Retention

Overview

The way you reward, sustain and promote your workers can impact how productive your organization is, how adaptive to environmental changes, and how long staff stay.

Retaining the right staff for your organization requires:

  • LISTENING
  • REWARDING
    • Using deliberate recognition practices and
    • Competitive compensation
  • SUPERVISION that is consistent and clinically focused
  • TRAINING AND EDUCATION
    • Providing training at the workplace and/or for supervisors and staff offsite
    • Providing opportunities for or information about educational advancement
  • WORK ENVIRONMENT that is supportive and adapts to changing needs
  • MENTORING that begins on day one

The field is small in many ways, and workers will move to advance their career or meet personal needs. How you relate to and support your workers, even with those who leave, speaks to your values and your ability to serve clients.


Listening

Staff members feel empowered, heard, and appreciated when we ASK them questions…Listen to their answers….
And take action!

These four question have been developed and tested by NIATx, a national resource for quality improvement in addiction services. They can be asked in any setting, and will give you actionable insight into the experiences of your staff:

  1. What do we do well here?
  2. What could we do better?
  3. What do you like about working here?
  4. What would make your work experience better?

You can ask these questions in survey form, but you are likely to get better results and help strengthen relationships through targeted conversations with small groups of staff.

Try using the Nominal Group Technique – where everyone has an equal opportunity to make suggestions and prioritize their ideas.

A Gallup Poll discovered twelve core questions that give an organization the most important information it needs to attract, focus, and keep the most talented employees.

They are:

  1. Do I know what is expected of me at work?
  2. Do I have the materials and equipment I need to do my work right?
  3. At work, do I have the opportunity to do what I do best every day?
  4. In the last seven days, have I received recognition or praise for good work?
  5. Does my supervisor, or someone at work, seem to care about me as a person?
  6. Is there someone at work who encourages my development?
  7. At work, do my opinions seem to count?
  8. Does the mission of my company make me feel like my work is important?
  9. Are my co-workers committed to doing quality work?
  10. Do I have a best friend at work?
  11. In the last six months, have I talked with someone about my progress?
  12. At work, have I had opportunities to learn and grow?

Source – The Gardner Shaw Group

High Point Treatment Center used the Four Questions and Northeast Behavioral Health used the "Twelve Questions" to gauge the satisfaction of workers and find out what might need changing; Providence Hospital adapted the questions and enaged staff in making ongoing change. Read more to see how staff and client feedback reinforced the existing practices, offered opportunities for responsive improvement, and improved the work environment.

Rewarding

Informal and Formal Recognition

In one program’s survey of 16 items, a personal note from the CEO was the fourth highest preferred recognition method.

Tell your own organization about the good work being done. For example,

  • Highlight staff in workplace community announcements
  • Provide periodic appreciation lunches
  • Hold an annual staff awards event
  • Institute a peer-to-peer recognition board for employees to recognize each other.
  • Tell your workers when they are doing a good job with individual notes or emails, from supervisors or even from the CEO

Go Public – nominate your staff or program for public recognition through many of the professional associations which exist.

The Bureau of Substance Abuse Services recognizes individuals every two years at its Innovations Conference. NAADAC recognizes individuals. ABH recognizes individuals and programs. See more Recognition Opportunities.

Compensation Income:

  • Determine whether your base salaries are competitive. If not, raise them if possible (see suggestions).
  • Offer increases for staff who become licensed and reimbursable.
  • Compensate staff for attending training.
  • Offer one-time payments for longevity or licensure.

Direct Benefits:

  • Provide medical (including dental/vision) and life/disability insurance, dependent care accounts and health care flexible spending accounts.
  • Give health club discounts.
  • Pay for licensing or certification exams.
  • Explore tuition reimbursement or provide information for workers about exploring reimbursement opportunities on their own. Some higher education institutions offer tuition reimbursement for programs taking interns.
  • Find out if you are in a shortage area – your workers may be eligible for loan forgiveness or payment through federal funds

Indirect Benefits:

  • Provide flexible and part-time options and extended family leave.
  • Offer a wellness program onsite.
  • Make an arrangement with local daycare for parenting workers.
  • Offer lunch on site.
  • Provide free health services, like flu clinics, on site.

Supervision

One of the key elements to retaining and developing workers, clinical supervision often poses difficult workforce challenges:

  1. Administrative activities often take precedence over clinical work.
  2. Training for staff and supervisors is not always aligned.
  3. Clinicians are often promoted without sufficient training in how to provide effective supervision.
  4. There is often a shortage of qualified supervisors.

What you can do:


Training and Education

Organizations face three issues related to training and education:

  1. It is a risk to pay for training or education of workers who may not stay.
  2. Third-party payers do not reimburse either workers or organizations for attending training/courses.
  3. Common training methods (e.g. one-day, exposure-level trainings) don’t encourage skill-building or organizational adoption of new practices.

Organizations can take a proactive approach to address supervision, training and education issues:

  • Program-level training: Train supervisors and those they supervise at the same time to ensure support of new skills being used by the individual and adopted in the organization.
  • Work-based Learning, where education is brought to the worksite, and workers are given educational credit for some of their work, provides new opportunities for organizations to minimize the time out of work for training/education, and new opportunities for staff.

Work Environment

A positive workplace culture is one of the most-often cited reasons for staying with an agency; a negative workplace culture is one of the most-cited reasons for leaving a position or the field.

“Members of the workforce, no matter how well prepared, competent, and compas­sio­nate, must function within systems of care. A competent individual placed in a toxic envi­ronment cannot function efficiently and effec­tively and is far less likely to be retained. Strengthening the behavioral health work­force requires creating environments that support the health and well-being, not only of persons…with substance use conditions, but of the workforce as well.”
Source - p.58 of the Annapolis Coalition Report

Quality Improvement projects have been found to have a profound effect on staff retention. When the quality of care increases, or paperwork or other administrative processes are streamlined, workers feel better about their jobs, and stay.

See Suggestions from the Workforce Development Stakeholder Advisory Group to get some ideas for ways to improve the work environment.


Mentoring

Workplace mentoring benefits new staff and the mentors themselves. A new worker feels welcomed to the culture and gets individual guidance in navigating the operational elements of a job. A seasoned worker, acting as a mentor, has opportunities to negotiate paths of advancement.

Some people find long-term career mentors on their own, in or outside the workplace.


Funding

If your organization is located in a federally-recognized shortage area, your staff may be eligible for tuition loan repayment in exchange for a specific length of employment there.


Resources

Network for the Improvement of Addiction Treatment
Massachusetts Executive Office of Labor and Workforce Development
National Addiction Technology Transfer Center
Providers’ Council document “Addressing the Human Services Workforce Shortage: A Guide to Recruitment and Retention
SAMHSA's Recruitment and Retention Toolkit

back to top