The Challenge: Turnover Impacting Operations

A local network of private behavioral health practices was experiencing significant turnover levels among their providers. While their turnover was at levels not uncommon in this industry, it was having a serious impact on the practices’ ability to maintain patient care operations and threatening market share in the region. The turnover was also wearing on the remaining clinicians and staff, and was preventing the practice from meeting the growth goals expected by its ownership.

Assessment Insights

Among employees there was a shared recognition that the internal challenges leading to turnover are not rooted in complex or systemic issues but are rather straightforward misalignments, often perceived as self-inflicted and unintentionally overlooked. Despite attempts to communicate these concerns, the practice’s response has often been characterized by defensiveness or redirection, with feedback being dismissed or employees being advised to abandon their grievances, fostering an environment of reluctance to bring forward issues.

Past solutions proposed by leadership often missed the mark, addressing concerns superficially without tackling the underlying issues, thereby eroding trust in the sincerity of any efforts to improve. The uniformity in employee feedback during our assessment underscored a significant gap between staff perceptions and management’s responsiveness. This consistency pointed to a critical need for the practices to take employee concerns more seriously and incorporate them into meaningful changes to rebuild trust and address the root causes of turnover.

Applied Methods

Given the difficulties in communication and feedback, and the preference of management to address superficial issues and avoid the underlying issues driving turnover, our first priority was to identify what the major issues were that employees had been unsuccessful in conveying to leadership. Among these were an absence of performance culture, a number of compliance concerns, and extreme levels of micromanagement from a central management figure. In this case, the management figure was impacting the majority of employee concerns with a heavily control-focused management style. So we involved the majority ownership of the practice to ensure leadership buy-in for the action plan and prevent sabotage of the process.

Given this combination of challenges, the next step was to clearly delineate which seats within the organization were accountable for which functions. The micromanagement of the manager identified by employees was driven by the organization’s lack of transparent KPIs. In the absence of clear performance targets and metrics, day-to-day activities and the methods clinicians and staff were using to do their jobs became the subject of scrutiny. Things like the time clock and Outlook calendars had become stand-ins for relevant and measurable outcomes.

Additional layers of direction-setting had also been missing. By installing, inviting input into, and openly communicating things like training outcomes and regulatory standards – employees were able to take ownership of their approach to their work. Management could focus only on gaps in specific, tangible outcomes rather than wasting time and damaging relationships with micromanaging.