In the toughest labor market this industry has seen, retention strategies are at the heart of children’s hospital workforce efforts. Nurses and specialty clinicians have more options for work than ever before and require more benefits to stay happy and motivated in the hospital environment. These five programs are helping children’s hospitals increase retention rates across their organizations.
1. Career flexibility
When Children’s Hospital of Philadelphia (CHOP) learned that nurses wanted more opportunities for professional growth than the traditional “ladder” system of career advancement, the hospital replaced their career structure with the Professional Excellence and Advancing Knowledge (PEAK) model. The new career model enables clinical nurses to pursue a variety of educational and professional development opportunities based on their individual goals and passions.
After implementing this and other initiatives, turnover rates among outpatient nurses dropped from 11.4% overall in 2021 to 8.7% in 2023, including a significant drop in the turnover rate of first-year outpatient nurses — from about 50% in 2021 to 12% in 2023.
2. Waste reduction
To reduce burnout for its employees, Nemours Children’s Hospital focused on waste — the daily hindrances to work that cause undue burden on staff. By reducing the work burden, the cognitive load, and the workarounds that require a lot of time and energy, health care professionals can do what they do best: take care of patients at the bedside.
Through the Get Rid of Waste (GROW) program, the hospital’s quality improvement staff work with teams in every department across the organization, teaching employees to recognize and surface waste within their processes and supporting them in creating solutions.
3. On-site child care
Only around a third of U.S. hospitals provide child care benefits, and few offer on-site services. Arkansas Children's Hospital's Child Enrichment Center and Driscoll Children's Hospital’s Children's Learning Center have a perpetual waiting list. Both centers meet an important need: providing a high-quality, education-based child care service located just steps from where the children’s parents work.
The high-demand convenience has been an effective source of retention, according to the hospitals’ leaders. At Driscoll Children’s, turnover rates are significantly lower for employees using the child care center than rates for those who do not use the center.
4. Whole-person care
Nicklaus Children’s Hospital is addressing the workforce challenge by supporting employees holistically throughout their life journeys. Their comprehensive well-being program incorporates seven dimensions of wellness: emotional, physical, social-environmental, financial, occupational, and intellectual. Offerings include a staff psychologist, life coaching, wellness stipends, classes, and financial counseling.
In 2022, Nicklaus Children’s overall nurse turnover rate was 15%, compared to the 32% Florida Hospital Association (FHA) nurse turnover rate for the same period. Nurse vacancy rates for the health system in 2022 were 9.8% compared to an FHA nurse vacancy average of 21% for the year.
5. Joy in work
Four children’s hospitals have found success using a framework developed to bring joy back to the health care profession. The IHI Framework for Improving Joy in Work outlines nine critical components of a system for ensuring an engaged workforce and the steps leaders and teams can take to get there.
