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6/25/2002

Pharmacist Retention Influenced By More Than Salary, ASHP Survey Shows

Donna Young

Health systems that offer pharmacists professional challenges, opportunities to positively affect patient care, flexible scheduling for work shifts, the tools necessary to perform well, and effective communication between management and staff tend to have lower vacancy rates than other facilities, according to a recent ASHP staffing survey.

Although the findings indicate that the shortage of pharmacists continues to be an issue of concern to pharmacy directors, the overall vacancy rate for pharmacists in nonfederal health systems is lower now (6.9 percent) than in 2000 (8.9 percent), when ASHP last conducted its staffing survey. The 548 directors who responded to the survey, conducted by ASHP between April 19 and May 15, indicated that they have the most difficulty hiring experienced frontline pharmacists and managers. In fact, hiring managers has become more difficult in the past two years. Experienced pharmacy technicians are also hard to find.

Douglas Scheckelhoff, M.S., ASHP’s practice leadership and management director and the survey’s coordinator, said that salary does not seem to be the most important factor considered by pharmacists when they decide to stay at or leave a job.

An in-depth look at the survey's data, Scheckelhoff said, revealed a lower vacancy rate at the hospitals that took into consideration an employee’s lifestyle, professional practice, and overall work environment.

Factors Influencing Pharmacist Retention in Health Systems

Retention Factor

% That Responded 'Yes'

Salary and Related Factors

Provides salaries and benefits competitive with other hospitals in region

85

Provides salaries and benefits competitive with other nonhospital pharmacist employers in region

36

Regularly monitors, tracks, and adjusts pharmacists' salaries (e.g. quarterly)

51

Staff Development

Provides annual opportunities for staff to obtain additional training or attend professional meetings at hospital's expense

78

Provides opportunities for pharmacists to progress into areas or assume greater responsibility based on experience and skills

70

Promotes and rewards professional development growth in hospital's performance and appraisal system

59

Actively mentors new, inexperienced practitioners

78

Lifestyle Considerations

Offers preferred shifts and schedules whenever possible, and assigns work that is not time sensitive to the preferred shifts

63

Offers significant incentives to those who work nonpreferred shifts

43

Meets with staff at least annually to discuss quality-of-life issues and adjusts work environment when possible

60

Offers flexible or creative schedules, when possible, to meet special needs

82

Professional Practice

Provides tools necessary for staff members to do their jobs (e.g., adequate references and electronic information sources, personal digital assistants, space, access to computers)

82

Provides professionally challenging and rewarding practice environment, including patient contact, to most pharmacists

76

Employs automation and technicians to perform duties that do not require a pharmacist's knowledge and expertise

81

Positions pharmacists to positively affect patient care and outcomes

93

Work Environment

Provides staff with regular communication from management

91

Gives staff regular opportunities to communicate issues to management

94

Employs managerial and other staff members who are enjoyable to work with

95

Employs technicians who are well trained and work collaboratively with pharmacists

92

Frames pharmacists' relationship with other professionals, such as physicians and nurses, to be positive, constructive, and collaborative

95

The survey's findings reinforce that it is "absolutely critical" for directors and managers to look beyond salary and signing bonuses as key elements in recruitment and retention strategies, Scheckelhoff said.

With the current pharmacist shortage, he said, pharmacy directors will be much more successful at employee recruitment and retention if they identify ways to provide a rewarding, challenging work environment and meet peoples’ professional and personal needs. "While salary is still a factor, by all means it is not the only factor. And the survey reinforces that."

Employees who are allowed to work their preferred shift, Scheckelhoff noted as an example, are more satisfied than others with their work environment.

Managers should attempt to find creative solutions to scheduling problems, he said. For instance, duties—such as packaging drugs, stocking the inventory, and ordering supplies—that often are performed by pharmacists who work the night shift could be moved to a day shift so that fewer employees need to work at night.

"It’s more work for the manager in terms of scheduling, Scheckelhoff said, "but managers should take the extra time to have a win–win situation for everyone."

Pharmacy directors, Scheckelhoff also said, should strive to build positive working relationships with staff members and other hospital employees. "People don't leave their jobs, they leave their managers," he said, citing a finding from a recent Gallup Poll. "Management needs to work well with staff, be fair, and communicate openly."

It takes an average of almost six months to fill a health-system pharmacist position, according to the ASHP survey, and an average of three months to train that new pharmacist. The average turnover rate for health-system pharmacists is 8.5 percent.

Based on his analysis of the survey's data—including the costs associated with having a temporary employee, recruiting the new employee, sign-on bonus offers, and training—Scheckelhoff estimated that it will cost a health system $65,400 for a typical turnover in a pharmacist position.

The survey, Scheckelhoff said, gives pharmacy directors the statistical support they need "to back up their requests to hospital administration" to provide employee services that consider lifestyle, professional practice style, and work-environment issues.

"People need to look at the total package and be proactive and assertive in implementing some of these programs," he said. Having pharmacists provide progressive services is not only "the right thing to do for patients," Scheckelhoff said, "it will also correlate to a better retention rate" for staff.