Retaining CHC Staff

Retention is an organization’s active effort to keep employees as part of the organization; it is the easiest and most effective method to maintain sufficient staffing. Without an adequate retention strategy, healthcare organizations will fall prey to higher turnover rates, wasting time and money on recruitment. Every staff member at a CHC is vital to the success of that organization; in order to retain highly qualified and motivated staff, create a retention plan to address the individual needs of each position, from front office to clinicians.

Click below or scroll down to learn more about:
Recruiting for Retention
Creating a Retention Plan
Additional Considerations for Retaining Health Care Providers
Sample Retention Workplan 
If They Leave
Additional Online Retention Resources


The best possible retention technique is a careful match of the candidate to the opportunity during the initial recruitment process. Careful attention to compatible backgrounds and personal goals will go far toward assuring that the new employee will feel at home and be easily integrated into professional and social settings.

For answers to Frequently Asked Physician Recruitment Questions, please click HERE.

For a step-by-step Physician Recruitment Plan, please click HERE.

For more Recruitment Tools, please click HERE.


A formal retention plan is necessary for every organization. Consider assigning the task of creating and maintaining a formal retention plan to a qualified individual or a committee. Begin by evaluating the organization; assess the organization and identify elements of your current retention strategy that work well and others that need improvement. Use the “CHC Developed Resources” throughout this page to learn about successful retention strategies and tools being used by other CHCs.

If your CHC is willing to share its retention strategies/tools,
please contact the CHAMPS Workforce Development & Member Services Director.

When creating an official retention plan, consider legal and regulatory issues, industry factors, the organization’s competition, and cultural influences, as well as the diverse interests of your employees. Organizations can demonstrate the value they place on their workforce by addressing the diverse needs, interests, and values of their employees, as well as the needs of each individual position, in their retention efforts. Be sure to consider the following topics when creating your retention plan:

The first item to consider after hiring a new staff member is an excellent, pre-planned, and organized orientation to your organization in addition to the new hire’s department and position. Set clear expectations, and your new hire will attain a sense of belonging to, and an understanding of, your health center. Familiarize your new hire with the organization’s mission, vision, and values. Provide an introduction to, and contact information for, peers and colleagues, and get your new hire actively engaged in his/her new responsibilities.

For tips on Orienting New Staff, please click HERE.

According to the 2004 CHAMPS Region VIII CHC Recruitment and Retention Survey, an organization’s mission and services are the most important factors influencing an employee’s decision to stay with an organization. (To download the 2004 CHAMPS Region VIII CHC Recruitment and Retention Survey, click HERE.) Work environment is included as another top influencing factor. Creating an engaging work environment in which everyone is connected to – and understands their role in achieving – the organization’s mission, is a very compelling retention tactic.

Nonprofits can be more effective at recruiting and retaining staff
by focusing on their mission.

 –Todd Cohen
Stanford Social Innovation

Each employee has an important role to play in achieving the organization’s goals. Share the mission, vision, and purpose/value statements with every employee and use them as motivating factors. Consider tying components of individual job descriptions and evaluation tools to the mission so that each employee knows how their individual efforts contribute to a healthy and successful organization. Individuals, teams, and the collective organization should all work together toward achieving organizational goals and success.

As everyone actively engages in fulfilling the organization’s mission, a culture of engagement will evolve – a culture that revolves around performance, attitude, service, and vision. A culture of engagement in turn leads to higher feelings of satisfaction, increased commitment to the mission and to the organization, and further engagement in the cause.

Additional Resources: Creating a Culture of Engagement

Engagement and Culture: Engaging Talent in Turbulent Times

14 Management Do’s and Don’ts to Motivate Employees
How to Create a Success Culture

HR Ringleader
5 Ways to Influence a Culture of Engagement

Idea Connection
A Culture of Engagement

Lifework Strategies
2010 CHAMPS/NWRPCA Annual Conference session presentation slides
Five Dysfunctions of a Team
Four Stages of Team or Group Development

Rural Health Value
Six page document for scoring current engagement and building effective relationships to create a shared vision for a successful future.
Physician Engagement – A Primer for Healthcare Leaders

Stanford Social Innovation Review
Nonprofits Must Invest in Human Capital

The Thriving Small Business
10 Secrets to Creating a Culture That Fosters Engaged Employees

While creating your retention plan, consider the various methods your organization may use to communicate with employees. Use communication in your retention efforts to:

  • Give feedback
  • Ask for suggestions
  • Identify worker concerns and challenges
  • Evaluate employee satisfaction and engagement (see below for samples)
  • Ask for feedback regarding current retention efforts
  • Prevent misunderstandings or unrealistic expectations
  • Enhance the information exchange between all sectors of the organization
  • Share future plans
  • Recognize employee efforts, behaviors, attitudes, and achievements
  • Resolve conflicts as they arise

There are many ways to not only communicate with employees but to also allow employees to communicate with leaders. Consider using focus groups, surveys, one-on-one or group breakfast or lunch meetings, bulletin boards, conflict resolution groups or mediators, email, listservs, newsletters, letters, memos, phone calls, conferences, interviews, reports, coaching, counseling, presentations, and staff meetings. In the occurrence of personnel issues, an organization’s communication may need to include disciplinary actions and/or other guidance.

Visit the CHAMPS Communication in the Workplace Resources webpage for a compilation of materials addressing effective communication skills, best practices for managing relationships in the workplace, conflict mitigation and management, and de-escalation techniques.

CHC Developed Resources: Engagement/Satisfaction Surveys
Following are engagement/satisfaction surveys developed and used by Region VIII CHCs to refer to as examples when developing or updating your own surveys.

Colorado Coalition for the Homeless, Colorado
Staff Engagement Survey, 2011

Region VIII Community Health Center (Anonymous)
Annual Employee Survey, 2010

Salud Family Health Centers, Colorado
Employee Satisfaction Survey, 2010

CHC Developed Resources: Stay Interview Process
Stay interviews are focused on individual provider job satisfaction. The following resource offers an explanation of the interview, an example of a stay survey, and a flow chart of the process.

Valley-Wide Health Systems, Inc., Colorado
Stay Interview Process, 2012

CHAMPS sends a special thank you to the Region VIII CHCs who have shared their surveys.
 If your CHC is willing to share an employee engagement/satisfaction survey,
please contact Workforce Development & Member Services Director.

Additional Resources: Communication

Association of Clinicians for the Underserved (ACU)
Implementing Staff Satisfaction Surveys Infographic

How to Analyze Survey Results
Types of Employee Satisfaction Surveys
Employee Satisfaction Surveys

National Association of Community Health Centers (NACHC)

Sample Employee Satisfaction Survey Questions
Employee Satisfaction Surveys—HR Survey Templates

Determining the appropriate salary range for each position is a complex task; refer to available salary surveys at the local, regional, and/or national levels, and consider working with state or regional Employer Councils for relevant compensation data. Over time, consider increasing monetary compensation; many organizations find that incremental pay raises cost less than turnover in the long run.

In addition to salary, traditional benefits like health insurance and 401K plans add significant value to your compensation package. If possible, also explore non-traditional benefits; for example, community health centers are fortunate to have access to various loan repayment programs for their health care providers. Many organizations also find it beneficial to help recent college graduates with their debt obligations through student loan repayment compensation plans. Consider giving employees a breakdown of the monetary value of their benefits package at annual evaluations to more greatly illuminate the worth of these benefits (Click HERE to download a sample Value of Benefits form). Additional ways to customize the benefits portion of your retention plan include redesigning benefits to reflect family structures; offering flexible hours, work locations, and job sharing (refer to the Work-Life and Family Support section below); and paying adequate attention to promotional opportunities.

Additional Resources: Compensation 

Association of Clinicians for the Underserved (ACU) and Nonstop Administration and Insurance Services, Inc. (Nonstop)
Strengthening Health Center Employee Health Benefits

BMC Health Services Research
Effects, Design Choices, and Context of Pay-for-performance in Health Care


Community Health Association of Mountain/Plains States (CHAMPS)
Region VIII Health Center Salary Surveys
Recruitment and Retention Surveys and Data webpage
State Loan Repayment Program webpage
Value of Benefits–Sample Form

Employers Council (formerly Mountain States Employers Council, Inc. (MSEC))
2010 CHAMPS/NWRPCA Annual Conference session presentation slides
Base Pay: An Overview

The Employers Council Utah

Medical Group Management Association (MGMA)
DataDive Provider Compensation Data

Montana Research and Analysis Bureau
Workforce Services Division

North Dakota Department of Commerce

Society for Human Resource Management (SHRM)

South Dakota State Employees Organization

Wyoming Business Council

US Department of Labor

U.S. Bureau of Labor Statistics

All organizations have some limits on their ability to increase monetary compensation, even for the most valued employees. Luckily, one of the most effective ways to supplement compensation and enhance retention is through recognition. Recognition leads to increased staff satisfaction, and satisfied staff members have fewer reasons to leave an organization. Recognition increases staff morale, boosts confidence, and helps to fulfill a person’s fundamental desire for acknowledgment.

Recognition programs are always at the core of a culture that values people. Without recognition, employees are disconnected from company goals, attrition is a major concern, and a business environment can be chaotic. With strategic recognition programs, employee responsibility and satisfaction become an integral part of a company’s success. This leads to improved customer satisfaction, and in turn, improved financial position.

–Recognition Professionals International

Using a recognition program not only reinforces the organization’s values in regard to employee behavior and performance, but provides a structured way to show appreciation and provide positive communication of acknowledgment to employees.

When designing a recognition program, allow staff to be involved in the process. Being involved will allow employees to be connected to the effort; employees that feel they are appreciated and have meaningful opportunities to contribute are more likely to be loyal to the organization. Give positive feedback when due and ask for suggestions. Remember that recognition can be formal or informal, monetary or non-monetary; employees appreciate the value of both monetary and non-monetary rewards. Create measurable goals so that success and the need for improvement are both obvious; then provide rewards/incentives for meeting the goals. An environment of supported employee growth will support organizational growth. Recognition can include: awards; event recognition (birthdays, anniversaries); cash; verbal praise; trophies; certificates; plaques; dinners; tickets, and many others. Be sure to measure the impact of the recognition program and use the gathered information to improve the endeavor.

Additional Resources: Recognition Human Resources
Employee Recognition, Rewards, Awards, and Thank You Ideas

Mountain States Employers Council, Inc. (MSEC)
2010 CHAMPS/NWRPCA Annual Conference session presentation slides
Incentive/Bonus, Performance or Recognition: Finding the Right Solution for Your Organization

Recognition Professionals International

Most employees desire to grow and develop personally and professionally as a result of their career efforts. When an organization invests in an employee, those individuals are encouraged to invest in the organization. This effort begins with giving everyone the skills, resources, and tools they need for success, and continues throughout an employee’s career by allowing opportunities for continued training, professional development, and promotion. Consider conferences, regional trainings, online learning, listservs, tuition reimbursement, training on new technology, on-the-job learning, leadership training, mentoring, internships, internal job postings, job advancement and promotions, career pathways, and succession planning.

Additional Resources: Development and Career Opportunities

Follow the links below to explore various continuing education and professional development opportunities described on the CHAMPS Website:

CHAMPS Distance Learning
CHAMPS Job Opportunities Bank (JOB)
CHAMPS Leadership Learning Opportunities
CHAMPS Library of Distance Learning Documents
CHAMPS/NWRPCA Annual Conference
CHAMPS Resources for Students

American Dental Education Association
Explore Health Careers

Bureau of Labor Statistics
Occupational Outlook Handbook (OOH)
O*NET Health Care and Social Assistance careers information

Lansing Community College
Career pathways and facts for a variety of health and human service careers

It is imperative to consider lifestyle and family when creating your retention plan. There are various elements to work-life, including: workplace flexibility; paid and unpaid time off; health and well-being of the employee; recreation; caring for dependents; financial support; community involvement; and relationships with coworkers. Consider these areas and what you can provide to your employees as part of your retention plan. Many companies and organizations have found investing in work-life elements not only beneficial to individual employees, but extremely successful and cost-effective for the organization as a whole.

It is especially important to consider work-life and family support factors if an employee is new to the area. They may need information or additional assistance concerning: spouse employment; recreational opportunities; schools and education; cultural activities; adequate housing; shopping facilities; and the physical environment. Many of these issues should have been considered and may have already been addressed in the recruiting process, but it is important to have continued consideration of these factors in the formal retention plan.

Additional Resources: Work-Life and Family Support 

Boston College
Building the Business Case for Work-Life Programs
Center for Work & Family
Work and Family Research Network

Families and Work Institute
In the Workplace: Employees Organize to Improve Workplace Wellness

Burnout is the loss of focus on the job or at home. Service and helping professions, such as those in the health care industry, are highly susceptible to burnout. Being aware of and taking precautions to prevent burnout in your retention strategy will help decrease turnover.

Burnout happens over time, and generally spirals out of control. Characteristics of burnout include: fatigue and exhaustion; loss of motivation and enthusiasm; feeling stressed and overextended; loss of joy, hope, and power; depression; and detachment from duties and people. Burnout affects many aspects of life, including communication, concentration, relationships, health and well-being, and appetite and sleep habits, and may lead to depression, anxiety, and alcohol and substance abuse. The person experiencing burnout may not be aware of these effects, but others around them may notice.

Burnout can be caused by numerous factors, including:

  • Stress
  • Working in a high-pressure environment
  • External locus of control
  • Lack of control
  • Unrealistic or unclear expectations
  • Too many responsibilities
  • Excessive work hours or working too much
  • Disorganization
  • Lack of communication
  • Dysfunctional workplace dynamics
  • Mismatch in values
  • Poor job fit
  • Job monotony
  • Lack of support
  • Lack of recognition
  • Ineffective stress management
  • Not enough time for relaxing and socializing
  • Not enough sleep
  • Perfectionist tendencies
  • Sense of failure
  • Depression
  • Pessimism

There are many ways to prevent burnout, as well as combat burnout if it has already occurred. Some key strategies to prevent and combat burnout include:

  • Recognizing the symptoms and causes of burnout
  • Keeping energy up and renewing focus
    • Remind employees of their role in achieving the organization’s mission
    • Promote a culture of engagement
    • Help employees rediscover the enjoyable aspects of their work
  • Keeping your employees informed on the expectations and responsibilities associated with their job description, opportunities for advancement, supervisory duties, workload, evaluation criteria, benefits, and salary information
  • Monitoring the workload
    • Make periodic checks to ensure realistic expectations
    • Allow flexible work solutions when feasible (like telecommuting or flextime)
  • Encouraging and practicing good communication throughout the organization
    • Allow employees to communicate with supervisors and other leaders
    • Have a supportive work community
    • Share successes
    • Provide helpful supervision
    • Promote effective conflict resolution practices
  • Identifying and evaluating goals
    • Express appreciation
    • Recognize efforts and behaviors
    • Encourage employees to celebrate all triumphs—even small ones
  • Providing opportunities for personal and professional growth
    • Allow employees to take on new responsibilities
  • Promoting healthy lifestyles, relaxation, and stress management
    • Promote healthy eating, exercising, and sleeping habits
    • Set boundaries, avoid overextension, and understand limits
    • Encourage a daily break from technology
    • Support creativity
    • Accommodate vacation time

Additional Resources: Burnout

Agency for Healthcare Research and Quality (AHRQ)
Physician Burnout Online Fact Sheet 

American Medical Association (AMA)
Physician Burnout – Improve Physician Satisfaction and Patient Outcomes

Association of Clinicians for the Underserved (ACU)
Start2 Center Burnout Resources Bundle

Star2 Center Burnout Assessment Tool

Taking Action Against Clinician Burnout – A Systems Approach to Professional Well-Being

Biomedcentral (BMC) Nursing
Burnout in Health-Care Professionals research article
Burnout Prevention and Treatment

HR Executive Online:
Reducing Burnout in 2018

Integrated Work Strategies
Bounce Back from Burnout, 2010 CHAMPS/NWRPCA Annual Conference session presentation slides
How to Stop Feeling Burned Out and Reignite Creativity

Mayo Clinic
Executive Leadership and Physician Well-being: Nine Organizational Strategies to Promote Engagement and Reduce Burnout

National Academy of Medicine (NAM)
Burnout Among Health Care Professionals: A Call to Explore and Address This Underrecognized Threat to Safe, High-Quality Care

Burnout and Job Satisfaction in the Physician Assistant Profession: A Review of the Literature

Gender-Based Differences inBurnout: Issues Faced By Women Physicians

Taking Action Against Clinician Burnout: A Systems Approach to Supporting Professional Well-Being

National Association of Community Health Centers (NACHC)
Workforce Wellness Toolkit

Oxford Journals Occupational Medicine
Burnout as a Clinical Entity—Its Importance in Health Care Workers


All CHCs realize the importance of retaining health care providers. Since new providers are often brought into the community from elsewhere, both professional environment and lifestyle factors should be considered during the initial recruitment of a health care provider. Since many of the alternative career options your new employee had when they chose your practice are still available through the early years, a disgruntled employee can readily move before many patient or community ties are built. Be sure your retention activities are ongoing even after the health care provider has been working at the organization for some time.

When developing a retention plan specifically for health care providers, consider including the following:

  • Periodic checks of the health care provider’s on-call responsibilities to ensure they are realistic
  • Ample opportunities for continuing medical education
  • Monitoring the health care provider’s patient load
  • Checks to make sure referral patterns are established and appropriate
  • Personal interactions with the health care provider; is he or she happy and content? (Consider setting up monthly breakfast meetings to discuss a variety of issues.)
  • Awareness of how well the health care provider and his or her family are being integrated into the community; are they included in social events? Do they have a sense of belonging?
  • Job match – try to sculpt the job to the individual as much as possible
  • Regular written communication
  • Patient relationships (these are often a large aspect of what providers find satisfying about medicine)
  • Opportunities to communicate appreciation for the health care provider

Further, consider addressing other areas of concern, including:

  • Payment practices. While most CHCs cannot provide excessive salary increases, attractive alternatives include:
    • Paying providers promptly
    • Offering financial incentives aligned with high-quality care
    • Offering financial incentives for increased productivity; be sure to improve front-line processes, consider departmental reorganizations, and/or utilize new technologies to improve a provider’s ability to capitalize on this type of incentive
  • Quality care.
    • Remove barriers to providing top-notch care
    • Build and maintain provider relationships (with other providers, specialists, hospitals, or patients) through outreach
  • Administrative burdens.
    • Simplify eligibility and credentialing processes
    • Simplify the process for health care encounter data submission

Additional Resources: Retaining Providers

Medical Group Management Association (MGMA)
Formalizing Your Physician Retention Strategies Amid Worsening Shortages

National Association of Community Health Centers (NACHC)
Clinical Recruitment and Retention Toolkit

STAR² Center – Association of Clinicians for the Underserved (ACU)
Solutions Training and Assistance for Recruitment & Retention
STAR² Center Financial Assessment for Provider Turnover Tool Video Introduction
STAR² Center Financial Assessment for Provider Turnover Tool


CHAMPS has developed a sample retention workplan based on these suggestions; you are encouraged to alter the document to serve the individual needs of your organization.

Please click HERE to view, alter, save and print the workplan.


No matter how comprehensive and thoughtful your retention plan is, some of your staff will leave the organization. When this happens, try to conduct an exit interview to find out why they are leaving. The answers you receive may enable you to resolve previously unknown problems or help in recruiting the next time. Consider having the departing employee complete an Exit Interview Questionnaire as an additional resource.

Please click HERE to view, alter, save and print a sample Exit Interview Questionnaire followed by some tips for a successful exit interview.

Additional Resources: Exit Interviews Tech Careers
Exit Interview Questions

Free Management Library
Exit Interview Resources

The Real Value of Getting an Exit Interview Right

Harvard Business Review
Making Exit Interviews Count

National Association of Community Health Centers (NACHC)
Exit Pulse

Talent Lyft
The Ultimate Guide for Conducting Effective Exit Interviews

Top Ten Ways to Retain Your Great Employees
Keep Your Best: Retention Tips

Centers for Medicare & Medicaid Services (CMS)
Promising Practices in State Survey Agencies: Retaining Surveyors–A Compendium of Promising Practices

Community Health Association of Mountain/Plains States (CHAMPS)
Recruitment and Retention Surveys and Data
Other Recruitment and Retention Resources

How to Create a Winning Employee Retention Strategy
Seven Ways to Retain Top Employees

15 Effective Employee Retention Strategies in 2024

Free Management Library
Retaining Employees—library of online resources

HRH Global Resource Center
International Health Worker Retention

11 Ways to Retain Employees in a Competitive Market
10 Effective Strategies to Retain Employees

Institute for Socio-financial Studies
2010 CHAMPS/NWRPCA Annual Conference session presentation slides
Creating High Morale Through Value-Focused Leadership
Your Unique LifeValues History
Your LifeValues Profile Quiz

National Academy of Medicine (NAM)
Utilizing a Systems and Design Thinking Approach for Improving Well-Being within Health Professions’ Education and Health Care

National Association of Community Health Centers (NACHC)
CHC Pulse
Health Center Workforce: Recruitment and Retention Toolkit

North Shore LIJ Health System
2010 CHAMPS/NWRPCA Annual Conference session presentation slides
Succession Planning for Your Clinical Staff

The Physicians’ Foundation
The Physicians’ Perspective: Medical Practice in 2008

Employee Retention Plan—How to Keep Good Employees

Society for Human Resource Management (SHRM)

STAR² Center
ACU Health Center Provider Retention and Recruitment Plan Template
Comprehensive template containing resources, charts, and tables that walk through each section of a healthy and evolving R&R plan.
ACU Burnout Resources Bundle
Compendium of articles, tools, and multimedia presentations that address provider stress and burnout.

U.S. Department of Agriculture (USDA) Economic Research Service
Factors Affecting Recruitment, Retention of Rural Clinicians

Virginia Department of Health
EMS Recruitment and Retention

World at Work
World at Work—The Total Rewards Association

Workforce Planning for Wisconsin State Government
Employee Retention Overview