Employee Retention: How to Keep the GREAT Employees
By Michele Okposo, R.Ph.
Life is change, growth is optional. Choose wisely.
–Karen Kaiser Clark
Your organization just hired the “perfect” home infusion employee. What can you do to increase your chances of retaining him or her?
A recent Infusion article, “Recruiting and Retaining Employees” (Rollins, September/October 2005), reminds us that companies are more successful in their recruitment and retention efforts when they foster an atmosphere of trust and openness, team spirit, opportunities for growth, and high morale. But all too often, training and development dollars are allocated to task competencies, leaving ongoing professional and process skill development unaddressed.
The costs related to nurturing such “soft skills,” often appear on the budget chopping block as items that an organization “can’t afford.” However, with professional development so integral to building and maintaining strong functional teams, the bean counters might be wiser to ask, “Can we afford NOT to invest in customer service, team building, problem solving, and excellence?”
Beyond “Feel Good”
Building a quality team and developing its members is not simply a feel good proposition. If done well, it can contribute to an organization’s bottom line.
As an operations manager for Apria Healthcare for more than 10 years, I had the opportunity to build a team and create a working environment through professional and skill development. Year after year, our region had one of the lowest employee turnover rates and one of the highest profit margins within our company. Exhibit 1 shows how personnel issues can affect revenues and expenses.
Exhibit 1
Personnel and the Bottom Line
Revenues Ç
Expenses È
Excellent customer service skills
Lower labor costs for recruitment, orientation, and training
Cross-trained team members who are able to eliminate bottlenecks in daily workflow
Root cause identification and successful implementation of cost savings ideas
Empowered employees who make quick and experienced decisions
Buy-in from staff in development and implementation of financial performance improvement measures
Flexibility with hours to meet the ebb and flow of work volumes
Greater error prevention and thus customer dissatisfaction
Reduced errors and disgruntled customers due to high personal and team accountability
Decreased on call labor
Full support and cooperation with sales team
Full support and cooperation with billing team
Experienced intake teams, which result in fewer write offs
How can you contribute to improving an atmosphere of trust and openness, team spirit, opportunities for growth, and high morale in your home infusion company? The following four skills directly contribute to these factors and will be discussed here:
* Effective communication
* Effective stress reduction
* Effective problem solving
* Effective team building
Effective Communication
We work in a fast-paced, high-tech, complex, emotionally charged environment where—despite our best efforts--mistakes are sometimes made. Incomplete intake information can thwart billing and delay payments, a late delivery causes a nurse to wait at a patient’s home before beginning her visit, a missed refill means that medication isn’t reordered, an incorrect supply order prompts a second delivery, and so on. These familiar scenarios can and do happen.
The question is how does your organization deal with them? Are your employees open and trusting in their communication with each other? Is there a team spirit that encourages everyone to pitch in and solve the problem? Or is your team fraught with an attitude of blame or indifference.
Effective communication fosters an atmosphere of trust and openness, which can go a long way toward problem solving and improved efficiency. There are two equally important sides to effective communication: articulate speaking and attentive listening (see Exhibit 2). I have found that each becomes more challenging when topics that create conflict or confrontation—even if it’s only perceived conflict—are involved.
Exhibit 2
Guidelines for Articulate Speaking and Attentive Listening
Articulate Speaking Don’t:
* Fail to let team members know what your topic is and why it’s relevant
* Ramble, change topics, follow tangents
* Talk in general terms without examples
* Plow through without checking listeners’ understanding/reaction
* Forbid feedback
* Make it personal
* Speak from emotion
Articulate Speaking Do:
* Clarify your intentions
* Tailor feedback to the individual
* Give feedback as close as possible to the event
* Be specific and descriptive
* Focus on actions or behavior, not the person
* Pause and check for understanding
Attentive Listening Don’t:
* Criticize team member’s comments
* Become defensive or react emotionally
* Wait to talk rather than listening
* Be “too busy”
* Interrupt
* Find flaws in others ideas and perceptions
* Switch to your own agenda
* Explain, intellectualize
* Focus on personalities and miss issues
* Initiate premature closure
* Roll your eyes, sigh, tap fingers
* Check out – glazed eyes
* Place conditions on your availability to talk
* Leave when things get sensitive
Attentive Listening Do:
* Listen with the intent of understanding
* Listen for the message and the message behind the message
* Listen for both content and feelings
* Listen with your eyes – your hearing will be improved
* Listen for others’ interests, not just their position
Listen, as you would like to be listened to
Take a moment to consider the courage one must find to engage in articulate speaking about a sensitive or controversial issue. When you listen with blocking behaviors (active listening don’t), it greatly diminishes effective communication. Almost all work cultures have made—either by choice, or lack of attention--at least one of these examples acceptable. Pick one or two you engage in, and work to change your behavior. If a colleague or boss engages in a particular blocking behavior that limits your openness and honesty, find a time to discuss the issue and ask for a commitment to improve.
Indirect communication—talking around a team member—can quickly lead to internal conflict. You can choose not to take part in indirect communication. Direct team members to address the person with whom they have an issue. Avoid confrontational communication by encouraging communication as soon as is reasonably possible (due to the situation or your composure), and in private.
Effective Stress Reduction
Stress is major contributor to low morale and team spirit. Studies show that stress-related illnesses have a severe impact, costing American businesses an estimated $150 billion per year in absenteeism, low productivity, and lost workers.1
The body’s stress response includes more than 1,400 physical and chemical reactions and 30 different hormones and neurotransmitters.- That’s great if you’re jumping out of the way of a speeding bus, but when a body is subjected to this response on a regular basis due to chronic stress, it produces a variety of undesirable physical, mental, emotional, and behavioral symptoms adding further to our stress and lack of productivity.
Experts agree that a few small every day steps can help us avoid chronic stress at work (see Exhibit 3). By encouraging self-care in reducing stress for yourself and others in the workplace, you continue to build an environment of trust, openness, and morale building.
Exhibit 3
Small Steps to Stress Relief at Work (2)
* Exercise. A brief stretch, walk around the building, or just getting up and walking to the break room for some water can change your perspective from overwhelmed to manageable. Do you have some movement built into your day when you are not at work?
* Manage your time. There is so much multitasking and constant interruption in a work environment, how do you keep track of what is urgent and important? Be sure to prioritize tasks and stay organized while allowing flexibility for all those issues that come up.
* Don’t be a martyr. When it’s time to ask for help, another team member or leader is there to pitch in. They will know that you’ll be there for them when they are overwhelmed.
* Reduce avoidable interruptions. Are you and your team members in the habit of interrupting when a new piece of information comes across that could be communicated without interrupting? Can you check your e-mails a few times a day instead of continually?
* Watch what you eat. Many of us react to stress by eating sugar, drinking caffeine, or going hours without eating or drinking. Bring healthy snacks to work so you are not stuck with the vending machine when you thought you would have time to get out and pick up lunch. Eat small amounts of healthy snacks every two to three hours and avoid heavy lunches that can slow you down in the afternoon.
* Take a short relaxation break. Take a few quiet minutes, close your eyes, take a few deep breaths, and remember that last vacation when you felt totally relaxed. Read the comics in the newspaper, laughter is healthy too!
Effective Problem Solving
One major way to promote growth and development is by involving all team members in effective problem solving. Conversely, ineffective problem solving can have devastating consequences in your attempt to retain those GREAT employees, so the process is important.
Here is one example of effective problem solving. While at Apria Healthcare, I was fortunate to work with Rad Dillon, R.Ph., C.Q.M., and have learned first-hand some of the techniques he shares in his Quality Management column. Following Rad’s instructions, my region was able to implement good problem solving skills that dramatically improved job satisfaction and outcomes.
By reviewing our call log, we noticed an excessive number of calls from patients and nurses regarding missed supplies. This problem--our opportunity for improvement—“cost” the organization in several ways; impacting our top and bottom line:
* Decreased patient satisfaction
* Deceased nurse satisfaction
* Poor feedback to referrals sources
* Additional on call labor
* Additional delivery (often after hours)
From here we performed a root cause analysis involving every staff member who might possibly contribute to the current situation and its solution (for more on root cause analysis see the July/August 2005 issue of Quality Management). Several possibilities were offered: incomplete supply lists, incorrect data entry, picking errors, lost supplies, etc. Our analysis pointed to picking errors in the warehouse.
We then drilled down on how the errors might have occurred, asking questions about every possibility and eliminating those that didn’t prove out. We discovered two root causes. First, there was confusion about who should be double-checking supply orders, sometimes resulting in that step being missed. Second, as supplies were being picked, the warehouse clerk was putting large check marks next to the items to track what he had picked. He would often be called away for another urgent task and upon return to the order, was unclear which line had been checked off and picked, resulting in missed supplies.
While the causes of—and solutions to—this problem were amazingly simple, the process and its result greatly benefited the team. A source of great frustration was removed, participating in a successful effort bolstered team members, and supply errors decreased by 80 percent.
Effective Team Building
Building a healthy and functional work group is a continuous process. A team is defined as a group of people with complementary skills who are equally committed to a common purpose, performance goals, and working approach for which they hold themselves mutually accountable.3 See Exhibit 4 for more on effective teams.
Effective teamwork can easily be blocked by a variety of behaviors, such as accepting assignment and not following through, discounting others’ ideas, feuding, interrupting others, hidden agendas, side conversations, reluctance to participate, and use of seniority or experience to dominate, just to name a few. Since teams are comprised of individuals, each with his or her own issues, the likelihood of these behaviors occurring is high. Good leaders should be on the lookout for signs of blocking behavior and address them immediately.
Exhibit 4
Effective Teams
Characteristics
〈 Produce results
〈 Have a clear purpose
〈 Members are invested in success of team
〈 Have fun
〈 Have clearly defined roles for each member
〈 Nothing is under the table
〈 Engage in candid discussion
〈 Able to keep sight of goal through ups and downs
Environment that supports team building
* Mistakes are viewed as learning experiences and responsible failure is a legitimate part of the process
* Product/services are improved continuously through experimentation
* Collaboration, compromise, and consensus building are core skills
* Status, control, and regimentation are de-emphasized
* Everyone has input--collaboration yields investment
* Individual self-expression is nurtured
* Diversity is encouraged
* There is respect at all levels
* Information is shared continuously
This is by no means an exhaustive examination of skills contributing to an atmosphere of trust and openness, team spirit, opportunities for growth and high morale. I invite you to continue the dialogue with your work group or with me.
Remember, you can learn and improve these skills, but they require practice just like inserting a PICC line, entering a new patient into the computer system, or calculating TPN components. Having a good coach or mentor greatly increases the likelihood of permanent success. Good luck!
Michele Okposo, R.Ph., is a consultant in personal and team growth and development based in St. Paul, Minnesota. She is a veteran home infusion pharmacist and has worked for Apria Healthcare and University Park Pharmacy, a local hospital based home infusion company . She can be reached at Michele @transformativepractices.com, on her web site www.transformativepractices.com or 612-310-8876.
References
1. (info on 1&2 are from the same article. Here is the reference):
Randolfi, E. Developing a Stress Management and Relaxation Center for the Worksite. AWHP’s Worksite Health. 1997; Vol. 4, No. 3, 40-44.
2. (Added reference)Adapted from Winslow, D. Dealing with Stress at Work: Workplace Wellness Tips. Wellness Junction. 2005; online Newsletter: www.wellnessjunction.com.
Childre and Martin 1999 (I got this off a slide from the Center for Mind Body Medicine. I called and they do not have any more info on the source. This information is factual and widely published so I would eliminate this information as referenced.)
3. Katzenbach, J and Smith, D. The Wisdom of Teams : Creating the High Performance Organization. Harper Business Essentials, 1993. (I do not have the page numbers)
Can you use complete references here? Using this article as an example, our format is” Okposo M. Employee Retention: How to Keep the GREAT Employees. Infusion. 2006;12(1):page numbers. For books, it’s: Crosby P. Quality is Free. NY: McGraw-Hill. 1979.
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Learn More
Come see Michele Okposo, R.Ph., at NHIA’s 15th Annual Conference!
Authentic Communication: Improving Efficiencies and Reducing Stress
Saturday, March 11
3:15 – 4:15 p.m.
