Sustain Recruitment and Retention Through a Strong Culture

 In Reducing Employee Turnover

For many healthcare providers, 2022 saw their staffing situation move from “shortage mode” to “crisis mode” – especially for nurses, CNAs and social workers. This dynamic creates a dual dilemma. The providers need to sustain or increase census to meet their budgets, but don’t have the staff to provide quality care for more patients. To attract staff from competitors, especially nurses, providers are offering increasingly bigger sign-on bonuses, which further burdens their budgets without the census to earn greater reimbursements.

Unfortunately, experts are predicting this staffing shortage is far from over. In fact, the situation will only get worse.

A 2022 report from McKinsey consulting said, “As soon as 2025, healthcare systems could be short 200,000 to 450,000 nurses – or 10 to 20 percent of nurses needed to care for all patients. The U.S. would need to more than double the new nursing grads entering the workforce every year for the next three years” (to offset this difference). Trouble is, our education system doesn’t have the nursing instructors available to meet this goal, even if enough students wanted to become nurses.

So, the brutal fact remains that providers are going to be competing for the same or shrinking talent pools. The pools will likely be shrinking. Because staffing shortages are creating greater stress on the staff that remains – until they’ve had enough and also resign.

Another report from National Association of Health Care Assistants cites data from CNAs who left or want to leave their jobs. For 84 percent, better wages and benefits were the primary reasons they said they would stay. Top reasons for leaving included burnout and exhaustion, magnified by the existing CNA shortage causing increased caseloads. In addition, CNAs said they felt unappreciated by their leadership with a lack of respect for what they do every day.

This report mirrors the findings of a recent national survey among healthcare workers conducted by Transcend Strategy Group and MAC Legacy. Respondents cited motivators that were based much more on emotional needs than rational ones, such as:

  • Fulfillment/achievement
  • Purpose and passion
  • Sense of belonging
  • Empowered to focus on what matters

How to tackle intimidating staffing challenges

You may notice the motivators listed above all can be influenced by one common denominator – your agency’s CULTURE.

Renowned management consultant Peter Drucker said, “Culture eats strategy for breakfast.” And it’s true. No matter what your business strategy or your brand is, if strategy doesn’t engage and resonate with your staff, it will fall flat and ultimately fail.

Build a better team

This truth means it’s time to double down on your culture and make sure each member of your team feels connected to it. Here are a few important steps you can take to achieve this goal:

1. Bake your purpose into your brand.

Your brand is much more than your marketing. For decades, I’ve been advising clients that “Your culture IS your brand.” Because your team members are the ones who have to deliver and fulfill your brand promise every day – so it’s essential they believe in what your brand stands for.

Does your brand truly reflect your agency’s purpose? If not, you can work on evolving your brand to do so. When the agencies formerly known as Hospice and Palliative Care of Greensboro and Hospice & Palliative Care of Alamance-Caswell (North Carolina) merged a few years ago, they seized the opportunity to create a new brand brimming with their combined agency’s purpose.

Working with Transcend, the new entity crafted the brand name AuthoraCare Collective. “AuthoraCare” had a double meaning – you are the author of the remaining chapters of your life, and you have authority over your care during that time.

According to CEO Kristen Yntema, AuthoraCare engaged a wide cross-section of their staff to define and communicate the agency’s purpose. Together, they developed a new mission statement: “AuthoraCare Collective empowers people to be active participants in their care journey, enabling them to live on their own terms through our personalized support for mind, body and spirit.”

AuthoraCare and Transcend also developed the positioning theme of “Your story. Our expert care.” This purpose-driven positioning of putting patients’ stories first was a rallying point for the entire team, which has further cemented their culture.

These factors contributed to stronger recruitment and retention. In a little over a year after the new brand was launched, turnover was reduced to 14 percent – far below the national average for healthcare providers.

2. Support each team member in feeling their contribution to your purpose – so it becomes their purpose, too.

AuthoraCare Collective has been very successful in helping each team member feel like they are supporting each patient’s unique story. Centrica Care Navigators – based in Kalamazoo, Michigan – has had similar success with connecting their staff to the agency’s culture.

Formerly known as Hospice Care of Southwest Michigan, the agency rebranded to reflect their broader continuum of care upstream from hospice and position their expert team as vital contributors to guiding patients and families throughout the course of serious illness.

Centrica Care Navigators focused on helping their team members see how “We’re all navigators” – either directly providing guidance or care for serious illnesses or navigating the process from one point to another in supporting that care.

Denise King quote

Denise King, chief marketing and development officer for Centrica, tells how this mindset helped sharpen their recruitment efforts:

“As a nonprofit organization, it was especially challenging to compete with large health systems offering unprecedented sign-on bonuses and incentives. In our particular market, not only were we trying to stay competitive with wages, benefits and sign-on bonuses, we also had an additional layer when a large local hospital offered not only a $20,000 sign-on bonus for the incoming nurse but also a $20,000 bonus for the nurse who recruited them. As a strategy firm that stays on top of this fast-changing landscape, Transcend had the foresight to adjust our marketing plan to prioritize our recruitment campaign to the beginning of the year, which has been a tremendous help. Transcend helped us craft and convey the messaging of looking at Centrica Care Navigators as a total package. It is not just about pay but also culture and a sense of purpose.”

3. Train each team member to be a brand ambassador and recruiter.

In addition to helping team members feel a sense of purpose at Centrica, their positioning helped staff articulate how they found a sense of fulfillment in their roles and appeal to their peers.

“Transcend was able to deliver a highly visible and compelling recruitment campaign featuring our staff and really showcase who we are as an agency down to our core,” Denise said.

“They took 10 staff members from a variety of positions, backgrounds and career levels and meshed them beautifully to tell our story.”

The new recruitment campaign featuring Centrica team members helped fill 30 open positions in just a few months. Turnover has been put in check, with applicants waiting in the wings for a variety of positions. With qualified prospects for jobs, Centrica has reduced the timeframe from first personal touchpoint to hiring the applicant to an average of only about 25 days. Not too shabby for healthcare’s volatile landscape.

Not sure how to put these principles to work for your agency? Need help in defining and communicating your distinctive culture in a meaningful way? Transcend is ready to assist. Email me anytime at



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