Using Stay Interviews as a Quality Improvement Tool for Healthcare Workforce Retention

Background and Objectives: The novel coronavirus of 2019 (Covid-19) pandemic exacerbated already persistent health care workforce issues—eg, overwhelming workloads, chronic understaffing, and burnout—associated with turnover intent and actual turnover. While turnover may be inevitable, strategies that help organizations anticipate and mitigate its impact require knowledge about how employees are experiencing their work (not just performing) on an ongoing basis. Unlike performance appraisals, “stay interviewsing” is a proactive management approach to assess the organizational and personal factors that influence current employees’ retention in their roles (ie, why they stay). We describe our process of developing and using a stay interview guide with current Women’s Health Patient-Aligned Care Teams (WH-PACT) employees and comment on the feasibility of conducting these interviews, their acceptability by participating employees, and their potential application to inform retention strategies in learning health systems (LHS) like the Veterans Health Administration (VA). Methods: We conducted 24 stay interviews with current WH-PACT employees, including women’s health primary care providers (WH-PCPs, n = 7), registered nurses (RNs, n = 6), licensed practical nurses (LPNs, n = 6), and medical support assistants (MSAs, n = 5) with established tenure (greater than 3 years for MSAs and LPNs, and greater than 5 years for RNs and WH-PCPs) at VA medical centers and community-based outpatient clinics. Using rapid qualitative analysis, we summarized interview transcripts for preliminary insights that describe the utility of stay interviews to collect feedback on clinician and non-clinician employees’ experiences of work in VA women’s health primary care. Results: The responses and feedback from our participants indicate that stay interviews are potentially feasible for LHSs to use as a retention tool and are acceptable to employees for sharing their perspectives. Conclusion: We discuss who should conduct stay interviews and the potential ethical implications organizations must consider before conducting them.