4 Ways to Increase Recruitment and Retention

4 Ways to Increase Recruitment and Retention

Leveraging a large scope of benefits, a children’s hospital shares its methods for low employee turnover and high engagement scores.
Nurse making heart shape with hands.

Hospitals across the country continue to grapple with severe talent shortages when striving to fill clinical, support and other vital positions. The scarcity of candidates puts pressure on health systems everywhere to find creative ways to attract and retain nurses, doctors and other professionals.

Nicklaus Children’s Hospital in Miami is addressing the challenge through a commitment to supporting employees and future employees holistically throughout their life journeys, in ways both big and small. This focus is making an impact at the 309-bed pediatric specialty hospital and its network of outpatient centers located throughout South Florida.

“At Nicklaus Children’s, we are committed to a comprehensive approach that considers the well-being of our employees—and prospective future employees—at every facet of life, in the workplace and beyond,” says Matthew A. Love, president and CEO of Nicklaus Children’s Health System. “Our employees are the heartbeat of our organization. Only through them can we fulfill our mission.”

This focused effort is helping minimize position vacancy rates and staff turnover. 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.

“The secret of our success is in large part due to the breadth and scope of benefits we offer employees,” says Kara Marante, vice president and chief people officer. “These run the gamut from tuition support for employees and potential future employees, as well as a scholarship program for employee children, a generous paid-time-off program, holistic wellness programs, and robust retirement and bonus plans that help staff fulfill current dreams and retirement goals, and more.”

1. Create an employee pipeline

Nicklaus Children’s has embraced a “pipeline” approach to future recruitment. Each year (with the exception of the pandemic years), the hospital has had a volunteer program that results in many of the high school and college-age volunteers later becoming employees. In 2022, 668 individuals who applied for a job indicated they previously had been volunteers of the hospital.

The hospital also offers a nurse scholarship program in collaboration with Miami-Dade College, providing 10, $8,000 scholarships for students already accepted to the nursing program. Student nurses will do some training at the hospital.

To assist existing employees, the hospital each year offers five employee dependents $10,000 each to pursue their educational dreams. Employees who are pursuing additional education to support their career development are eligible for the hospital’s tuition assistance program. In 2021 and 2022 combined, 511 employees were reimbursed for tuition expenses after successfully completing a program of study.

2. Offer total rewards

The foundation of the health system’s workforce commitment is a total compensation program, which includes salaries, bonuses, retirement matching, health insurance offerings, tuition reimbursement and other benefits. At the end of the year, the health system issues a Total Rewards statement, capturing the combined value of all those contributions. “These statements are very effective tools in reinforcing the value of the health system’s commitment to each employee,” says Marante.

Some highlights of the compensation program include:

  • Traveler nursing match. A source of tension at some hospitals is the disparity in pay between traveling nurses and staff nurses. Nicklaus Children’s sought to offset this in 2022, through the creation of an internal nurse traveler program. Staff nurses who agree to serve as travel nurses to any of the hospital centers as indicated by staffing needs receive a pay differential to address the unpredictability such work dictates.
  • Competitive salaries. To ensure salaries always reflect the market, the health system reviews each employee’s salary every three years and compares it to comparable positions in the South Florida market. Salaries are adjusted when found to be below market. In 2021, the hospital raised its minimum wage to $15.05, five years ahead of when Florida will mandate a $15 hourly minimum.
  • Retirement match. The health system matches 100% of employee contributions up to 3% of eligible compensation. In addition, at the discretion of the hospital board, participating employees receive a 3%discretionary match each year.

3. Invest in employee well-being

The hospital’s comprehensive wellness program incorporates seven dimensions of wellness (emotional, physical, social-environmental, financial, occupational and intellectual). Some highlights of this program include:

  • Staff psychologist. In addition to its offering of a traditional employee assistance program, Nicklaus Children’s in 2022 added a staff wellness psychologist to provide confidential support and guidance for employees for mental health first aid, stress management, burnout prevention and mindfulness.
  • Life coaching. General life coaching is available to support the intellectual dimension of wellness and mental well-being resources are offered to support mental health.
  • Stipends. By participating in the Health Lifestyles program, employees can earn a $1,000 credit on their health plan. Employees participate through annual biometric evaluations that can identify health concerns early to support intervention.
  • Classes. Employees can participate in wellness classes, including financial wellness programs, as well as traditional wellness offerings.
  • Financial counseling. Related to financial wellness, financial forums are offered each month on personal budgeting, future needs, and more.

4. Increase engagement

Nicklaus Children’s promotes engagement in many ways and measures success through the hospital’s Press-Ganey engagement scores. For 2022, the health system’s overall engagement score of 4.23 is .20 above the national average, placing the health system in the 75th percentile in the national health care comparison database. This current level is higher than pre-pandemic engagement levels of the hospital. As another engagement measure, average tenure with the hospital is 7.7 years, compared with a national all-industry average of 4.1 years, according to the U.S. Bureau of Labor Statistics.

Some engagement strategies include:

  • Career training. In addition to tuition reimbursement for classes at area universities, the health system offers internal educational opportunities to help grow its talent. Leadership training classes are offered to those who demonstrate an interest in future growth and are identified as potential leaders.
  • Internal promotions. In 2022, 250 Nicklaus Children’s staff members received promotions. A total of 24% of all positions with the health system are filled via internal transfers, reflecting opportunities for growth made possible through development, pipelines and education.
  • Employee appreciation. The hospital’s annual month-long celebration of employees features events, games, prizes, gifting and thanking employees for their good work. During the month, the hospital hosts observances for employees celebrating service milestones of five years, 10 years and upward in five-year increments, with some employees celebrating 40 years of service in 2022.
Written By:
Rachel Perry Bixby
Director of Public Relations, Nicklaus Children’s Health System

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