Across the 205 cancer programs who responded to the 2018 Trending Now in Cancer Care Survey, turnover levels vary by role, led by nurses with the highest rate and physicians with the second-highest.
Several common strategies to fight burnout and turnover are underutilized
Nearly all cancer programs—93% of those we surveyed—have implemented tactics to reduce staff burnout. The problem is well-recognized, but we consistently hear leaders struggling to retain an engaged workforce.
The most popular tactic to combat burnout is to establish a staff recognition program. However, when we asked cancer programs about the common concerns they hear from staff, "lack of reward and/or recognition" ranked in the bottom half of the list—perhaps because programs are doing well on this front.
Several of the less common strategies can not only reduce burnout, but also address the leading drivers of turnover reported by cancer program staff. To make the most of these tactics, focus them on the top issues experienced at your cancer program.
Top staff complaints, and what to do about them
We also asked respondents for the reasons behind staff turnover, as well as which issues staff complain about on a regular basis. Find the most common complaints—and our recommended strategies to address them below.
1. Heavy workloads and workflow inefficiencies
By far, the leading complaint reported in our survey, across all roles, are heavy workloads and workflow inefficiencies. To address these problems, cancer programs should conduct a process improvement analysis, such as a Lean evaluation. At present, fewer than 40% of institutions have done so.
For some staff, heavy workloads can even lead to turnover. A good proportion of survey respondents cited nurse-to-patient ratios in the top three reasons nurses left their cancer program last year. Compare your program to others on staffing ratios and other metrics by accessing our Oncology Volumes, Staffing, and Operations Benchmark Generators.
2. Bureaucratic tasks (e.g., EHRs, paperwork, reporting requirements)
For both physicians and advanced practitioners, heavy bureaucratic task load stands out as a main reason behind turnover, according to our survey. Organizations must re-evaluate "who does what" to leverage administrative and support staff for bureaucratic tasks, allowing physicians and advanced practitioners to work at top of license. Doing so will not only make more efficient use of these expensive staff members' time, but also helps to diminish burnout.
The EHR has also been identified as a leading cause of physician burnout. Optimize your oncology EHR system by accessing this tool, which maps various ways cancer programs are optimizing EHR use at their organizations.
3. Relationship with health system
The leading reason reported for cancer program administrator turnover is lack of support from executives and/or physicians, followed closely by difficulties with the employer or health system. Physicians agree, and add "loss of autonomy related to buy-out, merger, or acquisition" as a notable driver of turnover.
Getting these key staff members on board with system-level change is central to retaining your leadership and workforce. One approach is to develop an internal communication strategy to ensure staff understand that the actions of executives reflect the mission and values of the organization, as 28% of your peers have done.
Survey respondents attribute dissatisfaction with compensation to turnover for 34% of nurses and 28% of advanced practitioners in the past year. Make your compensation package more competitive by providing reimbursement for professional development, implementing clinical ladder programs for salary increases, and ensuring salary and benefits reflect benchmarks in your market. Dig deeper into this approach to engagement and retention with our Playbook for Staff Career Development.
5. Inflexible scheduling
Nurses reported inflexible scheduling or lack of self-scheduling as a top reason for leaving their cancer program in the last year. Survey your staff's preferences to identify potential adjustments that could be made to the nurse scheduling system.
While burnout, engagement, and turnover pose formidable challenges to cancer programs, there are a range of options to mitigate the effects.