Workforce Retention: Building Culture That Works

In this episode of Value-Based Care Insights, host Daniel Marino explores one of the most pressing issues in healthcare today—workforce engagement and retention. Since the COVID-19 pandemic, healthcare organizations have faced unprecedented levels of burnout, turnover, and staffing shortages. Daniel is joined by Tanya Allee, Vice President of Patient Experience at Campbell County Health, a rural health system that is making meaningful strides in workforce development. Tanya shares practical strategies and initiatives to boost staff satisfaction, improve retention, and create a healthy culture of support and engagement. Tune in for valuable insights on how health systems can navigate workforce challenges and create a healthy organizational culture resulting in better patient care. 

LISTEN TO THE EPISODE:

 

 

Daniel Marino:

Welcome to value-based care insights. I am your host, Daniel Marino. Across many of our healthcare organizations, whether it's a hospital or a medical group, health system. Focusing on workforce culture, workforce alignment and just the experience of the of the workforce has been top of mind for organizations, really, since the pandemic. And maybe even before the pandemic. What we saw was after Covid, a lot of high turnover with staff just getting burned out, particularly in nursing. And we talked about that on this program before, where you know the burnout factor is really high. The stress level is really high. There's been challenges with working remote and then hybrid. And now there's a big push to get everybody back into the office. It's not really affected healthcare too much, because at the end of the day we need to be in the clinic or in the hospital in order to take care of patients. But this this drive to improve our workforce experience, and making really our staff and our physicians, our providers, happier and more engaged in the work that we're doing is still a major focus. And still is a major challenge for a lot of organizations. And if you think about it, it's a challenge for all. But it's particularly a large challenge for rural health providers. Rural health providers find it difficult to recruit staff. So oftentimes what they do is they'll put in place some good training programs and group development programs. And if folks get frustrated and then they leave again, major disruption major cost, human capital is always difficult to replace.  

Well, I'm really excited today to have a great guest. A lady who's been working in this space for some time. Tanya Allee, Vice president of Patient Experience at Campbell County Health. It's a rural health care provider. Tanya has been leading the workforce improvement initiatives at Campbell for some time, and just has a great amount of knowledge as well as I think, some, some wonderful wins and suggestions for us as we think about tackling the workforce challenges and improving our overall experience of our staff. Tanya, welcome to the program. 

 

Tanya Allee:  

Thanks, Dan. I'm very excited to be here today and visiting with you. 

 

Daniel Marino:  

So, Tanya, when you look across the country and you hear about many of the challenges that organizations have. Healthcare organizations have. What do you see, as really, you know, some of the largest challenges that we're facing these days? 

 

Tanya Allee:  

I think you did a great job on hitting on a few of them right off the top. We've got significant turnover. We've got competition pulling because we don't have a huge, vast staffing resources to pull from. And so we're competing with other organizations. And certainly, as you mentioned before, our rural health care is also very difficult to get people out here in some of the cold weather and lack of some of the opportunities that they would have in some of the bigger locations. So I think that that does make a big difference in what we can pull in and what we can keep, and so managing our staffing, managing our turnover, managing that engagement within, and really creating a culture where people want to thrive and work in, come to and stay in is really our big focus. 

 

Daniel Marino:  

Well, and it's a I sort of describe it as a slippery slope of challenges right? That sort of feed off one another. For the staff, if you're short staff, then the staff that are there become even more challenged and more burned out. And then, if they leave, or they don't see some progress, or maybe we're putting pressure on them to fill in for the staff that has already left right? It just exacerbates the problem. So you know, as we think about this, it's almost difficult, really, to get ahead of this. If you're going to put in any type of improvements. 

 

Tanya Allee:  

Yeah, I think the slippery slope was a perfect analogy. And I think that's exactly what we've been up against. And assuring that we can still provide high compassionate care with teams that are overwhelmed and burdened and burnt out, and pulling extra shifts and managing extra responsibilities and duties. It's a lot to ask. 

 

Daniel Marino:  

Do you see differences in some of the challenges that staff are facing? Is there differences in the challenges with the clinical or the nursing personnel versus the administrative or non clinical personnel? Or is it really that same frustration, level? 

 

Tanya Allee:  

I  think the frustration level is probably pretty comparable. However, I think, on the clinical side it's certainly more intense in the fact that we don't have a lot of capabilities to backfill. And the clinical needs in our community, and I'm sure in many others are rising, our patient volumes are increasing, the acuity is increasing, and so the need for adequate qualified staffing is also increasing. 

 

Daniel Marino:  

Right? Yeah, absolutely. You know, when, when we've when we've spent some time working with organizations, and we've done a little bit of work here and there with trying to improve workforce, and particularly around, you know, like the OR improvement, and so forth. Oftentimes staff look to leadership that says, well, leadership isn't doing this or administration isn't doing that. I don't really see that as the case. I think it's really an organizational change that has to occur now. It probably starts with the leadership, but at the end of the day, if we're really going to improve the whole workforce experience, in my opinion, it needs to be an organizational commitment. What are you seeing as you started to make some changes in your organization? 

 

Tanya Allee:  

I love that analogy, because that was a huge part of the conversation when we initiated our culture PIT team. Where does this really need to lie? Where's the responsibility at? And there was a lot of back and forth within our champions of it absolutely needs to be from the top down, and others would say, Nope, definitively, it needs to come from the bottom up. We have to have that engagement infused. And really to your point, what we came to an agreement on is ultimately everyone needs to be engaged. Everyone needs to have that ownership. Everyone needs to be empowered to create the desired outcomes and results, and the culture that we want to work and live and thrive and serve in. 

 

Daniel Marino:  

Yeah. And I don't think anybody will argue with that. I mean theoretically, that makes really sense, I think, where the rubber hits the road is where you start right? Because it's overwhelmed right when you think about it, that you know, if you, if you come to the realization that this needs to be an organizational based initiative, you know, where do you start? So where did you start as you started to have that conversation, you know, with your colleagues, and with the with the staff, and so forth? 

 

Tanya Allee:  

Well, you're exactly right. And we initially started with a small group of leaders or champions that we knew were very strong outside of the box thinkers and really started plugging into where are we at? What are the issues or concerns? And then looking at what are the desired outcomes? What are we trying to achieve? What are we trying to accomplish? What kind of environment do we want to come to work in every day? Part of our mission vision is to be the 1st choice in healthcare. And that's not just for our patients and residents, but it's also for the people that we employ, the people that work to serve those patients and residents. And so we had a lot of very detailed, quite frankly, raw conversations. There was a lot of back and forth. There was not always agreement. And I think ultimately that's what catapulted us into some of the initiatives that we ended up going live with. I think those ideas, and challenging each other, and being open and willing to have some of those more difficult conversations amongst the team really helped move us forward. And ironically we went back and forth, and we had tapped into multiple resources and multiple different ideas. And everyone brought something to the table. And really, in the end, after all of those discussions, we came back to framework that we had actually initiated over a decade ago. 

 

Daniel Marino:  

Wow! That's great. 

 

Tanya Allee:  

It wasn’t new, and that's what was the best thing about it. 

 

Daniel Marino:  

Yeah, yeah. Well, those you know clearly, I mean, that was the value, the values that were inherent in your organization. But I love that approach because, you know, againpulling people together and aligning around the vision of where we want to go. You know it's an old adage,if if you don't know where you're going, any road will take you there right? And I think to be able to get folks together and align around what that future vision is. Your billing consensus, your billing alignment, your billing building, the realization of what it's going to take for us to get there. But you know, at the end of the day I mean, it sounds like it really came back to what was what was the initial value drivers of the organization. 

 

Tanya Allee:  

Yeah, yeah, it was. And I do think that gave us a little bit more solid ground to reopen this initiative or this movement, if you will. Because it wasn't the next new flavor of the month. It wasn't something that we were going to dive in and then lose steam on. It was something we'd already committed to like, I said over a decade ago. And so it was much easier to get buy in and get people to participate. And again, basically, we just need to figure out we've got the basics. We've got the bare bones. How do we recommit? How do we reconnect? How do we reinforce the accountability around the things that we already stand behind. 

 

Daniel Marino:  

If you're just tuning in, I'm Daniel Marino. You're listening to value-based care insights. Having a wonderful discussion with Tanya Allee, Vice President of Patient Experience at Campbell County Health. And we're talking about improving the workforce and some of the initiatives that Tanya's deployed as she's been able to tackle this within her organization. Tanya, when you when you started this though did you form a task force? How did you get? How did what was this the structure you put in place to get input right? Because I mean, frankly, I'm assuming you went out there. And if staff are frustrated, I mean, Heck, you could walk down the hall, and you can probably get a ton of opinions. How do you? How do you create some type of a structured approach to not only get the opinions, but kind of coordinate those opinions until some into some type of an output? 

 

Tanya Allee:  

And really it was we very strategically aligned culture champions that we knew would be willing to be raw and forthright with what's going on, and what we have some opportunities for. But would equally be solution seekers and be willing to say, and here's what we can do. And here's how we can tackle this. And here's how we get to move forward. And so it was, it was very intentional, and I have to say I feel personally, we knocked it out of the park. The group that we pulled together for this were just absolutely beyond exceptional. And I said, tough conversations, but the outcome was phenomenal. 

 

Daniel Marino:  

That's great. That's great. Well it sounds like this is what you did. You want to have those formal leaders. But you also want to have the informal leaders right? The informal leaders who are the influencers. And you know, as I've said, for many, many years, even when I used to manage a lot of my medical practices, the informal leaders were more influential than even the formal leaders, right? Because they were the ones that were involved in kind of managing the conversations around the grapevine. So that that sounded like, you know, a lot of what you've been able to do. Talk a little bit about some of your initiatives. What were some of the things that came out of that group that all of a sudden started to propel you forward. 

 

Tanya Allee:  

Well, I think the biggest thing, and that taps in completely to those champions throughout the entire organization. But one of the big movements, the big focus was the “We are CCH.” So we were trying to break down silos. We were trying to get people collaborating together and reinforcing that we're all here on the same ship, trying to accomplish the same thing. Which is to provide the best compassionate, patient care. And so the “We are CCH” became our phrase our go to phrase, that's what represents all of our standards. It kind of summarizes everything, and everyone is used to that now. And so we hear that regularly throughout the halls and within meetings, and sometimes when behaviors or things aren't aligned with what we are, what we're doing, we'll hear people say, hey, “We are CCH” and this is how we're going to move forward with this, and it reinforces the solution seeking opportunities versus the problem presenters. 

 

Daniel Marino: 

Right? Well, it sounds like that mantra was probably, or that phrase was probably the element that really allowed you to kind of get past the challenges or currently getting past the challenges, but leading you to what the vision is going to look like, right? Because it's just early on, I mean, at the end of the day. We all have to collaborate around what a future vision is going to look like. And that phrase probably helped you get past some of the challenges and keeps you on that right path. 

 

Tanya Allee:

Exactly right. And we refer back to that very frequently. 

 

Daniel Marino:  

So when you started this, you know again the staff, both clinical, non-clinical, I mean, critical to the organization. But you can't forget the physicians right? And the physicians are extremely influential, you know they drive the patient care right? How did you communicate with the physicians? Were they part of the process? Did they provide that input? Where did they fit in? 

 

Tanya Allee:  

Well, we initially rolled this out with just our department leads, managers, directors, supervisors. Then we started to infuse that into all staff. And so our culture champions, with all of their enthusiasm and energy, went to all of the staff meetings and shared the initiative and the movement, and where we were going where we were headed, and excitement behind that. And then the final step has been to start, including those providers in those conversations inviting them to the staff meetings. To be part of our challenges every month and making sure they're well informed of the initiatives that we're rolling out, and eventually we'll be taking some additional steps to continue to engage them to become additional champions for us.  

 

Daniel Marino:  

Well, I would. I mean I would assume that your physicians have to be pretty excited about this, because typically physicians and providers, if there's challenges with the workforce, if there's high turnover, you know, they're the ones mostly impacted and affected. So I would assume that they would be excited. And for the most part pretty supportive of the direction you want to go. 

 

Tanya Allee:  

Yeah, we have not seen where we're getting any significant pushback. I would completely agree with you on that. I would like to make that assumption as well. And I know we've got some just like we did with the leaders. We've got some phenomenal physician champions that we'll be tapping into more and more to help kind of spread that eagerness and that enthusiasm for where we're going. 

 

Daniel Marino:  

Yeah, that's great. So why don't you share with us? Maybe a few of your successes? What are some of the things that I guess maybe you're particularly proud of with you and your team. And you know, as you kind of look back, what were some of those good success stories. 

 

Tanya Allee:  

Well, we with a few of the initiatives that we've rolled out, and “We are CCH” being a huge piece of that. We've had so many success stories. I was just in a meeting yesterday, and people were sharing that we've created this environment we are creating. It's still an active process.  

 

Daniel Marino:  

And it always will be right. This is a journey. 

 

Tanya Allee:  

Right. And so we were really creating this environment where it's safe to have these conversations, it's safe to hold each other accountable. It's safe to redirect and coach people back to our framework, and our standards of behavior, and leaders and staff alike are seeing that actively happening, and where people again, are being more solution oriented versus problem dumping. And so I think a lot of that has aligned with you know, this isn't just this department, or this person, or this leader or executives issue. This is our issue as CCH. And so how are we going to work to resolve that? And I think that's a critical piece. 

 

Daniel Marino:  

Wow! That's great. And I'll tell you, creating a safe place within the work environment is huge. Because, you know, as we see oftentimes when we go into different organizations and we do a lot of work around process improvements both clinical and non-clinical. We often see Staff really scared to voice their opinion right? They don't feel that there's a comfortable place to do that. And I think and it's you probably see this. And you know it sounds like you have that in one of your stories, the staff have great ideas in terms of how to improve and put in place new solutions. But oftentimes they're scared to voice those opinions. And creating that safe space, I mean, that's where you really pick up a lot of the momentum. 

 

Tanya Allee:  

Absolutely. And one of the initiatives that we rolled out we're calling our quarterly career conversations. That's really the full intent of those conversations all leaders are meeting with their staff quarterly, and we have a hodgepodge of various formats that we've put together in one. So we get an opportunity to round with the employees, we get to harvest ideas and suggestions and get some additional momentum from them. We also get to provide feedback and assessing how they're aligned with our standards and their day-to-day interactions. And then we also get to align that with our strategic goals and our mission. And then finally, they get an opportunity to establish a personal goal where they feel like they're really engaged in part of where we're headed. 

 

Daniel Marino:  

Yeah, well, that's wonderful. And that engagement is, I think it's critical, you know, just being able to empower folks. It probably was a breath of fresh air, I would think to a lot of folks, and especially those young up and comers within the organization. I mean, they want that right? They want to be able to be with an organization where they can grow, they can contribute. They feel like they're a part of something. 

 

Tanya Allee: 

Absolutely. 

 

Daniel Marino:  

Have you? Have you seen any? Has there been any responses or feedback from patients? Have patients noticed the difference? 

 

Tanya Allee:  

You know we have had some feedback. We take in a lot of feedback in a lot of different capacities, good, bad, or indifferent, and we've noted that there's been comments from patients or calls from patients where they're saying, Hey, we've seen a significant difference. We were there a couple of years ago, and now we're seeing that the staff seem happier, they seem more engaged. They're very enthusiastic about the work they're doing. And so I do think it's getting observed on multiple levels, not just internally amongst our peers, but also for the people that we're so privileged to be able to serve and take care of. 

 

Daniel Marino:  

Yeah, well, and you know, you're part of the community, and especially for a small rural organization, you know, integration with the community and with the patients is so critical. And not only are they patients that we serve, but they're our neighbors. So everybody talks right. And you know what's going on there. So I would think a lot of those positive vibes that you're getting through the organization based on some of the improvements. I mean, it has to be funneled out through the community. 

 

Tanya Allee:  

Yes, yep, absolutely, and said, we we've had our hard knocks, and we've had our obstacles had to overcome, and the community is not afraid to reinforce those and remind of those, but I think we have plenty of opportunities to celebrate the key things that our hard, hardworking staff are doing, and that our team and our executives and our board are very committed to, and it's all worth celebrating. 

 

Daniel Marino:  

Yeah, that's great. That's great nice job. So when you think about where you're at now and where you want to go, a few goals come to mind? What are you looking to? Maybe accomplish immediate, say over this next year? 

 

Tanya Allee:  

Really, we want to keep the foot on the gas pedal with the initiative rolled out over the last 12 months. We want to make sure that people don't think this is just a flash in the pan, and so I think that's absolutely critical, and then continue to build on those. And so we've got some great momentum with that continuing to infuse in our providers. Certainly our new employees. We're doing a significant amount of leader onboarding and training to assure that everyone is aligned and providing the same type of interaction and communication. I think that's going to be a critical piece moving forward. 

 

Daniel Marino:  

Yeah. Well, it sounds like as you put those things in place. You're going to see some great outcomes from it, right? I'm sure it's going to decrease some of your turnover. And you're just going to have happier employees. And I'm sure the providers, as you start to integrate them more. The physicians and the staff certainly are going to come together. If  you were to think about for any of our listeners who are interested in kind of tackling these same things within their own workforce, any recommendations you can give to our listeners? Where do they start? 

 

Tanya Allee:  

As I said earlier, I think, starting with finding your internal champions. 1st and foremost, find your thought leaders. Find your galvanizers, find the people that have the energy and the enthusiasm, and that ability to see the reality and the things we have to work on. But, more importantly, the ability to figure out. Then how do we bridge that gap? How do we get to the next step versus focusing on what's not working as well as we'd like to see it. And I think by pulling those people together in a room and having some tough conversations, and then figuring out what that ultimate goal and outcome is that's going to give you the framework and the purpose to get where you need to go. 

 

Daniel Marino:  

Well, you're I couldn't agree with you more. The champions are key. I also like what you did about setting the vision, and I think if I think back on how, what organizations have done, and at least the work that we've done with organizations thinking about some of the workforce challenges and the changes that they've made, those that have been able to define the vision of where they want to go have made the greatest progress. So I think that, combined with the champions. And then, you know, celebrating the wins right? Those are the other things that I've seen that are big success elements. 

 

Tanya Allee:  

Absolutely. And we're really trying to dive into that and remind people. It's so easy, I think, especially in healthcare, where we know where we're wanting to go, and we're high achievers. And so, as you accomplish things, you lose the excitement. And so we don't. We don't want to let go of that. We want to recognize all the small little wins. 

 

Daniel Marino:

Yeah, that's great. Well, if any of our listeners have questions or they just want to connect with you, I know you're on LinkedIn. Would you mind sharing your LinkedIn? 

 

Tanya Allee:  

No, not at all. Please feel free to reach out to me. It's Tanya Allee on LinkedIn, and I'm happy to continue to engage in these conversations and brainstorm with other leaders, and what they're doing, and how we can maybe collaborate to continue to make healthcare a wonderful place to work and serve. 

 

Daniel Marino: 

 Well, I agree, and sharing the stories and sharing ideas, I mean no sense reinventing the wheel. I think the more that we can collaborate as a network, you know. That's really key. Well, Tanya, thanks so much for coming on and sharing your story. I wish the best of luck to you and to Campbell, and to your organization and to the staff. It sounds like everybody's working really hard, and I'm so happy to hear that you all are making great progress. 

 

Tanya Allee:  

Thank you. Thanks so much for having me on today, and we're very excited to see what the future holds for us. 

 

Daniel Marino:  

And to our listeners. I want to thank everybody for tuning in until our next insight. I am Daniel Marino, bringing you 30 min of value to your day. Take care. 

About Value-Based Care Insights Podcast

Value-Based Care Insights is a podcast that explores how to optimize the performance of programs to meet the demands of an increasingly value-based care payment environment. Hosted by Daniel J. Marino, the VBCI podcast highlights recognized experts in the field and within Lumina Health Partners