AskAdvisory about … turnover and retention, VBC, and more

Have a question but aren't sure how to find the answer? AskAdvisory can help. Our library of resources covers a wide variety of topics, including turnover and retention, value-based care (VBC), and operating room (OR) efficiency.

Turnover and retention

According to Advisory Board's 2021 hospital turnover and vacancy benchmarks, turnover among health care workers has reached new highs in recent years:

• Median turnover among full-time and part-time staff (excluding PRN, per diem, and casual staff) increased to 18.8% in 2021, up from 15.5% in 2020 and the highest figure Advisory Board has recorded in 15 years.

• Median turnover for bedside RNs has also doubled over the past decade, going from 8.7% in 2010 to 18.8% in 2021.

In addition, a survey from the American Association of Critical Care Nurses found that 67% of RNs said they planned to leave their current position within the next three years, compared to 54% in 2018. Of this group, 36% said they planned to leave within the next year, with 20% planning to leave within the next six months.

To help your health care organization reduce turnover and better retain your workers, Advisory Board offers several resources, including:

• To retain staff, organizations need to invest in well-being beyond the workplace: This blog provides different ways to help your staff recover while they are away from work, improving their overall well-being and satisfaction.

• 6 ways to keep your top talent amid the 'Great Resignation':  Record numbers of Americans across several different industries have quit their job as part of the "Great Resignation." This Daily Briefing article, which includes Advisory Board's own take, offers several strategies to help employers combat turnover and retain their employees.

• Why nurses quit (and how to persuade them to stay): In this Daily Briefing article, we highlight the top challenges facing the nursing workforce, how nurses feel about the Covid-19 response, and what your organization can do to retain your nurses.

There are also different resources to help your organization keep track of and predict turnover more readily going forward:

• How Aurora uses a homegrown analytics tool to predict employee turnover: This case study profiles how Aurora Health Care invested in a data and analytics team to take a more proactive approach to managing employee retention.

• Annual Turnover, Vacancy, and Premium Labor Benchmarks: This tool provides turnover data that you can analyze by region, bed size, and teaching status to compare your organization's performance against other hospitals.

Value-based care

For a quick refresh, read Advisory Board's Back to basics on VBC resource, which explains what VBC is, its future, and more. In general, value-based payment structures are often used to incentivize health care providers to improve their quality of care and reduce spending, which can then significantly impact patient outcomes and costs.

For example, Humana has released data showing Medicare Advantage members who received value-based care had more preventive care, lower costs, and better outcomes in 2020 compared with traditional Medicare members. Many organizations have also begun transitioning to value-based care payment structures to better attract and retain new workers amid high demand for physicians.

Use these resources to keep up with VBC trends: 

• The right questions to ask about the future of value-based care: This episode of Radio Advisory focuses on where the health care industry is currently at with value-based care, how Covid-19 has impacted the industry's VBC journey, and the questions providers should be asking themselves about risk.

• How is value-based care changing health care delivery?: This resource library contains cheat sheets to learn the basics of value-based care or go deeper into a specific topic.

• 4 insights on the current (and future) state of commercial risk: This blog provides an overview of the current state of commercial risk, as well as what it could be like in the future.  

We also offer several resources on the best practices for providers who are taking on risks with VBC, including:

• Value-based care is back in the spotlight—what should health care leaders learn from their past experience?: Health care executives should focus on strengthening their payer-provider relationships to advance their risk strategy. Balancing the needs of patients, providers, and patients has never been more complicated. This resource offers the top considerations for payers and providers who want to enter new contracts, succeed in existing ones, and achieve scale.

• 6 mistakes you'll make with VBC (and how to avoid them): Your transition to risk-based models is a marathon, not a sprint. This blog offers insights to ground your VBC strategy and ensure you don't fall victim to common mistakes.

• How to improve your risk performance: This analysis of successful Medicare ACOs provides three main takeaways for organizations hoping to improve their risk performance and achieve similar results.

OR efficiency

With operating rooms often accounting for one of the costliest centers of a hospital, making an idea reality can be difficult. These case studies provide real world insight into how your peers have implemented new strategies to improve OR efficiency:

• 3 ways Intermountain improved its OR efficiency: This blog explores Intermountain Healthcare's approach to reduce cumulative OR tardiness on three factors: case on-time starts, case duration, and turnover time. Intermountain's three-pronged approach focused on creating a culture of urgency, tracking case duration, and redesigning staff roles, all of which led to a 15% decrease in average OR turnaround time.

• Brazil: Improving Operating Room Efficiency: This research article highlights how the health system Américas Serviços Médicos used strategic partnerships to develop and implement a plan to improve OR efficiency across six hospitals in its system. 

If you are looking to improve perioperative processes at your organization, these resources can be helpful:

• The Surgery Compendium: This research report provides best practices to improve overall surgical efficiency. The report addresses scheduling tactics before analyzing preoperative and postoperative processes to improve surgical flow. 

• 3 strategic benefits of surgery prep program: This article explains how pre-surgery prep programs can lead to volume growth, improved patient satisfaction, and better conditions for value-based care.