Successful Strategies for Decreasing First-Year Turnover


That’s expensive.


Cost of First-Year Turnover

In 2016, the cost of first-year turnover to our health system was several million dollars. That doesn’t take into account the indirect costs, including the emotional wear and tear on teams and managers.

In the past year, we’ve implemented a number of strategies – some developed by our Intermountain Healthcare system and others pioneered at our hospital – to stop this revolving door, which has been especially pronounced in our service and entry-level jobs.

The good news – many of the strategies are working!

We started our work by conducting dozens of exit interviews with employees who’d given notice they were quitting. We wanted to understand where our efforts to engage them had fallen short and what issues motivated them to leave. We learned a lot, and these interviews informed a number of our strategies.

The biggest take-away was a re-affirmation of the importance of the relationship between new employees and their manager. A lot of our strategies have focused on systems and tools to support managers in fostering that relationship.

Employee Retention Focus

One of our resulting tools is to hold 30, 60 and 90-day conversations between managers and new hires, which cover a series of conversation guides we’ve developed. We’re tracking these onboarding meetings and have found that turnover is 50 percent lower in departments where managers are conducting these visits consistently compared with those who aren’t.

Our second focus has been on consistent rounding by our leaders. In clinical departments, especially, we’ve encouraged managers to adjust their schedules so they can regularly connect with their swing, night, and weekend shifts. Our managers who’ve done this report that it’s been very positive in building team cohesiveness, helping them to get to know all their employees, and increasing their understanding of various challenges in their departments.

Our third initiative has been to develop a “One Team” approach to strengthen the culture that strengthens retention. For example, when we looked at a particularly high turnover rate in Environmental Services, we worked in partnership with our nursing departments to make sure they included their housekeepers in morning huddles, team celebrations, etc. That’s gone a long way toward increasing engagement and satisfaction for those housekeepers; it helps them feel like they belong. Through these focused efforts, our Environmental Services team has been able to reduce first-year turnover by 55 percent year to date compared to the same period last year.

Our next effort has been to educate managers on how to hire employees who will stay and how to assess if an employee is at risk for leaving Intermountain. It’s been rewarding to share best practices among our managers on these two nuanced strategies.

And finally, we’ve implemented stay interviews and a resignation recovery/buyers remorse program where we call an employee who’s left within two weeks of their departure. We’ve found that sometimes the grass isn’t always greener! 

If we sense an employee is thinking about quitting, we encourage managers to conduct a “Stay Interview” where they try to determine what changes would help create a situation that would incentivize the employee to stay. Surprisingly, it’s often small and very do-able things that make the difference. When good employees actually give their notice, we have an initiative called Resignation Recovery, where we reach out to them and talk about their motivation for leaving and see if we can resolve those issues. While we aren’t successful in every case, we’ve had several employees change their minds and decide to stay with us.

We haven’t perfected retention, but these efforts have helped us make a direct impact on a key operational priority. Overall we’ve reduced turnover by one-third this year compared to the same time frame last year. We have confidence that as we make these practices a consistent part of our work, we’ll see even greater returns in our efforts to retain talented caregivers.