Morale, not Satisfaction, Key to Retaining Your Hospitalists

Hospital medicine is the fastest growing medical specialty in the past 25 years. One troubling problem for hospital leadership is that the average hospitalist turnover rate is 12.5 percent to 18 percent.

Why is this happening and how can hospital leaders reverse the trend, given that replacing a hospitalist often costs tens of thousands of dollars in lost unit productivity while retaining an experienced hospitalist can reduce health care costs by $800 per case and decrease length of stay by a half-a-day?

Most hospitals try to address hospitalist turnover in the usual way—by surveying them about how satisfied they are. But standard satisfaction surveys only measure how they feel about their job, and physicians are usually happy with the career they’ve chosen.

Research is revealing that measuring hospitalist morale—how they feel about their workplace rather than their work—is a much more reliable predictor of turnover. And while hospital and department leadership can’t change a physician’s basic work, they can change the environment in which they do their work.

Hospital medicine tends to attract those who are relatively early in their career, and because of that, they are likely to be sensitive about issues like a positive workplace environment, work-life balance and career development.

The Hospitalist Engagement and Retention Survey is being used throughout the Johns Hopkins-affiliated hospitals so that hospital and department leaders/managers can adequately measure hospitalist morale and help identify areas for programmatic improvement, with the goal being to increase overall hospitalist satisfaction and retention rates.

The survey results are analyzed by Johns Hopkins hospitalists and biostatisticians and incorporated into a report that includes a score that can be compared to other hospitals to help you gauge your staff against the national average. With this score and report, hospital leadership can address existing problems in an effort to retain and engage experienced and valuable hospitalists.

Hospital and department leaders have implemented the following as a result of their Hospitalist Engagement and Retention Survey:

  • A lactation room was established that helped retain several key hospitalists
  • Mandatory moonlighting policy was revamped
  • New scheduling protocols were put in place
  • Hospital leadership improved their direct engagement with hospitalist staff
  • Mid-level leadership was established to both improve understanding between leadership and hospitalists and advocate on their behalf with leadership.

Implementing the survey requires only buy-in from whomever is responsible for hiring, on-boarding, managing and retaining hospital medicine staff. After that:

  • The participating hospital provides a list of emails of staff they want surveyed
  • Johns Hopkins pushes a web-based survey tool, which will remain active for 30 days
  • Participants will receive weekly reminders to complete the survey
  • Results are analyzed by Johns Hopkins experts

Learn how you can give your team the Hospitalist Retention and Engagement Survey.


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