

seen a lot and again speaking with a lot

of companies out there you know you have

leadership and they will come up with an

amazing strategy and I'll spend a lot of

time and do retreats and spend the money

but they failed to communicate that

effectively to the people that are

actually doing the work every single day

and you know a friend of mine is an HR

analyst he is the example of listen if

you're if you're a soldier and you're

going to battle and your general just

says March in that direction but you

don't know what you're doing and why

you're doing it and what the intended

outcome is it's very easy for you to get

demoralized and not really have a good

sense of clarity and how we're going to

sort of win that battle if you will and

so outlook I think is very

and again it's something that doesn't

cost any money it could simply be hey

here's a video from our CEO here's a

video from our chief strategy officer or

people walking around and sharing that

vision and this is who we are and what

we're doing Brian I'll I'll let you

comment on that as well because I know

you know I've had some discussions

around getting in front of your people

yeah and I know we're getting close on

time here so I'll make it real brief and

I think just three just very quick

things one is I love the question on the

first part of figuring out role clarity

asking people do you have the tools to

do your job and I think it's one of

those questions that if you get a blank

look you know they don't know the role

and if they have clarity about what

those tools are and you get that clarity

now you can assess whether they whether

you're lined up that's part one part two

on them on the second part on the

organizational view I love stories and

in a healthcare setting especially there

are no shortage of great stories in your

organization so every big meeting we had

instead of getting up fun and doing what

we like to do as corporate leaders and

talk a lot of corporate language you

know I forced it to all come back to a

story and we would always tell a story

and as ways of reinforcing the emotional

and and you know vision of what we were

trying to do and I did one other thing

with those stories after that to kind of

be clear and that is I always have

metrics you might you know it's a given

I do have a finance background you know

which which is also went with a theology

and Social Work first majors in college

before I switched but so you know I have

a strange kind of balance but but those

metrics give also life metrics tell

stories to but but they also clarify

whether you're winning or losing and you

and it takes it out of kind of general

language that people aren't quite sure

put in it know these metrics here are

telling us a story and they're telling

us whether we're winning or losing

towards towards the Nets finished I'll

quickly yeah I know that's yeah that's

really that's really interesting

again we're gonna wrap up here in in a

couple minutes so if you have some

questions you can write them in on the

right side we have a couple questions

coming in here I'll get to in a minute

but just some quick takeaways on today

again we break them down into four areas

to manage your team you know the

research driven term is psychological

safety right

a couple of takeaways is you know have

check-ins and and give that person the

opportunity to express their ideas right

so one question is you know what's one

thing that I can do to make your life

easier make your day better today and

Brian to your to your story about you

know the people that are quietest

they may not be the extroverts that are

going to raise their hand however given

the opportunity and the right

environment to say hey how are things

going or what might do to make your day

easier there you need some really

valuable information that's going to

that's going to come out it out the

second around community I'm not sure if

anyone on this call I'm sure they do

have have kids I've got two young boys

six and four years old and they have

something called the Buddy bench at

school right that's somebody who may not

have a friend and you can go sit on the

Buddy bench and then somebody else comes

over and sits next to you right maybe in

the workplace that may be a bit extreme

but it's that sense of you know how do

you onboard somebody successfully where

they they have that sense of community

faster right and it's something that

they feel part of something that's

bigger than themselves right and we we

do lunch and learns we still lunch

learns in my last organization as well

and we also used to ask questions you

know what's one thing that nobody knows

about you and you know mine was I'm an

Eagle Scout nobody knew that and you

know they oh that's interesting about

that the third is around impact right

just understanding what is it that

excites them you know why do they get

out of bed every day and drive to work

right and and I think it's important to

get out of your own space and when I say

space I mean your own headspace right

and Brian your story earlier about you

know walking on one side of the office

versus the other you know it's

interesting because you're thinking hey

I'm just you know I'm going to work and

I'm getting my stuff done and I'm not

bothering these folks right there was an

interesting brief story a couple of

companies ago that I had I was closing

my door and I used to have my door open

my office and I didn't notice it and

then all of a sudden one of my employees

came to me and said hey is everything

okay because you're closing your door a

lot lately and the reality was I was

really stressed with something we had

going on in the business but because

that employee came over and asked me

that question all of a sudden I thought

okay this is not my sort of burden about

all alone

and then we sort of worked as a team and

again it fostered that community and it

was really very amazing the forest is

around outlook again you know some

things that we've done in the past is

you know asked for ask that person say

you know tell me what you do of course

you know okay I'm a nurse but what do

you actually do can you describe that

for me and you'll get a good sense on

the clarity of their role and then you

can have that dialogue and say you know

what are the areas that maybe are a

little cloudy for you and again what can

I do to make your day easier right and

then you know another thing that we've

seen is have them explain and say you

know where do you think your role is

going to be in two years with everything

that's going on in healthcare with

technology with consolidation and things

like that and you're going to get a good

sense on what they believe their role

looks like and how they believe that

they're going to sort of fit in that

organization in the in the future so one

questions and Brian this is probably

something you're going to have to take

is one of the questions coming in which

is interesting is you know healthcare

organizations are so large how do we

actually get down and reach say that CMA

right somebody who's maybe not at the

top of the organization or even in the

middle but somebody who's actually

grinding out every single day how do you

sort of traverse the the entire

organization or get to that one person

hello wow I told you I told you no hard

quit well I've been quite it's a good

question I mean and that could be true

for any large organisations which is how

do you sort of get down to the ground

troops and make them feel that impact

well I think you know you kind of hinted

at it before and that again the only

thing I learned about this space because

it was hard space is you have to get

kind of that cascade working so you have

to create the expectation that at every

level the organisation is essentially

rounding you know on the next level down

and communicating it and I I resisted

things like sending a lot of CEO

messages because I thought it undermined

each leader down the chain being

accountable and knowing what's going on

you know because that's amazing how many

times organization will go look this is

just what they told us you know so I

always wanted the communications that

come from the person right above

and only a couple times a year in in

real appropriate settings what I choose

to communicate whole to the organization

so I think it's about creating that

culture where everybody is looking down

for the next group below and there's an

expectation and I would round at the

bottom to test whether people seemed to

know what was going on so that that's

the way I kind of did it was that's

interesting yeah levels down and then I

would go to the bottom of the

organization to test yeah that makes a

lot of sense you know one one quick

piece on that and there were at our time

here but again we've seen in

organizations of how do you how you get

that message across obviously technology

is a great way to do that and it doesn't

have to be a polished you know video or

well written memo it could simply be

somebody with their iPhone who record

the video and sends it around and people

watch them they go okay yeah I'm getting

some face time here I'm understanding

I'm hearing the tone of the voice and

and the excitement of this whether it's

new strategy or something that's going

on again but I think that that's a

cultural issue because some healthcare

organizations they don't want that they

say okay you're down there and we're up

here and those are the ones that have

big turnover issues or that have

profitability issues that are happening

well anyways we are we are at our one

130 mark and we want to be respectful of

everybody's time today thank you very

much for joining obviously we could talk

about this for another hour it's

something that we're excited about and

passionate about if you want to learn

more you can go to echo be calm or C

suite solutions we are recording this

and so we will send this out as a

follow-up as well and you can find on

our website if you want to watch it

again or share with any of your

colleagues thank you very much for

taking a half hour out of your day and

we hope you have a fantastic week thanks

so much