Situation: A large, multi-location, private medical practice was concerned about the nearly100 percent rate of employee turnover. The practice engaged us analyze the problem and recommend how to resolve it.

Approach: Our analysis included several steps to assess the effects of leadership and management and organizational design on employee turnover.

1) Gathered data on the average length of service, departments, and functions within departments as well as each practice location to determine how and if they impacted turnover.

2) Met with existing employees to find out what prompted staff to leave, including the effect of the leadership skills on turnover.

3) Reviewed each manager’s recruitment, Teamworkinterviewing and selection process to understand the organization’s leadership and management philosophy, practice and style.

4) Conducted a salary and benefit survey to determine if compensation met or exceeded state averages. We concluded that the organizational design of the practice and the leadership skills of its managers were excellent; however, there were too few processes and systems to support managers.

Results: To improve leadership and management, we created and implemented new processes to support recruitment, interviewing and selection, and implemented a new-hire orientation and training program. We conducted leadership skills training for the managers to help them develop processes to ensure a skilled, experienced and long-term staff. In time, the turnover rate declined to 35 percent, well within the industry norm and Employee Retention was greatly improved.