11/27/2017 Cancer Registry Staff Engagement in a Comprehensive Community Cancer Program GATRA November 8, 2017 Northside Hospital Cancer Program • Oncology Analytics – large department of 30+ staff – Comprehensive community cancer program, having received 5 consecutive Outstanding Achievement Awards from Commission on Cancer – Staff comprises cancer registry & clinical registries functions – Cancer registry functions include reporting for three hospitals, 5 radiation oncology facilities, and various physician practices – Abstractors are 100% remote – Staff retention ranges from 1 year to 25 years – Mix of positions ranging from resource to full-time 2 Presentation Objectives • Provide strategies to improve staff retention • Address planning & coverage during staff turnover • Describe specifics for staff development & engagement with a cancer registry 3 1
11/27/2017 Disclaimer • People are works in progress • Leaders don’t have all the answers • Despite great planning, failure can still happen • Much is out of your control 4 Basically, Keep People Happy 5 At the Beginning: Hiring • Hire the best candidate – Choose the best candidate based on the most complete skill set, greatest fit for the needs of the department – Assess your department’s short-term, mid & long term needs – Better to have no one in the position than to have a poor fit for the candidate & the facility – Understand what you’re getting yourself into • Monetary & Intangible Costs – Hiring a new employee – Training a new employee – Disruption to operations – If it doesn’t work out • There’s a cost to the staff in your department • There’s a cost to your reputation 6 2
11/27/2017 Setting Expectations: Critical 1 st Year • Early Engagement with New Staff – Provide Necessary Resource Documents for successful 1 st week • Be ready on Day 1 with equipment, access, parking, etc. • Provide documents necessary for their day to day function • Training materials (including staging manuals, desktop shortcuts) – Give overview of how the department & the staff fit into the organization • Organizational Chart • Clear & Transparent: – Review & agree upon written expectations for job over the next year • Ensure expectations are measurable • Give them a copy & provide a place for them to access, if needed – Review the expectations for service skills, includes communications, cooperation with team, customer service – Meet mid-year / check in on their expectations – no surprises @evaluation 7 Building the Relationship • Consistent communication • Be present / listen • Mentoring/ Pairing Staff – 1 year – “Best Friend” at work • Check-in – 30, 60, 90 Days – Adjust as needed – do you need weekly meetings? Bi-weekly meetings? – Engage others in process, i.e. leadership • Provide clear & immediate feedback & encouragement 8 Recognition Early & Often • Recognize professional accomplishments – Passing CTR or other certification / degree – NCRA week • Recognize birthdays & anniversaries – Big anniversaries: 1, 5, 10, 15, etc • Day to day – when it goes right, recognize it right away – Public recognition at staff meetings & physician meetings – Gift Certificates for project well done – Food – bagels, candy – Notes on desk 9 3
11/27/2017 Millennials • Open to new ideas • Engage in team building • Growing careers • Millennial junior mentorship • Increased use & familiarity with communications, media, & digital technology • Lower retention rates • Expect flexibility • Cell phone utilization • Engaged in social media 10 Leadership & Stability • Support your leadership if you want them to stay • It’s “lonely at the top” • Let them know you care but keep it professional • Meet them where they are – just like your staff 11 Strategies for Staff Retention • What does your staff want? – Surveyed the staff for their top priorities – Open communication / relationship building • What do they need? – What do they think they need? Do they trust you? 12 4
11/27/2017 Staff Determines Your Retention Strategies • What motivates staff & how they think will determine the strategies you use • One strategy does not fit all • A department is typically a hybrid of the various ways of thinking Examples: – Analytical thinkers are not interested in warm fuzzies – Communication folks need to feel heard – Hire a visionary -> then give them opportunity to utilize that skill 13 Engaging Telecommuters • Virtual world – Instant Messaging / Chat / Skype – Abstracting Teams – Weekly Abstractor Meetings (Conference Call) – Monthly Staff Meetings (Webcam) – Abstractor Roundtable (Conference Call) – Virtual baby shower (Webcam) • Annual retreat 14 High Risk Model: Staff Assessment High Departure Cinderella Risk Moderate Departure Risk Low Departure Risk Sleeping Beauty High Operational Moderate Low Operational Impact Operational Impact Impact 15 5
11/27/2017 Communicating Risk for Departure • Transparent & open with leadership – Discuss other offers, head hunters competing for them • Drop hints about future plans – Retirement, leave of absence – Discuss dreams for professional advancement • Behavior changes – Less engaged in meetings, conversations – Take on less challenges – Start to “check out” – Taking all their Vacation/Sick time (PTO) – Passive Aggressive / Hostile 16 Toxic Staff Can Impact Good Staff Retention • Ensure the work environment is as fair & professional as possible • Toxic staff can impact a good atmosphere & drive good staff away • Tend not to resign • Coach those staff members more, not less 17 Disciplinary Tract • Employ fairness across all staff at all times • Document, document, document • Engage Human Resources • Stay the course 18 6
11/27/2017 Staff Development Certification • Casefinding • Quality Improvement • Follow ‐ up • Abstraction • Operations • Conference • Treatment Coordination Summary • RQRS Entry Level Management 19 Supporting Staff Growth • Support staff through variety of professional avenues – Membership & activity through state or national organization – Tap into Your Facility’s Training Department – Certification Program – Mentorship • Identify things they may enjoy doing – Allow yourself & them to think outside the box – Facets of projects • The more successful they are -> the more they’ll consider higher goals • If they don’t want to take on more, don’t pester – It may not be the right time, the right project, the right person 20 When Staff Has Outgrown Registry Now What? • Assume they will find fulfillment elsewhere • Can they transfer to another department within the facility? • If requested, guide them with available options 21 7
11/27/2017 When It Doesn’t Work Out • Acceptance – Very few people stay at their first job for the rest of their lives – Attempt to keep the person if it’s worth it • Learn from it – Talk to the staff leaving – Ask HR to conduct exit interviews – Talk to your staff -> what’s their perception? • Was there something you could have or would have done differently? – If not, move on • What are you learning year in & year out? – What books are you reading? What articles are you finding? Leadership classes? How are you investing in you? 22 How to Cover Staffing Shortages • Alert leadership of staff at risk for leaving & for staff with upcoming leave of absence • Cross-train your staff –> especially those areas you are most concerned about – Write or revamp process guidelines • Talk to contractors/ contract companies – Consider keeping them on retainer even if you’re not using them – Include an employee non-compete clause – Network with contractors at meetings (don’t wait until their needed to begin your search) • Consider using RN’s on light duty • Student programs • Volunteers 23 Oncology Analytics Staff / Annual Retreat 24 8
11/27/2017 Questions??? References • Toxic People, Marsha Petrie Sue, 2007 • Why employees stay, Vincent S Flowers & Charles L. Hughes, Harvard Business School, https://hbr.org/1973/07/why-employees- stay • https://www.zanebenefits.com/blog/bid/312123/employee-retention- the-real-cost-of-losing-an-employee • https://www.bls.gov/news.release/tenure.nr0.htm 26 9
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