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To Heck with Retention: 5 Reasons Turnover in Your SPD May Be a Good Thing

As a sterile processing manager and then system director, one of the human resources metrics that I never appreciated was employee retention. Don’t get me wrong, I was and am a big fan of developing high-functioning, happy sterile processing teams. What I’m not a fan of is the status quo. One of the unfortunate things that employee retention encourages is keeping the status quo in place. This metric or measurement does not account for the many good reasons that a department may experience a high degree of employee turnover. Here are five of the most persuasive examples of when and how low employee retention numbers are something to celebrate.

Finding a better fit
One of the primary roles of any department manager is to identify the strengths and weaknesses of their staff, and then lead them accordingly. This also means ensuring that everyone on the team has the same access to education, tools, and accountability necessary to do their jobs well. However, there is another important, though often overlooked role for department managers, and that is the occasional need to find someone a better career fit.

We are not all cut out for work in sterile processing. It is a grueling physical job at times, with continuous lifting, pulling, pushing, and carrying weights of 75 lbs or more, depending on the size of instrument trays and case carts. It is also detail oriented and meticulous; for example, when refilling minute implant trays and inspecting ophthalmic instruments. There are many professionals in the industry who, for whatever reason, are not up to these complex and critical tasks. And that’s okay, but it means that department managers need to be proactive in identifying this early on and help these individuals find a better career fit, either inside or outside of the hospital setting. Turnover in the name of career fit is the right decision for everyone.

System trainers
If your hospital is a part of a larger health system or integrated delivery network (IDN), there may be another reason why turnover in your sterile processing departments signal something good is going on. Let’s say you have three facilities in a metropolitan area: one large academic hospital, one smaller hospital, and one ambulatory surgical center (ASC). It might be a great idea to treat your academic facility as the primary training facility for all three locations. When new positions open at the ASC, for example, instead of throwing a new technician off the street into a busy workflow without a dedicated trainer or department educator, experienced technicians from the academic facility could be first in line to take the role at the ASC.

The vacant position at the academic hub would then be backfilled with a new hire who can receive the full training regimen with adequate support at the main campus, and the cycle continues. Smaller facilities in the system get the luxury of hiring from a trained pool of SPD staff, and the larger training hub can better manage the burden of orientation without feeling quite the strain that might be experienced by trying to train at an ASC. If you only looked at employee retention at one facility, you’d never get to full picture of strategic training and hiring across the system.

Hospital pipelines
Because someone doesn’t want to be a sterile processing technician forever, it doesn’t mean he or she won’t make s great technician for a little while. This can most easily be seen in the large numbers of future surgical technologists and operating room nurses who start out in sterile processing and later transition on to the professions that really spark their passion. Department leaders who understand this dynamic can tap into an eager, thoughtful, and driven pool of potential candidates for their open SPD positions, as long as everyone involved understands certain limited time commitments that may be involved.

For instance, it’s no secret that many folks who want to get their foot in the door at a hospital apply for jobs in sterile processing first because there is often little or no prior experience required. As mentioned above, this is not inherently a bad thing. Everyone has to start somewhere, even eventual OR directors and chief nursing officers (CNOs). They might as well start in your SPD, as long as they are willing to commit to give you a good two years of hard work and focus before deciding to transfer out to another department in the hospital.

Leadership accelerators
These next two points can really get under the skin of your human resources team, but they are some of the most important of the list. Another critically important opportunity that high-performing departments provide is a type of leadership acceleration for their high-performing all-stars. This means that instead of needing to hire your next lead tech, supervisor, manager, or director from outside the hospital or even out of state, you intentionally develop, mentor, and promote high performers within your own department. To do this well, you may need to rewrite your 20-year-old job descriptions to reflect more importance placed on merit than simply on time served. Instead of requiring five years of experience to apply for a supervisor role, you require two certifications and one year of experience. This incentivizes go-getters and builds a culture of meritocracy, rather than mere seniority.

This might also get you a department full of eager, credentialed, and well-mentored potential leaders who want to grow however and wherever they can. This may mean at the hospital across the street instead of your department. It’s a risk that you should still take because it’s ultimately the best thing for them and gives you more room to hire, train, and do it again.

Outcomes vs. metrics
Finally, the biggest breakdown between retention metrics and reality is the actual quality outcomes of your department. Yes, we’d all love to live in a world where no one ever quits, no one ever has to be trained as a new leader, and it’s the same team yesterday, today, and forever. But that’s not the real world. In light of this, the primary target for sterile processing departments should not be some arbitrary percentage of employee turnover; instead, our targets should be quality outcome oriented. As long as our error rates, infections, immediate-use steam sterilization (IUSS) use, and similar metrics are low and our production efficiency and morale are high, we should view our department headcounts as a success.

Employee turnover alone never has and never will tell the full story of what is going on in your SPD. If you have good reasons for the new faces walking in your door, give them your full attention, and tell HR to heck with retention.

What say you?

Feature articles exclusively for Ultra Clean Systems by Weston “Hank” Balch, BS, MDiv, CRCST, CER, CIS, CHL

Weapon of Mass Microbial Destruction * Professional Clean Freak * Podcast Host * Safety Addict * CS/SPD Consultant

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