Strategic Health Management for Employee Retention in Rural Healthcare Settings

The purpose of the assignment is to provide remedial framework for addressing the issue of health workforce shortage due to high turnover of skilled health professionals. It has been found that health care organizations are highly depended on skilled health professionals and improved medical technologies.

Running head: STRATEGIC HEALTH MANAGEMENT
STRATEGIC HEALTH MANAGEMENT
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Summary:
The purpose of the assignment is to provide remedial framework for addressing the issue
of health workforce shortage due to high turnover of skilled health professionals. It has been
found that health care organizations are highly depended on skilled health professionals and
improved medical technologies. However, the health sector is suffering from high turnover of
health workers which may lead to the consequence of poor health service, reduction in
productivity, medical errors and reduction in the reputation of health care organizations. The
world Health Organization has identified the issue of workforce shortage as global issue. Data is
indicating that Australia may suffer from shortage of 2700 doctors and 109,500 nurses by the
year 2025. It has been identified that poor infrastructure, remuneration issue, poor incentive
structure, lack of health and safety factor in the workplace, excessive workload, stress and lack
of motivation play the central role in the high turnover of health workers. Thus, it is important to
introduce effective strategies in order to improve the health workforce retention plan. In this
regards it has been identified that effective policies for improving the incentive structure,
adequate training for the nursing students, improving the infrastructure in order to maintain the
health and safety in workplace, developing rules and regulations for the health care staffs to
provide service in the rural settings and appreciation for the contribution of health workers could
be some effective management strategies that could help to retain the skilled health workers in
the health sector.

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Introduction:
The service sector associated with health care or hospital industry particularly depends on
the availability of the adequate highly efficient health professionals in various health care field
and improved medical technologies (Al-Sawai & Al-Shishtawy, 2015). It has been identified in
the previous assignments that the health care sector suffers from high employee turnover,
especially the rural health sector lacks skilled health professionals, thus, it has become difficult
to provide adequate and effective care to the rural population, as a result various health issues
have led to the consequence of high mortality rate (Ognyanova, Plotnikova & Busse, 2014). One
of the main reason of such high employee turnover in health care sector is the lack of effective
strategies for employee retention in rural settings. It has been identified that lack of motivation in
the health workforce is one of the important factors that affect the health workforce. There are
other factors as well for example, poor infrastructure, remuneration issue, poor incentive
structure, lack of health and safety factor in the workplace, excessive workload, stress and others
(Russell et al., 2017). Such poor management leads to high turnover of skilled and highly
efficient health professionals in the health care sectors, especially in rural settings.
The health workforce turnover has been identified as the global issue in health care sector
by the World health Organization. According to WHO, the performance and productivity of a
health care organization relies on the quality of care, composition of health workforce and
appropriate distribution of health workers (WHO., 2014). It has been demonstrated that half of
the global population especially the people residing in rustic areas face difficulties in accessing
adequate and effective health service and one of the most significant reason of such poor health
service is the shortage of health workforce (Crisp & Chen, 2014). The health care sector of
Australia heavily depends upon the skilled health professionals and the statistics have indicated

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that the country would suffer from 2700 doctors and 109,500 nurses by the year 2025 (). The
workforce of health sector is aging which causes reduction in the working hours. The geographic
distribution of health workforce has indicated poor and unequal distribution of health workers.
Such condition may resulted in poor health service, reduction in productivity, medical errors and
reduction in the reputation of health care organizations (ahha.asn.au, 2018). Thus, it is important
to introduce effective employee retention strategies in order to retain the skilled health
professionals and address the issue of high turnover. In this regards the assignment aims to
provide effective remedial framework that could help to resolve the issue of health workforce
shortage and improve the health service in an effective manner.
Remedial framework:
Identification and selection of strategic management approach:
In order to introduce effective management strategies it is required to understand the
health workforce and select the appropriate management approaches that could help to decrease
the turnover of highly qualified and skilled health professionals and resolve the issue of
workforce shortage in health care sector. In this regards the process of SWOT analysis would be
beneficial as it helps to identify the strength, weakness, opportunity and threat of the health
workforce, thus could facilitate the way of introducing management strategies while considering
the above mentioned factors (Hill, Jones & Schilling, 2014).
SWOT analysis of health workforce:
Strengths: The health workforce contains highly skilled staffs and health professionals which
can be considered as the biggest strength. On the other hand there is effective training and
clinical practice session that helps the nursing students in order to understand the way of

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providing adequate and effective care to the people with need (Duffield et al., 2014). In addition,
it has been found that there are some health professionals that are interested in working with
community health care service which could increase the availability of health service (Newman,
Ye & Leep, 2014). Furthermore, it has been found that there is scope for inter professional
practice in the health care sector that allows the health professionals to understand the
responsibilities of each other and collaborate in an effective manner in order to provide quality
service (Pourshaban, Basurto-Dávila & Shih, 2015). Thus, it is required to introduce strategies
in order to improve such strengths and retain the skilled health professionals in the health sector.
Weaknesses: There are some significant weaknesses of the health workforce for example, most
of the skilled professionals avoid working in the rural settings they provide service mostly in the
metropolitan cities. Such condition leads to inadequate health service in rural settings (Duffield
et al., 2014). On the other and the lack of motivation, poor incentive structure, poor infrastructure
and lack of health and safety in the workplace also play an important role in demotivating the
health workforce (Newman, Ye & Leep, 2014). In addition due to workforce shortage most of
the health professionals or nurses has to take care of many patients, which lead to poor nurse-
patient ratio that affect the quality of care as well (Liu et al., 2012). Thus it is important to
implement effective management strategies while considering such weaknesses of the health
workforce in order to address them in an effective manner.
Opportunities: Beside the strength and weaknesses there are several opportunities for the health
workforce that could be utilized in order to resolve the issue of workforce shortage or retain the
efficient health workers. One of such opportunity is the introduction of effective policies to
improve the incentive structure and set some rules and regulation for the health professionals to
provide service in the rural settings (Duffield et al., 2014). On the other hand, there is

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opportunity to encourage and appreciate the health workers for their contribution in order to
motivate them to continue their quality service. Further, the health care organizations could
consider the health and safety factors for the health workers and improve the infrastructure to
reduce the rate of occupational death of health workers in the workplace (Bertman, 2016). In
addition the improved training process and scope of practice for the nursing students could help
to attract the students to join the health workforce (Newman, Ye & Leep, 2014). Utilizing such
opportunities could be helpful to resolve the issue of high turnover in health care sector.
Threats: In order to implement adequate management strategies it is essential to analyze the
various threats and implement effective strategies to reduce the threats and manage the condition
in an effective manner. In this regards it has been found that the migration of health professionals
could be one of the biggest threat for health care organization. Due to lack of opportunity many
health workers in the rural or poorly developed places are migrating to developed areas for better
career opportunity (Pourshaban, Basurto-Dávila & Shih, 2015). Thus, it is important to improve
the retention plan in health care sector in order to reduce the prevalence of migration of health
workers.
Effective management strategies:
The above discussion has identified potential strengths, weaknesses, opportunities and
threats for health workforce. Based on such identification the following strategies could be
implemented in order to retain the skilled health professionals and attract new health
professionals in the health sector in order to address the issue of health workforce shortage.

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The first remedial strategy should be introducing new policies and developing existing
policies in order to improve the incentive structure to retain the skilled health workers and attract
the new graduate students to join health workforce (Bryant & Allen, 2013).
Secondly, it is required to improve the health and safety factors in the hospitals. In this
regards improvement in the infrastructures is important in order to provide adequate measures
during emergency (Al-Sawai & Al-Shishtawy, 2015).
The third strategy should be introducing some rules and regulations for the health
professionals in order to encourage them to provide service in the rural areas which could
increase the availability of health service in such areas (Russell et al., 2017).
Fourth, it is required to improve the training process of nursing students and introduce
effective learning approaches that could motivate the nursing students in order to provide quality
service and join the health workforce. Effective training could help the students to learn the
essential skill and use them in the clinical practice in order to become efficient health
professional (Al-Sawai & Al-Shishtawy, 2015).
Lastly, it is required to introduce some appreciation for the contribution of the health
professionals in order to motivate them to provide consistent performance with high quality
(Bryant & Allen, 2013).
According to the current situation Russell et al., (2017) have demonstrated that future
demand for health service will be increase due to high prevalence of various communicable and
non-communicable diseases, aging of the population and changes in the expectations of the
consumers. Thus, it is important to implement such strategies in order to retain the skilled health

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professionals and attract the new health workers to mitigate the health workforce shortage in an
effective manner (Al-Sawai & Al-Shishtawy, 2015).
Critical argument around remedial framework:
While critically analyzing the strategies for healthcare employee retention and their
development in the rural settings, it should be mentioned that these strategies are useful for each
kind of organization as all of these are inclusive of different concepts and theories of workplace.
These concepts are ethical consideration, social responsibility, teamwork, leadership as well as
humanistic management using which organizations can understand the strategies using which the
employee retention could be achieved.
The first strategy used for this aspect was associated to employee benefits which is given
in the form of incentives. Further, the strategy also mentioned about creating a policy or
improving an existing system so that the helathcare employee who are leaving the rural
healthcare setting due to excessive work and less amount of pay can be compensated. As per the
research of Sinha and Sinha (2012), incentive system is an important system to motivate
employees to include their extra efforts for the benefit of the organization and in return they are
provided with a specific monetary reward. The researcher also mentioned the best aspect of this
policy and strategy as it can be implemented in any organization with a large work force and a
better policy related to incentives are always accepted by the workforce as they are being paid
for their extra effect they made for the betterment of their organizations well as for themselves
(Lowe, 2012).
On the other hand, the second strategy discussed about one of the major factors due to
which majority of the healthcare professionals are leaving their job and the reason is

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occupational health and safety. There are several incidences has been registered and discussed in
the research articles that majority of the critical infections the healthcare professions acquire,
occurs due to the helathcare hazards and lack of safety policies in the healthcare facility (Huang,
You & Tsai, 2012). Therefore, the strategy mentions that healthcare organization should
implement strategy using which enforcing helathcare occupational health and safety could be
implemented and followed. This is the ethical responsibility of the employer to include this
aspect in the helathcare facility as there are evidences that indicated to the fact that lack of
educational health and safety is an important aspect for majority of the healthcare professionals
job quitting. Therefore, implementing health and safety policies in the organization should be
used as one of the strategy for employee retention in the rural healthcare settings.
Further as per Lowe (2012), training is the process using which a large number of
workforce can be provided with education and skill training and those knowledge persist in their
memory for a longer time as audio visual mode of resources are used in the process. Therefore, it
is an important aspect for the growth and development of the employees of the healthcare
department (Aguenza & Som, 2012). There are instances when the employees of rural healthcare
settings cannot complete their training period and due to burnout they quit their job to move to
other cities or metropolitans (Lowe, 2012). Therefore, it is the responsibility of the helathcare
facilities to take care of the helathcare professionals and their knowledge and understanding
about the care facility in the primary days so that while working in the helathcare facility or
attending training processes in their primary days they can understand the need of their retention
and their value in the healthcare facility (Aguenza & Som, 2012).
Another strategy which was involved in the helathcare facility for the involvement and
retention of helathcare professionals in the rural settings was creating rules and regulation for the

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people as well as for the employee in the helathcare facility (Huang, You & Tsai, 2012). This is
an important aspect as majority of the helathcare employees chosen metropolitan cities for their
occupation and in the course, the rural helathcare facilities and their nurse to patient ratio
increases drastically (Mosadeghrad, 2013). Therefore, it is the duty of the local as well as
national government to make regulations and policies so that while going through the process,
they can provide ample taskforce to the rural helathcare facility (Aguenza & Som, 2012). As the
researchers mentioned that making policies and regulations will be able to make changes in the
healthcare policy and number of workforce in the rural healthcare facility can be increased
(Huang, You & Tsai, 2012).
The introduction of rewards and recognition have been reported to prevent employee
attrition in organizations effectively (Dobre, 2013). It has been seen that employee turnover rate
can be controlled to a significant extent with the introduction of motivation strategies. Studies
have further revealed that money is not the only motivation factor that could successfully prevent
employee turnover rate (Muogbo, 2013). Rewards such as the introduction of the incentive
scheme can help in the promotion of motivation. Rewards could also be in the form of a token of
appreciation or a gift card that could be an equivalent for an appreciation of a good work.
Further, inclusion of awards on the basis of performance can help in motivating other employees.
Recognizing the good performance of an employee can also help in appreciation and at the same
time inspire other employees to engage in a healthy competition (Sajuyigbe et al., 2013). It has
been significantly observed by researchers that employees perform better on being exposed to a
healthy competitive environment.
The recognition and reward policies could comprise of aspects such as giving away
promotional materials or in case of exceptional performance awarding a short trip. In addition to

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this publication of the success stories of top performers can help in shedding light on the efforts
put in by the people and the obstacles encountered. Rewards might not be in the form of gift
cards or promotional material always, it can also be other benefits such as granting an extra leave
that could be availed by the employee for working post the shift timing in order to uphold the
value of client commitment. It should also be critically mentioned here that the rewards and
recognition scheme should be based upon the evaluation made by the key performance indicator
tools (Sajuyigbe et al., 2013). The KPI tool could engage and cover a multitude of aspects such
as performance, attendance, client satisfaction and communication (Njoroge & Yazdanifard,
2014). For each category it is advised that there should be a separate range of rewards in order to
inspire employees to perform to the best of their ability. It would not only help in the prevention
of employee turnover but also attract other professionals from different areas.
Conclusion and recommendation:
Conclusion:
Hence to conclude, it can be said that employee turnover is a serious issue that leads to the
negative promotion of the brand name of an organization. It is important to understand the fact
the employees are the most valuable asset of an organization and the employee-organization
relationship is broadly based upon demand and expectation. Therefore. The organization must
take into consideration the employee needs and accordingly reform the existing policies so as to
promote a healthier and positive environment. The most important factor that determines
employee motivation is the flexibility in terms of organizational policies and improves employee
benefit schemes. The inclusion of benefit schemes such as better leave policy, improved
incentive structure, medical benefits and recognition can help in maximising employee
satisfaction to a great level.

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Recommendation:
In order to prevent the employee retention in the concerned organization it is suggested that the
Organization must adhere to the following strategies:
 Reform the organization policies and involve the employees equally while undertaking a
critical decision for the organization
 Inclusion of training and workshops in order to equip the nursing professionals with
better opportunities so as to enhance their skills while dispensing service delivery
 Improvisation of the organizational infrastructure and inclusion of upgraded instruments
so as to engage the professionals in advanced learning
 Inclusion of an incentive plan, better leave policies, bonus schemes, reward and
recognition and recreation therapies can help in inducing motivation among the workers
 Inclusion of a risk safety environment and counselling sessions for employees can help in
mitigating work related stress and promote a positive work environment that would
facilitate better work output.

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