Fuller credits innovations in the work environment for the lion's share of the gains but admits the hospital tries to make sure salaries are within 3% of nearby Sioux Falls. For instance, Prairie Lakes is rolling out flexible work arrangements for managers as well as directors, to help retain good people.
Focusing on retention and reduction of turnover doesn't mean that low performers should be allowed to hang around, says Studer. Quite the contrary, in fact. But how can firing low performers help with turnover?
It's a hard concept to integrate into an organization. Studer related a story about a hospital he worked with recently that told him there were 258 people out of 6,000 who weren't meeting performance targets over a long period of time. Of those 258, managers had only 50% with documentation about their low performance.
"They said they were confused. How do you lower turnover and also get rid of people? It's a good point. So we have them identify the people and talk about how much time to give them to meet performance expectations or have them out. Then we add some time onto that."
Until then, these underperformers don't count against turnover calculations for the managers. Using this philosophy, he says, an organization can come as close as possible to ensuring that the turnover they do experience is good turnover.
"CEOs own mortality and length of stay," Studer said, "and they have to own turnover."