These healthcare retention strategies have helped us keep the best talent while maintaining the highest quality of clinical care.

At a service-based organization, people are your product, which means that finding and retaining the best employees is a top priority. This becomes even more critical in healthcare when you’re asking patients to place their health and well-being in the hands of your staff.

It’s a challenge my company, LEARN Behavioral, faces every day. We provide therapy and special education services in home, school and clinical settings to children with autism and other special needs through a provider network of thousands of highly-trained professionals. As autism awareness and insurance coverage has matured, it has had a major impact on our growth and talent requirements. In 2017, we hired 40 people per month: since then, it has been closer to 100 people per month.

To keep pace, we had to widen the talent pipeline while identifying and addressing key attrition points. Identified through trial and error, these are some of the healthcare retention strategies we found worked best to help us find and retain great talent while maintaining the highest quality of care.


Challenge: Limited pool of recruits

Even at the entry level, candidates with bachelor’s degrees are preferred for jobs at LEARN Behavioral, preferably in education, applied behavior analysis or psychology. Candidates also need direct experience with an individual with special needs, and must undergo a rigorous pre-screening process.

With a limited talent pool and a growing need for recruits, we had to find creative ways to widen the funnel and attract more candidates.

Solution: Tuition support

We operate in a relatively new but promising field, which makes education and career support very attractive. By establishing a generous tuition assistance program, we have been able to attract undergrads from colleges, universities and research hospitals that specialize in autism and applied behavior analysis. The opportunity to gain both real-world experience and formally recognized licenses, certifications and credentials while working here is a huge draw for new grads.

Our entry-level, front-line therapists and technicians are eligible to receive tuition support to complete a graduate degree in psychology, primary education or special education. Our strongest candidates are also assisted to obtain a Board Certified Behavior Analyst (BCBA) certification with free supervision for a 1,200-hour practicum on the job. Supporting the pursuit of advanced credentials as one of our healthcare recruitment solutions in this emerging area enables us to attract and retain the most motivated employees and develop one of the most qualified, advanced workforces.

Challenge: Communicating job realities

The screening, onboarding, training and provisioning of new recruits represents a huge investment of time and money. When just one of them leaves, it affects our bottom line and presents real challenges for the clinical teams who have invested so much in the relationship and have patients and clients who are relying on the continuous delivery of service.

Exit interviews and surveys told us that many of our people who left didn’t realize how difficult the work would be, so we needed to figure out a better way to communicate the realities up front. Providing therapeutic support to a child with special needs can be incredibly rewarding, but also extremely stressful. We were losing entry-level staff because they were not mentally prepared for the realities of the job.

Solution: Decentralized recruitment

Initially, recruitment across North America was centralized at our Baltimore headquarters. But we quickly discovered that establishing a local connection with talent was needed to effectively communicate what their jobs would really entail.

As a result, we decentralized and embedded regional recruiters in our local offices, where they can sit in on clinical meetings and hear first-hand about the challenges that clinicians experience. They can speak to uniquely local elements of the experience such as the commute, work environment and team culture. And when an office loses a clinician to attrition, they see the impact on the team and the families receiving care.

Bringing our recruiters closer to the job realities and getting them more invested in the hiring outcome has had a measurably positive impact on retention. Our retention has increased more than 10% overall since we decentralized our recruitment efforts, and our retention rate in new growth markets is double that of our legacy territories.

Getting recruiters closer to the job realities and more invested in hiring outcomes has had a measurably positive impact on retention.

Challenge: Employee isolation

Our therapists and technicians primarily work on their own, delivering therapy to their clients one on one in a home environment. Even experienced employees can find this intimidating, but for people who are new to therapeutic service delivery and to the world of work, it can be incredibly stressful. We were losing recruits in those first crucial months of employment because they felt unsupported and out of their depth, and our healthcare retention strategies needed to address this.

Solution: Supportive technology and teams

Maintaining a high-touch relationship with new employees early on helps our staff get through the first three months when we experience the majority of drop-offs. Those touchpoints are delivered through technology and traditional team-building.

We provision each new employee with a top-of-the-line mobile device that enables them to connect to their supervisors, team and even clients at any time. When they’re on their own in a new environment or facing a new situation, a source of support is always accessible. They can access their supervisor in real time, collaborate with colleagues on their clinical teams and group-solve difficult problems. We’ve also successfully implemented remote supervision which allows for not only real-time communication between line therapist and employee but also recorded sessions that supervisors can review with their teams to improve clinical practices.

At the same time, nothing replaces face-to-face support. Our model brings individual clinicians together regularly to strategize and operate as a team. We also schedule regional meetups, professional-development events, a speaker series and other in-person activities that help new recruits feel connected and supported.

Today, no one on staff has to feel as though they are facing their difficult job alone.

Challenge: Keeping culture strong

Helping employees feel connected to something bigger than themselves is essential to their commitment and motivation. But as LEARN Behavioral expanded geographically, it became harder to communicate the company’s culture and values to our widening network of clinics and recruits.

While each clinic should reflect the needs and character of its location, we also needed to ensure that every employee felt connected to a shared purpose.

Solution: Measurable competencies

We developed a set of culture and leadership competencies used to define the expectations for every role in our company. To ensure they were representative and authentic, both the company’s leadership and its employees were part of the process.

Our managers now coach to these traits and all employees are evaluated on them so that, at every location, we know we are supporting shared values and a shared level of service to our clients.

Those competencies are also translated into metrics that track the performance of each clinic according to a shared standard based on hard numbers and “soft” people metrics. Everyone is evaluated based on this shared standard that drives company culture and ensures our clients are receiving the highest quality treatment.


Here’s the bottom line.

Talent is never easy to find, and in healthcare, where the talent pool is limited and the job is potentially stressful and isolating, it’s an especially tall order.

Healthcare retention strategies including investing in the right employment perks, communicating the realities of the job, and using technology and real-world support systems to foster a culture of teamwork, communication and shared values has helped us to attract and hold onto the employees we need to sustain rapid growth while maintaining an exceptional level of clinical care.


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