If Your Strategic Plan Doesn’t Focus on Retaining Staff, You Don’t Have a Strategic Plan!

 In Reducing Employee Turnover

Strategic plans … developing one is challenging enough, but executing it is another feat entirely. The complexity of today’s home-based healthcare environment (and healthcare in general), financial constraints and workforce challenges are seemingly nebulous obstacles to overcome.

One thing is for certain, if you don’t have a workforce, it’s difficult to deliver care. That may seem cheeky, but the sentiment holds true. In the age of shifting from fee-for-service to value-based care, the focus of strategic plans, boards and executive committees can sometimes rest on the shoulders of diversifying payers, negotiating with ACOs, healthcare systems and other referral sources. While those are indeed essential components of a successful strategic plan, they are not the full story.

Clinician charting medical info at a kitchen table

Transcend has worked with many clients experiencing workforce challenges. Mid- and post-pandemic job markets caused a flurry of recruitment activity among our client base. Some were throwing all their weight, and the best intentions, at improving their recruitment strategy and investing in Indeed and other platforms to reach clinical talent. Transcend’s analysis, by way of Trancend’s Workforce Development Model, would often reveal that there were as many, if not more, opportunities to improve retention over recruitment.

In truth, time and resources would have been better spent on process improvement and addressing burnout to retain existing staff before investing further in recruitment. Why? No amount of recruiting can mask inefficient processes, poor morale and undertrained teams. Of course, it takes time and concerted effort on the part of all leaders and managers at your home-based care agency to address reasons why employees may be unsatisfied. A long-term commitment such as this unequivocally belongs in your strategic plan. Plus, retaining staff members saves your organization money as training and onboarding new employees is incredibly expensive and time consuming.

Home care clinician sitting on couch educating a patient or family member

Retention is not a quick fix with a silver bullet, but here are some key areas to consider including in your strategic plan when it comes to retaining staff:

  1. Establish methods of soliciting feedback from staff on a continual basis.
    Annual engagement surveys are not enough. Provide employees with year-round communication channels and a culture of psychological safety so they feel confident to tell you in their own words exactly what is causing burnout and dissatisfaction. Their answers may surprise you, and they will definitely inform you.
  2. Understand and improve what is causing burnout.
    Take the time to fully understand through process mapping what is burdening your staff mentally and taking up too much of their time. For example, include documentation efficiencies as a process improvement initiative and report progress regularly.
  3. Adjust staffing levels to be one step ahead of census.
    Instead of cutting it close with staffing levels, or having just enough staff, consider what staying ahead of census might do for employee morale. If employees see that you are taking care to manage their caseloads by thinking ahead on staffing levels, it may impact how respected they feel by your organization.
  4. Consider your multigenerational workforce.
    Perhaps for the first time, four separate generations make up our workforce today. Each carries its own set of values, communication preferences and expectations. Transcend has helped clients analyze and evaluate their area workforce through market research, which can lead to strategies around tailored messaging, health equity initiatives, communications plans and more.

Callout Stat: 52% of Gen Zs and Millennials are not satisfied with their current organization’s progress in creating a diverse and inclusive workplace


There are many reasons why retaining staff belongs on your organization’s strategic plan. Consider the ripple effect it has on organizations:

  1. Quality of care – High staff turnover disrupts relationships between caregivers and patients, which can lead to inconsistencies in care delivery and communication breakdowns.
  2. Continuity of relationships – For most patients and families, placing trust in caregivers to enter their home and provide care for their loved one is a huge deal. When a relationship that has been formed is then severed, it can disrupt the continuity of emotional support, which families rely on during difficult times.
  3. Cost savings – Work with HR on your team to conduct an analysis of what it costs to recruit, hire, onboard and train new employees. Experienced staff tend to be more efficient and productive, contributing to even more cost savings in the long run.
  4. Employee morale – If an organization is experiencing high turnover, trust me, employees will feel it, if only from the increased workload. They will also start to wonder what they are missing out on by being left behind.
  5. Knowledge and expertise – In the simplest of terms, retaining experienced staff ensures the organization retains valuable institutional knowledge and expertise. This knowledge is critical to handling home care and hospice’s complex cases, making informed decisions and maintaining compliance.
  6. Maintaining reputation and competitiveness – Reputations are hard to build and easy to lose. High turnover is one of the most visible signs of instability and can signal poor quality care, and poor experiences and reviews can spread like wildfire. Keep turnover low to help mitigate potentially harmful effects from social media, Google reviews and word-of-mouth tales.

Does your strategic plan need a tune-up? Transcend has guided many leaders and organizations through crafting strategic plans and other bespoke engagements. Reach out to schedule a conversation – hello@transcend-strategy.com.


Transcend experts speak on "Betting on Employee Retention in Home Health & Hospice" at the 2024 NAHC FMC conference in Las Vegas on July 21 through July 23, 2024.

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