1 |

Creating a staff retention strategy: diagnostic tools

2 | Creating a staff retention strategy: diagnostic tools

Retention domains

About my organisation• Recognition

• Board visibility

• Branding

• Clear direction of travel

• Valuing all staff groups

• Leadership

• Culture of openness and transparency

• Long-service awards

• Learning from excellence

• Clear strategy

• Operational connectivity

• Celebrating the diversity of the workforce

About me•Shift selection

•Flexible working

•Worth

•Psychological contract

•Who listens to me?

•Clear personal objectives

•Career pathway map

•Tools to work at the top of their capability

•Can I do what I need for my patient?

•Free from bullying

•Ownership

•Making a difference

•Part of the team

•Recognised as an individual

•Benefit package

•Health and wellbeing

•Burnout alarm

About my team•Learning environment

•Correct team skill-mix

•Good rostering practices

•Meaningful induction

•Physical environment

•Team spirit

•Local operational leadership

•Performance

•Patient type

•Error reporting

•Learning from others

•Workload

•Vacancy rate

•Bank and agency usage

•Reputation

•Multiprofessional working

•Two @the top

3 |

Setting an aim

Creating a staff retention strategy: diagnostic tools

S Specific (significant, stretching)

M Measurable (meaningful, motivational)

A Achievable (agreed, attainable, acceptable, action-oriented)

R Relevant (realistic, reasonable, rewarding, results-oriented)

T Time bound (timely, tangible, trackable)

Get the aim right…

My SMART aim is…

4 |

Pitfalls to avoid…

Creating a staff retention strategy: diagnostic tools

“By implementing an electronic

medical record, our chronic

disease patients will get better

care”

“We will create a truly

interdisciplinary team to

provide patient-centred care for

those suffering from chronic

conditions”

“We will improve management of diabetes

patients served at the Brown Street Clinic.

By May of next year, we will aim to increase

the percentage of patients meeting their

targets for A1C and blood pressure from

50% to 75%”

5 |

Driver diagrams – identify drivers

Creating a staff retention strategy: diagnostic tools

Aim Primary drivers Secondary drivers Actions

6 | Creating a staff retention strategy: diagnostic tools

To improve the inpatient experience

for adult female inpatients on a

mental health unit in order to increase

satisfaction by 25% in 10 months

Ward environment

Bed occupancyReview of delays at weekly

bed meetings

Stop sleep outs Rewrite protocol

Multidisciplinary ward team process

Nursing inputEnsure daily 1:1 time with

named nurse

Pharmacy inputOffer pharmacy advice to every patient during stay

Family SupportTrain one staff member on each ward to use support

skills

Patient choice

Ward roundChange concept of large

MDT ward round meetings

Complaints

Ward activities

OT Programme

Add senior OT to project team

To change IT programme content

AimPrimary drivers

Secondary Drivers

Change ideas

7 |

Spend time considering available action…

Creating a staff retention strategy: diagnostic tools

Logical thinking, operational

business as usual

Using typical service

improvement methodologies

Transformative thinking

• Level 1: Doing the right thing

- Effectiveness, focus and working to priorities

• Level 2: Doing things right

- Efficiency, standards and variation reduction

• Level 3: Doing things better

- Improving, thinking logically about what we are

doing and listening to suggestions

• Level 5: Doing things that other people are

doing

- Observing, copying and seeking out best practice

• Level 6: Doing things no-one else is doing

- Being really different, combining existing

concepts, and asking ‘why not?’

• Level 7: Doing things that cannot be done

- Doing what is commonly thought to be

impossible, questioning basic assumptions,

breaking the rules

• Level 4: Doing away with things

- Cutting by asking ‘why do we do this?’ and

simplifying by stopping what doesn’t matter

8 |

Putting plans into actionSequence actions…

Creating a staff retention strategy: diagnostic tools

9 |

Model for improvement

Creating a staff retention strategy: diagnostic tools

What are we trying to accomplish?

How will we know that

change is an improvement?

What change can we make that

will result in improvement?

Act Plan

DoAct

Plan

Study

Do

Aim

Measures

Ideas

10 | Creating a staff retention strategy: diagnostic tools

. Very small-1

scale test

2. Follow-up

tests

. Wide3 -scale tests

of change

. Implementation of 4

change

Changes that

result in

improvement

Hunches

and

theories

PDSA cycles

11 |

Seven steps to measurement

Creating a staff retention strategy: diagnostic tools

Source: ACT Academy, Online library of quality,

service Improvement and redesign tools: seven

steps to measurement for improvement

https://improvement.nhs.uk/documents/2164/seven-

steps-measurement-improvement.pdf

12 |

Sense check…

Creating a staff retention strategy: diagnostic tools

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London,

SE1 8UG

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© NHS Improvement November 2018 Publication code: IT 12/18

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