Avoiding Coordinator Turnover
One of the really knotty problems in support coordination, especially with psycho-social disability, is high staff turnover. It happens almost across the board and it is bad for everyone – bad for participants, bad for providers and annoying for LACs.
High staff turnover means only one thing: unhappy staff. So, to avoid high turnover, providers need to avoid things that staff do not like. Put simply, happy staff do not leave.
One of the main causes of staff dissatisfaction is what many organisations call their ‘KPI.’ This is the target percentage of hours that organisations require their staff to spend doing billable work. The most common target is 80%, but they can range as high as 85%. The KPI basically dictates how much revenue the coordinator must generate each day.
Financial KPIs have become all-pervasive. You see them being mentioned in employment ads, and I can attest that the first question that many jobseekers ask is ‘what is the KPI?’ They are not asking ‘in a good way.’ This is because most good coordinators dislike the idea of a financial KPI. They feel a financial KPI makes generating revenue the only part of their employment that is valued or managed. This is such a shame because support coordinators are generally really good people who want to work hard. They do not need a KPI to get the best out of them. What’s more, none of them wakes up in the morning looking forward to ‘meeting that KPI.’ Instead, they go to work each day wanting to help disabled people make their lives better.
It is no coincidence that organisations that focus on financial KPIs are the ones that face high staff turnover. Nor is it any coincidence that organisations with high staff turnover are struggling financially – one large mental health provider announced in February that it had lost $10 million in its first four years working in the NDIS.
What these groups seem to often miss is that a high KPI is actually the cause of their troubles. In their cases, the high KPI is both the cause and the consequence of high turnover. Let me explain.
A full-time support coordinator only works about 42 of the 52 weeks in the year, due to annual leave, public holidays, sick leave etc. In these 42 weeks, that full-time support coordinator only needs to bill about 44% of available time to cover their own salary and super. If we allow another 16% of available time (which is generous – it equates to more than $25,000 a year) for associated costs, such as management, rent, travel reimbursement, etc, then a support coordinator only needs to bill at about 60% of available time for their work to be sustainable. For most people, this is a doddle.
So, why does the organisation ‘need’ the extra 20-25% to make itself sustainable? Why do so many organisations need their staff to generate so much more revenue than they need to employ the staff member? The answer: staff turnover. When a staff member leaves, someone new needs to be recruited in their place. This new employee cannot generate as much revenue in the first few months of their employment. In fact, it is not until about the sixth month that a typical support coordinator has averaged billing of 60%, which is the level needed to cover all the costs of their employment. That means that, for the first six months of someone’s employment, the organisation has to ‘cover’ at least some of the cost of that staff member. Remember that because it is an important point: staff operate ‘at a loss’ for the first six months.
In the psycho-social disability sphere, a relatively few large providers dominate the sector. These large providers all tend to have high staff turnover. In fact, staff tend to spend no more than 12 months with them, on average.
Now, put those two time periods together: (i) a new worker runs at a ‘loss’ for the first six months; and (ii) the average employee only stays for 12 months. This means that the first six months is actually half of the average person’s total period employment. At any one time, this means that half of all employees are employed ‘at a loss.’ The only way to make up that loss is for the other half of the employees (the ones working from their seventh to their 12th month) to make up the loss by billing at the unnecessarily high rate of 80% to compensate. This gives the organisation a chance to bill somewhere around 60% as an average across the whole staff team.
The problem is, 80% is really tiring. People can only do it for a while. Then they become worn out and decide to leave. When they leave, someone else has to work harder to cover the cost of the replacement member of the team. This is a classic ‘vicious circle:’ people have to work hard to cover a new employee. They get tired and resign, and another new employee is needed. The remaining staff have to work harder to cover the cost of this new employee. And so on.
There is a simple solution to all this. Stop focusing on financial KPIs. Make quality the priority instead.
Before starting Calm Consulting, I spent some time with a large provider of NDIS services who were using the 80% financial KPI (and losing a lot of money). They were struggling to hang on to good people, and were a classic case of the cycle described above. Understanding that retaining staff for longer would improve both the quality and the financial performance of our service, I made reducing staff turnover my own KPI. Happily, it worked. Over the first eight months, we reduced staff turnover by more than 80%. We did this mostly by removing the emphasis on the financial KPI and instead emphasising staff having a satisfying work experience. We basically assured the staff that we trusted that they would work as hard as they could and we did not need to monitor this on a daily or weekly basis. We were more interested in helping them than measuring them.
This approach worked. As I say, staff turnover fell by more than 80%. Obviously, this improved the quality of our work as we had a more settled and experienced team providing consistent support. The staff were happy and so were the participants – the number of complaints fell dramatically. It was a good thing to be a part of.
Happily, there was also a strong positive impact on our finances: average revenue per person actually rose by 15% – because, with few staff leaving, we did not need to recruit a whole bunch of new staff who could not do much work yet. When we moved the focus away from revenue and towards quality, revenue took care of itself. This is the silly paradox of financial KPIs: focusing on high financial KPIs means you need high financial KPIs. Making revenue your sole target is counter-productive because it raises your costs. Reduce your costs and you need less revenue to break even.
Put very simply: when quality is the only KPI, the revenue takes care of itself. If you want to fix your revenue, stop focusing on it.