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Retention Management And Metrics

The First Year of an Online Exit Interview Program in Healthcare:
How INTEGRIS Health is Investing in the Future

The healthcare industry is very competitive, which can be both a blessing and a curse for HR executives responsible for recruiting and retaining healthcare professionals.

By Laura DiFlorio and Kerrie Main

“Why are we spending money on useless data that’s not telling us anything?” Rick Bedlion, System Director for Organizational Development and Learning at INTEGRIS Health Inc., recalls asking about their previous exit interview process at a senior leadership meeting in early 2011. INTEGRIS Health is Oklahoma’s largest healthcare system and it had a unique problem – unlike other industries in the current economy, the healthcare industry was (and is) booming.

In a down economy, workers tend to stay at their organizations in fear of not being able to find other opportunities. But in the healthcare industry, things are different. According to the 2012 National Healthcare & RN Retention Report by Nursing Solutions, Inc., more than 88 percent of hospitals view retention as a “key strategic imperative.” In Oklahoma, healthcare jobs are the fastest growing occupations, and job openings are projected to grow at a rate of 23.3 percent between 2010 and 2020, per findings by the Oklahoma Employment Security Commission.

INTEGRIS Health knew that exit interview systems are proven strategic tools that allow organizations to gain insight into why their quality employees were leaving, so they can make the necessary changes to retain them. This organization was also aware that healthcare organizations have to work harder than other companies in other industries to retain good workers. However, their previous method was not effective, and in 2011, they knew it was time to make a change. Below is their story about how they’ve begun to tackle their retention issues, and how they can be a model for other healthcare organizations with the same goal.


INTEGRIS Health Inc. has about 9,000 employees in 13 hospitals. According to Spencer Anthony, Workforce Planning Specialist, “We are in a highly competitive healthcare environment in a state with some of the lowest unemployment in the nation.” In this particular industry and region, it’s simple – healthcare employees have other options. So organizations have to do everything they can to retain the “good” ones. In early 2011, INTEGRIS Health was outsourcing their exit interviews to a company that promised to conduct telephone exit interviews, but the process wasn’t working for several reasons:
  • Exit interview participation rates were around 7 percent.
  • When they received their exit data from their vendor, everything was combined, so they couldn’t see different department’s data separately.
  • They only had raw exit data, so they couldn’t customize their reports to identify turnover trends.
  • Blame was being tossed around from department to department, and senior leadership didn’t have the exit data to substantiate the different claims.
In addition, INTEGRIS Health was asking managers to provide a reason for leaving for each of their voluntary terminations from a list in their HRIS. Bedlion and Anthony felt they were receiving ambiguous reasons for leaving, and they needed to find out why people were REALLY leaving. For example, they were often hearing “personal reasons” or “better opportunities,” but in several cases, they later learned those reasons were not accurate. According to Bedlion, “Sometimes turnover is good turnover, but we were experiencing too many losses of good people.”

The Search for a Solution

After coming to the conclusion that their current exit interview system was failing, INTEGRIS Health knew that something had to change. Anthony was in charge of looking for a better solution. He began his search by contacting other organizations who had recently switched to an online exit interview system. He identified three to four companies who offered online exit interview management solutions, one of which was Nobscot’s WebExit.

“For a number of reasons, there were several things that attracted me to WebExit,” Spencer said. He was drawn to WebExit’s ability to give organizations data in real-time, rather than having to wait for it at an “undetermined future time.” At this point, Anthony recommended the INTEGRIS Health leadership team move forward with a WebExit demonstration, which was set up immediately. After the positive demo, which featured robust reporting capabilities, Anthony “didn’t feel like we needed to look for anything further.” Bedlion agreed that WebExit was a “much superior tool” than other companies who offered exit interview systems, as well as their current process.

Training and Implementation

Following the brief contract phase, INTEGRIS Health began training and implementation. Overall, it was “pretty seamless,” according to Anthony. It began with an introductory call between their salesperson, Laura DiFlorio, and their new client services manager, Raquel Frazier, PHR. “Nobscot focuses on making WebExit a super easy program to implement,” said Frazier. The process typically begins with the initial account setup call, in which Frazier, who has an extensive HR background, helps organizations identify their specific reporting needs by learning about HR initiatives already in place, as well as the organization’s main retention focus. For example, some companies want to identify the drivers of early turnover (employees with the organization for less than a year) or they may be having issues retaining women or diverse employees. Other companies want to focus on monitoring feedback on corporate changes, such as recent mergers and acquisitions or compliance issues and ethics violations.

“Nobscot uses this specific client feedback to gauge what demographic selections we need to make. We figure out what their individual goals are for the exit interview program and the overall goals of the organization so we can identify what types of reporting will help them achieve those goals,” said Frazier. She added, “It is so much simpler to do that on the front end and help them think through that process.” During the account setup phase, which usually takes about a week to complete, both core and custom demographics are chosen, and the exit interview questions are decided upon.

INTEGRIS Health, like other healthcare organizations, chose to include employment status in their custom demographics, as it measures how full-time, part-time, occasional part-time and per diem employees view the organization. According to Frazier, “That’s really valuable for healthcare organizations to see which type of employee is most satisfied.” The account setup phase took about a week to complete, and Nobscot then tested the system on their end. At that point in the process, INTEGRIS Health was given access to go in to the system to see if they wanted to make any further changes.

Training was divided into two parts. In Part One of the training, which usually takes about 45 minutes, the WebExit administrator (Anthony) learned how to enable (set up) and track the exit interviews in the system. Part Two of training, which usually takes about an hour, occurred after INTEGRIS Health got some exit interview volume. This part of training focused on how to break out the results by viewing reports via different demographics and selections.

The First Year

INTEGRIS Health implemented WebExit in 2011, and it went completely online in June 2011. They communicated the new system changes to both their managers and employees, and everyone was very excited about it. In fact, some employees wanted to start seeing the exit interview results two weeks after implementation!

When asked how things have changed since starting WebExit, Anthony said that things were going well and that they have “substantially higher ROI than we did with our previous vendor.” In March 2012, they identified they were having significantly higher turnover of metro nurses that were leaving before the 90-day mark. Since recognizing this startling trend, they’ve identified specific cultural issues with their onboarding process, and have begun implementing new initiatives to stop it. Seeing the specific data for this trend, “really got senior leadership’s attention.”

INTEGRIS Health has also used WebExit’s data to amend their leadership institute’s curriculum. This institute is focused on hiring and retaining the best, and their exit data is allowing them to “proactively stem new and future losses.”

Major Successes

Besides substantially increasing their exit interview participation rates, INTEGRIS Health has seen several other major successes from using an online exit interview management system. Anthony really loves the open-ended comments feature, “It’s funny – sometimes the most telling thing about an exit interview can be one little comment that somebody has taken the trouble to type in. It really gives you a much better picture that there was a disconnect between what that person expected the environment to be and what they actually experienced.” Bedlion concurred with, “We are very satisfied with this tool. WebExit is a cost-effective measure that meets our needs.”

Anthony also noted that he’s been fairly surprised at the high ratings that most departing employees give their organization. He said, “The nature of my job tends to focus on where there are problems in the organization; it is good to be reminded that most of our employees, even those leaving, having a fairly positive view of INTEGRIS Health.”

Moving Forward

While INTEGRIS Health has done the difficult part – deciding to make a change and getting a new system in place – there is still much work to be done. Real change takes time, and retention problems, especially in the healthcare industry, cannot be fixed overnight. However, they now have the right tool in place and are gathering the appropriate data to make informed changes. As of October 2012, they have 260 completed exit interviews, which is a lot of great information to see trends and start making significant improvements.

Originally published in ASHHRA: link

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