Bring up retention rates, bring down stress levels 

Home Health Agency Tools for Building a Resilient Team

Goals for home health agency leaders are likely to include some key aspects of recruitment and filling the staffing gaps. Beyond the initial hiring process, however, lies the alarming statistic from 2024 of a turnover rate of nearly 80% within one year for direct care staff. How can home health agencies not only hire, but build a resilient team that stays the course?

Sources of Stress in the Workplace

It is well known that stress is the precursor to burnout which can ultimately harm patients, and organizational culture, as well as trickle into the personal lives of the individuals impacted. Though each staff member will have their own list of stressors that erode their ability to thrive at work, there are areas where leadership can target resources to make the most impact on their entire team. Several primary reasons why direct care workers leave their positions include the three W’s: wages, work-life balance, and workload.

Wages for direct care workers has minimally increased in the last 10 years leading to financial instability. With headlines bringing much attention to skyrocketing inflation rates, it’s no wonder workers are under stress financially. ZipRecruiter reports the current average hourly pay of direct care workers in the United States is $15.07 an hour, yet fast food workers are making $20 per hour nationwide on average. Alarming, yet true.

The buzz phrase “work-life balance” has gained attention in recent years, and for good reason. As described by Mental Health America, work-life balance is the constant competing responsibilities from work, family, friendships, hobbies, and more, and the angst to try and do it all. More than 25% of Americans report they feel excessive amounts of stress leading to impaired mental and physical health. Sustained levels of increased stress lead to more sick days, heart disease, irritability, and depression all of which can directly impact patient care and quality within their organization.

As the aging population grows and prefers to stay in their homes, direct care workers are caring for more medically complex individuals than before. For nurses, add in the fact that home care and home health is 250,000 nurses short nationwide and the remaining staff undoubtedly experience increased workloads. Cited as a top reason for nurses leaving the profession, workload is affecting even the less seasoned nurses. The National Council State Boards of Nursing reported in 2023 that 610,388 registered nurses plan to leave by 2027, many of which have less than a decade of experience. Pairing these statistics with the wave of retiring nurses, America has a major workload burden on its hands.

Resiliency Recommendations

Fact. Leaders of home health organizations are faced with tremendous challenges surrounding budgets and staffing. Also fact; agencies can still make some headway to support the improvement of their retention rates by giving employees some tools to boost resiliency and manage workplace stressors.

As more states enact pay transparency laws, workers will have the opportunity to better compare employers for pay equity, and fairness and be able to match up their skills and experience to the right pay. Leaders are advised to evaluate factors related to the wages they are offering such as the cost of living for geographical regions and offering tier pay ranges from lesser skill and experience to those with more advanced expertise. Leaders can survey their employees to identify the struggles faced by their employees anonymously to ensure they are focusing time and energy in the right places. If wages cannot be increased, employers can attempt to be creative by offering indirect financial benefits targeting themes identified by the survey. These could include:

• flexible scheduling or flexible start and end times to allow individuals to either reduce or avoid the costly expenses of childcare or needing a second vehicle
• offering mandatory meetings or training online, or offering multiple sessions on various days
• offering an extra personal or mental health day
• corporate discount programs for wellness, healthy eating, employee assistance or memberships
• having a break room stocked with a variety of snacks, coffee or other drinks
• providing lunch for on-site meetings

The “Health and Human Services Surgeon General’s Framework for Health and Well-Being” offers a comprehensive overview and resources for employers to tackle well-being topics and reduce workplace stress. One area of focus, opportunities and growth, recommends employers:

• offer training and education for employees to gain confidence and feel valued with potential impacts to reduce stress related to caring for increasingly complex patients,
• appeal to the human needs of accomplishment and learning with the potential to improve workplace satisfaction.

Offering educational sessions on topics most often encountered by direct care staff or problematic for the agency is beneficial. To promote work-life balance, training can be offered before or after staff meetings to allow for flexibility. This approach combines both the aspects of advanced education and flexibility all in one. On-demand training or online courses viewed as a group can save on cost and allow community or team growth. This approach appeals to education and a culture of collaboration, both promoting resiliency.

Agencies can offer direct resources or training on resiliency to help employees work to reframe or manage stressors more positively for personal growth. The American Heart Association report that 76% of employees in a national survey undergoing resiliency training identified it as valuable, and positive and it improved their perception of employer support. A top-rated topic for resiliency training programs was dealing with difficult people, which can easily apply to the home health setting. A free training, for example, is offered by Creighton University in 10 minute bite-sized videos covering comprehensive resiliency training that could easily be incorporated into a staff meeting or orientation.

Given the right tools and tactics, employees can build the resilience needed to weather the expected level of stress working in home health. Leaders must communicate with employees they are valued and attempt to put some of their employees’ worries at bay. Value put in action by home health agency leaders includes an attempt to improve wages, workload and well-being. There will never be zero stressors in the workplace, but letting employees know the retention and resiliency plan in place can set your home health agency apart.

The Takeaway

Given the right tools and tactics, employees can build the resilience needed to weather the expected levels of stress working in home health. Leaders must communicate with employees they are valued and attempt to put some of their employees’ worries at bay. Value, put in action by home health agency leaders includes an attempt to improve wages, workload, and well-being. There will never be zero stressors in the workplace, but letting employees know the retention and resiliency plan in place can set your home health agency apart.

References:

1. Minimally salary increases in the last 10 years
2. Work/life balance stats from Mental Health America
3. Health and Human Services Surgeon General’s Framework for Health and Well-Being

Other blogs you might find helpful:

1. Home Health Certification Training – The key to exceptional staff building
2. Six keys to solving staffing issues in homecare agencies
3. Boosting job satisfaction to retain home health nurses
4. Home care agency work/life balance tips for clinicians
5. Top strategies for developing strong homecare teams
6. Is it time for a policy update in your home health agency?