. . . and start working smarter to improve retention.

By Allison Duda

I’m not denying the numbers; yes, I know we need more staff, but we also need to stop working so hard to get people in the door if we’re not being smart about doing what we can to keep the employees we have. Too many organizations are so focused on stopping the bleed, they aren’t being strategic about fixing the actual problems that exist in their culture like poor leadership skills, lack of accountability, poor communication and customer service, or a lack of appreciation shown to staff.  

Instead focus on creating a true retention strategy one that maps out the entire life cycle starting from day one. Here’s a hint: Day one starts even before a candidate walks in the door and does not end even after they leave an organization.  

Budgeting for Culture

If your retention is down and you have a suspicion that your organizational culture is less than a pleasant experience, trust me your marketing budget will actually be better spent focusing on improving your culture rather than advertising to potential candidates. Even if you successfully trick people into wanting to work for you, they will ultimately feel duped and quit.

Wow Candidates

Assuming your culture has some highlight-worthy experiences, and that you have employee’s willing to share their stories in advertisements or through word of mouth referrals, then you’ll want to focus on wowing your candidates. How can you create a truly sensational recruitment experience with an easy to use application process and a fun memorable interview? Things to keep in mind: applying for a job shouldn’t be confusing, difficult, or inconvenient. Interviewing doesn’t have to be nerve wrecking or painful. When an applicant walks in the door make sure they feel welcome, like they just walked into their new home.

Help Them Get Hired and Start

If a candidate had a great interview and you want to hire them, then do what you can to ensure they actually last long enough to make it to orientation. Make it easy for them to do background checks, medical tests, proof of licenses, etc. Plus, you’ll want to continue to wow them with your awesome culture. Trust me stranger things happen in the in-between phase from offer to start date that suddenly cause applicants to worry if they are making the right decision.

It’s up to you to squash their fears. Make sure you’re communicating with them often, keeping them up to date with where they are in the process, and invite them in to meet with additional team members. Plan a lunch, send them video links to team member stories, resident experiences, and share your excitement about your new hire on social media.


Orientation isn’t just about the nuts and bolts, the mandatories, the policies. It’s about so much more. It’s also about welcoming employees, introducing them to their leaders and their peers. You want to create opportunities for new employees to get to know one another and who they will be working with, both staff and residents. Nothing is worse then when you buy something brand new and you are so excited, you get it home, and it’s not what you expected. Apply this concept to orientation. Don’t let anyone be excited for their first day only to return home feeling underwhelmed. Orientation should be fun and memorable. New hires should leave their orientation feeling like they can’t wait to wake up the next day and come back time and time again.    


Like orientation, it’s not just about the skills and policies. Invest in developing your trainers. Make sure they are ‘people people’. That’s right, not just clinical people but that they are good with educating people. They should know how to teach, not preach. They should have strong leadership and customer service training prior to becoming a trainer. That said, they also better know the clinical stuff to the measure of the law as well.  


New employees who go through a structured onboarding program are 58% more likely to be with the organization after three years. Onboarding is not an event but a process, and all too often people consider their orientation plus two weeks or less of training their “onboarding”. In my opinion onboarding really starts during the in-between phase from offer to hire, and then lasts a minimum of 90 days. Most places have a “probation” period that ends after 90 days making this a clean and logical transition ending the onboarding period.

This does make sense, but here is my two cents. A 90-day “probation” translates for me into “hey we don’t trust you so we’re going to check up on everything you do for the first 90 days, then afterwards we expect that you’ll never make any mistakes so try not to fall on your face because we won’t be there to catch you if you do.” Is this the culture that retains employees? I think not.

Instead onboarding really needs to focus on creating an opportunity where you’re setting your new employees up for success, developing trust, building relationships, encouraging your employee to ask a lot of questions, and getting to know the ropes so both you and your new employee feel comfortable and confident that they can do their job well. Ask for feedback throughout the first 90 days, not just at the 90-day mark. After the 90 days are up, sit down more formally and discuss what went well, what could have gone better? What skills, education, or tools do you need to grow and learn in this position over time? Here is where you should also agree to meet regularly for ongoing coaching.

Ongoing Engagement

A major focus of your overall retention strategy needs to be on-going employee engagement. There are numerous ways to engage with your current employees, Gallup Inc. focuses on the 12 statements most linked to employee engagement, and Drive has developed a short resource that can be used with employees during coaching conversations and performance management discussions (sign up to receive our newsletter and we’ll send you the free resource).

Many organizations still use the annual performance evaluation to meet with employees, I’m not against having a formal sit down once a year, but this absolutely can not be the only time you’re meeting with employees to give and receive feedback. Consider your turnover numbers, if people are leaving within the first year that means they aren’t even making it to their first annual review. You need to make sure that your culture is one that embraces giving and receiving feedback on a regular basis; having open dialogue, meaning two-way communication.