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4 Strategies for Keeping Your Millennial Healthcare Workers

Analysis  |  By Christopher Cheney  
   February 20, 2019

Techniques to retain millennials include dress code changes and providing opportunities for career advancement.

Having trouble with turnover in your millennial healthcare workforce?

Since more than a third of the U.S. labor force are millennials, according to the Pew Research Center, you want to ensure you have strategies in place to understand the needs of the millennial workforce and how to retain them.

Not to mention that a 2016 Gallup report estimates millennial turnover costs the country $30.5 billion annually.

It matters to keep millennials happy in the workplace. That's why one Indianapolis-based health system has made millennials the focus of its workforce strategy.

At IU Health, about 59% of its new hires are millennials, says Amanda Bates, vice president of human resources. "We employ a lot of millennials, and strategically as we look at growth and future hires, they will become more and more of our new hires."

"Forty-one percent of our workforce is millennials. Fifty-one percent of our nurses are millennials, and 31% of our physicians are millennials. So, a lot of our key jobs that touch our patients are millennials, and they will continue to grow in terms of the numbers employed. Strategically, we need to accommodate these folks."

IU Health has implemented four strategies to accommodate and retain millennial healthcare workers at their organization.

1. Adopt a new dress code

IU Health, with 16 hospitals across Indiana, has relaxed its dress code to allow all staff members to have tattoos and piercings, which are defining characteristics of many members of this generation. The change took some courage and it came with a measure of controversy, Bates says.

"The one thing we did that was the big difference maker was go to our patient advisory councils. We went to our patients and asked, 'What's important to you?' We found that what patients really cared about was the quality of their care and the compassion of their caregivers. They cared less about what their caregivers looked like."

Bates and other health system leaders addressed opposition to the new dress code by demonstrating the necessity for change.

"When we rolled it out, there was overwhelming acceptance, but there was a small group of people who were sending me letters about selling out to tattoos and piercings. My response was that we had not sold out at all—this is reality. Millennials present differently than the baby boomers presented, and we needed opportunity for that expression," she says.

2. Provide opportunities for career advancement

IU Health has adapted to the desire of millennials for career mobility and advancement, particularly for nurses and medical assistants, Bates says.

"In nursing, we started developing career pathways, which are ways for people to develop knowledge and incremental skills in areas of their preference like research, leadership, clinical care, safety, or informatics. We give people in clinical areas many options in terms of their development and pathways to gain knowledge or certifications."

Prior to establishing career pathways and ladders for medical assistants, they had the highest job turnover of any other clinical role at IU Health, she says.

"We did focus groups with our medical assistants, and we found out that they wanted career development and career progression. It was a very flat job that did not pay a lot. So, we talked with them about the skills that would be of most benefit, then we developed opportunities for people to become trained and certified in those skills. Now, we have 65% of our medical assistants who have received promotions on our career ladder, which comes with pay increases and increased responsibility. Our turnover is down to the 10th percentile."

IU Health also has established career pathways and ladders in other areas of the organization, including human resources, finance, and information technology.

3. Reform hiring and training practices

The health system has made the hiring process more appealing to millennials, Bates says.

"Until 18 months ago, you had to apply the old-fashioned way—getting on a computer and filling out an application that took 30 minutes, then taking a test to measure job aptitude. You can still apply that way, but 65% of our applications now are made on a mobile app—it takes just a few minutes. We significantly reduced the number of questions that we asked, and we have doubled the number of applications that we get."

Texting is the next frontier of IU Health's hiring efforts, she says. The health system is adopting a texting application that helps communicate with applicants with a text rather than a phone call.

IU Health is starting to conduct screening interviews via text. The health system has built a library of standard questions that recruiters ask of each candidate, which they can auto-populate into the chat trail for quick conversations to learn about factors such as candidate qualifications and shift availability. A transcript of the conversation can be shared internally to help avoid duplicate questions being asked when the hiring leader conducts interviews.

Millennials tend to be more job ready than earlier generations of healthcare workers, so the health system has streamlined orientation processes, she says.

"A couple of years ago, we reduced the amount of time new hires spend in orientation before they join their units. For our nurses, we used to have service requirements before we would move them into operating rooms or ICUs, but we discontinued that. We can move millennials into jobs that require fast-pace and critical thinking."

With the proclivities of millennials in mind, IU Health also has been innovating in how the organization trains employees in ways that are novel, fun, and social, Bates says.

"We recently rolled out an escape room program for new nursing hires. They are broken into groups and have an hour to solve safety and quality puzzles. You need to try to beat the time of the other cohort teams in your training group."

4. Enhance tuition reimbursement for continuing education

IU Health also is using tuition reimbursement to cater to millennials as an opportunity for career advancement, she says.

"We have improved tuition reimbursement. We stopped making it a requirement for nurses to have a bachelor's degree and offered a generous tuition reimbursement. We doubled the number of academic programs that we would pay for. In one year, we tripled the number of people in our tuition reimbursement program."

Christopher Cheney is the CMO editor at HealthLeaders.


Millennials account for one-third of the U.S. labor force.

At IU Health in Indiana, about 59% of new hires are millennials.

A growing percentage of IU Health's workforce are millennials, and the health system has adopted several strategies to attract and retain them.

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