11/27/2017 Cancer Registry Staff Engagement in a Comprehensive - - PDF document

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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

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Presentation Objectives

• Provide strategies to improve staff retention
• Address planning & coverage during staff turnover
• Describe specifics for staff development & engagement with a

cancer registry

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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

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Basically, Keep People Happy

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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

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Setting Expectations: Critical 1st Year

• Early Engagement with New Staff

– Provide Necessary Resource Documents for successful 1st 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

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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

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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

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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

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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

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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?

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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

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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

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High Risk Model: Staff Assessment

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High Departure Risk Moderate Departure Risk Low Departure Risk High Operational Impact Moderate Operational Impact Low Operational Impact Cinderella Sleeping Beauty

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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

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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

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Disciplinary Tract

• Employ fairness across all staff at all times
• Document, document, document
• Engage Human Resources
• Stay the course

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Staff Development

• Casefinding
• Follow‐up
• Conference

Coordination

Entry Level

• Abstraction
• Treatment

Summary

• RQRS

Certification

• Quality

Improvement

• Operations

Management

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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

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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

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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?

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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

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Oncology Analytics Staff / Annual Retreat

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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

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