The presentation will begin shortly. This webinar will be recorded and used for future presentations.

1. Retaining Your Key Health Care ProfessionalsKathy Suvia, MBA, Director of Education & Workforce Services,Health Alliance of Northern California and Katrina Delevati, MBA, PHR, Director of Human Resources, Shasta Community Health Center The presentation will begin shortly. This webinar will be recorded and used for future presentations. Funds for this webinar were provided by the U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA) with the American Recovery and Reinvestment Act (ARRA) funding for the Retention and Evaluation Activities (REA) Initiative. This webinar is offered by Health Alliance of Northern California and the California Statewide AHEC program in partnership with the Office of Statewide Health Planning and Development (OSHPD), designated as the California Primary Care Office (PCO).

2. WELCOME EVERYONE!Thank you for joining us today

3. Raising your hand to ask a question

4. Sending Notes

5. Muting your phone

6. Retaining Your Key Health Care Professionals Kathy Suvia, MBA, Director of Education & Workforce Services Health Alliance of Northern California and Katrina Delevati, MBA, PHR, Director of Human Resources Shasta Community Health Center

7. Learning Objectives • Ever increasing importance of good retention strategies. • The Psychological Contract between you and your staff • The two-factor theory of motivation • Drivers of retention and a few interventions • Best practices from a community health center

8. Good Retention Benefits Everyone • Clinicians • Support staff • Clinic/health center/hospital • Patients • Community

9. “High performers are like frogs in a wheelbarrow – they can jump out at any time.” --McKinsey & Company study, 2001

10. The Psychological Contract • The unwritten expectations employees and employers have about the nature of their work relationships.

11. Assumptions of the Contract • Employer provides: • Competitive compensation and benefits • Career development opportunities • Flexibility to balance work and home life • Employee provides: • Continuous skill improvement • Reasonable time with the organization • Extra effort when needed

12. Job Satisfaction & Organizational Commitment • Job satisfaction: A positive emotional state related to job performance • Individual ability & motivation • Job design • Organizational commitment: • Acceptance of organizational goals • Desire to remain with the organization

13. Individual Performance

14. The Two-Factor Theory* There are certain factors in the workplace that cause job satisfaction (motivators), while a separate set of factors cause dissatisfaction (hygiene factors). Herzberg, Frederick etal;(1959) The Motivation to Work, 2nd ed. New York: John Wiley, ISBN 0471373893

15. Two-factor Theory Examples Motivators Hygiene Factors Achievement Recognition Work itself Responsibility Advancement Professional growth Opportunity to mentor Management Organization policies Relationship with peers Working conditions Salary Work-life balance Security and safety

16. Questions so far …

17. Drivers of Retention

18. Retention – Why do People Stay? • Great company • Values and culture • Well managed • Offers exciting challenge and growth • Great job • Freedom and autonomy • Exciting challenges and patient mix • Reasonable call schedule & access tospecialists

19. Why do People Stay? • Compensation & lifestyle • Competitive salary and benefits • Geographic location • Community • Loan Repayment Benefits

20. Best Practices in Retention • “Setting expectations [with staff] beyond the bounds of salary helps to create a more patient-centered and collaborative environment.” – Rob Coulton, Office of Staff Affairs at Cleveland Clinic • “With further education staff will become more effective leaders …result is professional, dedicated staff to care for our community; after all, that’s what we are here for.” – Morris Eagleman, VP Patient Services, Mercy Medical Center, Mt. Shasta – A Dignity Health Member • http://www.youtube.com/watch?v=LmpsE77NHl4

21. Retention Phases

22. A Word about Orientation

23. Reward and Celebrate • Career development and training • Recognize accomplishments

24. Questions so far …

25. Shasta Community Health Center A Study in Retention

27. U.S. Physician Workforce • 64, 000 – projected shortage in FP by 2025 • Projected national shortage of 130,000 by 2025 • 25% of the national physician workforce is age 60 or older

28. (Image obtained from: AMA-ASSN.ORG )

29. Shortages and Turnover • 46% of CEOs said access to care in their service areas has been compromised by a shortage of physicians • Turnover results in disruptions to patient care and the work environment (PCMH Teams, etc.) • Increase in new patients through Healthcare Reform

30. Retention Strategy: No Longer an Option • 50% of all physicians leave their first practice within 3 years (22% of physician recruitment takes over 12 months to fill): 30-50%-practice culture 20-30% - compensation 20-40% - family reasons

31. Retention Strategies • NHSC Loan Repayment (Medical students graduating this year face average loan debts in excess of $162,000) * • Flexibility in schedule (Work life balance) • Competitive compensation, variable incentive plans • Team-based approach (Have them at the table)

32. Retention Strategies (cont.) • Keep a “pulse” on clinician development • Residency and teaching • Support, support, support • Communication • Community Involvement • Balance in scheduling/ patient panel

33. SCHC Clinician Quotes - 2013 • “I enjoy the variety of patient care opportunities in the very collegial and supportive environment. I enjoy interacting with our excellent staff.” • “Working M-F from 8-5 with an hour lunch in a modern dental clinic is rewarding.” • “The most rewarding areas are working with my patients and a solid PCN team; I also enjoy being part of the Residency Program.” • Retention Calculator-NHSC

34. Your Successful Retention Strategies

35. Resources Bowman, Lee, Scripps Howard News Service California AHEC, www.cal-ahec.org Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, Findings of the First Year Retention Survey of the Multi-State/NHSC Retention Collaborative, 2012 Health Workforce Initiative Agreement 11-307-021, Butte Community College, Chancellor’s Office, CCC Linzer, Mark MD, Preventing Clinician Burnout, 2013, Center for Patient and Provider Experience, Hennepin County Medical Center, Madison, Wisconsin National Health Service Corps, http://nhsc.hrsa.gov/ Recruitment & Retention of Clinicians, Best Practices Model, 2005 Bureau of Primary Health Care Rice, Chelsea, “4 Ways to Keep Physicians from Leaving,: HealthLeaders Media, February 25, 2013 State Physician Workforce Data, AAMC

36. Contact Information Katrina Delevati, MBA, PHR Director of Human Resources Shasta Community Health Center 530-256-5977 kdelevati@shastahealth.org Kathy Suvia, MBA Center Director, Northern California Area Health Education Center Director of Education & Workforce Services Health Alliance of Northern California 530-247-1560, Ext 112 kathy@thehanc.org