Hospice of the Western Reserve: Engagement High, Turnover Rates Low

Chief Clinical Officer of Hospice of the Western Reserve Judy Bartel sends a note when a member of the staff has had a particularly difficult time doing their “sacred work,” Bartel told Home Health Care News. That’s the environment the organization is trying to push forward.

Similar to many other hospices, Western Reserve is working to decrease its turnover rates, as staff retention seems to be a problem for providers across the industry. The national turnover rate for hospice registered nurses is about 19%. For Western Reserve, though, turnover is only 12%, according to PEW Charitable Trusts.

Since adding support services over the last few years, Bartel has noticed a difference within the staff. Most recently, the organization created a specific role, director of staff engagement, to more specifically deal with compassion fatigue and create opportunities for engagement, she said. The position was filled by Lisa Scotese Gallagher, a clinical director at Western Reserve. She took on the new responsibilities last year.


Hospice of the Western Reserve is a community-based nonprofit that operates across nine counties in Ohio. The organization has 1,000 paid employees, both full and part-time, and 3,000 unpaid staff. The hospice serves 1,200 patients on a daily basis and the majority of care is in the home and in nursing homes.

“A lot of the support that employees get is from their team and the other teams at their site,” said Bartel.

The company requires each employee to sign a concept of covenants, essentially a set of promises, when they first start. “We commit to honest dialogue with our team members,” reads one of the covenants.


That means, according to Bartel, that if there is an issue between two members of a team, they try to work it out with each other before bringing it to a supervisor. When that doesn’t work, the organization has predictive indexes from each employee that indicate their personality type, which can allow for easier conflict resolution.

The organization also has tools for staff to use when they’re experiencing compassion fatigue, the state of becoming numb to the suffering of others, in order for them to instead experience “compassion satisfaction,” Bartel said.

For example, Western Reserve offers reiki, an alternative healing technique that promotes stress relief, and yoga sessions to help staff replenish. Bartel also noted that care workers have apps on their phones that allow them to reflect before they go into a patient’s home.

Western Reserve allows for movement within the company, too, which also helps with staff retention.

“We had one nurse go work on the finance team to help with insurance companies,” Bartel said. The company has many different teams and types of care and encourages employees to move amongst them and try new positions, she said.

At its core, the organization tries to appreciate the work its employees perform on a daily basis.

Each site does something different to memorialize the patients who have passed, according to Bartel. Some workers hang butterflies, for instance, to remember and acknowledge each patient.

“We try to celebrate all the work that is done so that [staff] feels engaged and appreciated,” said Bartel.

Written by Kaitlyn Mattson

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