Applied Final Project:

Effects of Employee Turnover in Emergency Preparedness

Ester Todd

Department of Leadership Studies, Fort Hays State University

LDRS: 802 Organizational Systems, Change, and Leadership

Dr. Jeni McRay

May 13, 2021

Applied Final Project Proposal:

Effects of Employee Turnover in Emergency Preparedness

Employers across the United States are facing growing concerns with workforce management,

specifically in the areas of employee availability and turnover rates. In the U.S. Department of Labor’s

analysis on trends in job openings and turnovers, they recently found that it is increasingly more difficult

for employers to fill their job openings (Riley et al., 2020). The Society for Human Resource

Management has noted that we have more jobs now than people to fill them, indicating that labor

shortages will to continue grow (Tarallo, 2019). In the most recent data from 2017 and 2018, Kansas saw

a 19% decrease in annual fill rates, defined as the hires to job openings ratio. In correspondence with the

availability of job openings, Kansas employers in Kansas have also experienced one of the higher

turnover rates in the Midwest as employees seek greener pasture elsewhere (Riley et. al, 2020).

What causes high employee turnover rates? How does this affect employers and their

organizations? What strategies can be used to increase retention rates? This report addresses these

questions through a systems analysis of the Preparedness Program within the Kansas Department of

Health and Environment (KDHE). Government organizations are not immune to the same turnover and

retention issues faced by private and NGO industries, and in fact offer valuable cross-sector insight due to

the availability and public nature of annual government labor reports and trends. The data used in this

analysis will focus primarily on sources published prior to the COVID-19 pandemic, as official labor

reports throughout the pandemic are still in progress.

Background

The KDHE was created in 1974 when the State Department of Health and the State Board of Health were

combined. Kansas is one of twenty-seven states that has a decentralized public health system, meaning that

local health departments in each county have jurisdiction over most public health issues (Barbacci, 2012).

The KDHE provides oversight, resources, and suggestions to each county. The KDHE’s vision is “Healthy

Kansas living in safe and sustainable environments.” The organizational mission is “To protect and improve

the health and environment of all Kansans” (Kansas Department of Health and Environment, 2021).
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Organization Structure

The agency employees between 800-1,000 employees, fluctuating based on job demand and

funding availability (Department of Administration, 2016). The agency has also hired 100+ temporary

employees as part of their surge response to the COVID-19 pandemic. KDHE’s top official is the Secretary

(currently Lee Norman, MD), a position appointed by the Kansas Governor. This position also serves as

the State Health Officer. Organizationally, the agency is organized into four main divisions: Administration,

the Division of Health Care Finance, Division of Environment, and the Division of Public Health. This

report focuses on the Preparedness Program, which is an area that falls under Community Health Systems

in the Division of Public Health. The Preparedness Program usually has a twelve person staff that provide

guidance on how to prepare for, mitigate, respond to, and recover from disasters, infectious disease,

terrorism, and mass casualty emergencies.

Overview of Problem

Employee retention is an important measurement for any organization, but it has specific

implications for any fields related to crisis response. Preparedness manages confidential information and

systems within the healthcare industry, works with homeland security sensitive data, and plans the State’s

responses to bioterrorism events, manmade disasters, and natural disasters. When an employee leaves the

agency, communication and data system passwords and access must be immediately changed to maintain

confidentiality. Depending on access levels, some employees are not allowed to complete their two-weeks

once they have submitted their resignation. In addition, because so much of the program is dependent on

information sharing, community relationships, and data gathering, when an employee leaves a lot of

irreplaceable knowledge is lost.

In a staff of twelve, the Preparedness Program has averaged two to four position turnovers every

year for the past five years. This high turnover rate has led four major issues. First, the of program suffers

from lack of continuity, meaning that each time new directors or supervisors are hired, the focus and

processes shift. Second, the program has seen a lot of knowledge loss as employees rarely have the
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opportunity to train a replacement and few positions have a desk manual or formal process to transfer

knowledge before departure. Third, employees experience decreased moral. When another supervisor

leaves it often is interpreted as giving up. Steady moral is also impacted by the constant change in team

dynamics, as strong interpersonal relationships take time to develop. Finally, high employee turnover has

led to poor relationships with partner organizations, such as local health departments and hospitals.

Changing leadership and a lack of employee expertise and knowledge within the Preparedness Program

create trust issues for partner organizations, as they look to the State office for guidance, resources, and

support.

Research

High employee turnover rates increase costs to the organization in monetary terms, morale and

culture expenses, and production metrics. According to research by Cloutier et al., recruiting a new

employee can cost up to 200% of the previous employee’s salary (2015). A report published by the Work

Institute in 2018 found that U.S. employers would pay $600 billion in turnover costs in 2018, with the

expectation that those costs would continue rising (Nelms, 2018). Cloutier et al. also found that

advertising and salary overlapping have impacts employee morale, and turnovers can lead to missed

production goals (2015). Time is also expended when organizations have to onboard and train new hires.

Causes of Turnover Rates

In the 2018 Retention Report: Truth and Trends in Turnover report, the Work Institute reviewed

234,000 exit interviews to determine the top three reasons for employees voluntarily leaving their jobs:

career development, work-life balance, and manager behavior (Nelms, 2018). Other top categories for

leaving included compensation and benefits, job characteristics, relocation, retirement, well-being, work

environment, and involuntary (termination) (Nelms, 2018). When looking at the root causes for employee

turnover rates, I have grouped the types of reasons for employee’s leaving their jobs into two main sets, as

detailed below in Table 1.

Table 1

Organizational Reasons Environmental Reasons

Can be anticipated Cannot always be anticipated

Can be mitigated The organization has little ability to mitigate

Employers should focus on these issues. Employers should always be prepared for

unexpected situations.

Examples: Pay satisfaction, organizational Examples: Health issues, family complications,

support, employee engagement. pandemics

When looking at these reasons, the organizational set of reasons are the most capable of being mitigated

and addressed by the employer, and therefore will receive the most focus in this report.

Research indicates that the top reason for voluntary turnover is career development, accounting

for 21% of all reasons that employees left their positions in 2017 (Nelms, 2018). Interestingly, this same

study also points out the correlation between the economy expanding and career development reasons

increasing. Employees want to learn new skills, have growth and training opportunities, and have

promotion opportunities. However, this focus on career development is strongest when job markets are

favorable for seekers, and employees are not afraid of losing their positions. Marvin Weisbord backs this

up with his work tying Maslow’s Hierarchy of needs with employee satisfaction. Essentially, employees

whose basic needs are met require more complex satisfiers such as growth and training opportunities,

versus just receiving a paycheck (Weisbord, 2012). The Work Institute warns that “as career opportunities

increase, employers must take steps to understand the needs, preferences and goals of their workers or

miss out on opportunities to keep workers that they need” (Nelms, 2018).

Industry Data

In a 2016 publication by the American Public Health Association, 40% of federal, state, and local public

health staff said they were “either considering leaving their organization or planning to retire by 2020”

(Leider et al., 2016). This study looked at the public health workforce and their drivers for job satisfaction
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and intent to leave an organization. Staff who were younger, more educated, and more diverse had the

highest indication rates of looking elsewhere for employment within the next year (Leider et al., 2016).

In order to better understand the satisfiers and turnover rates within the public health emergency

preparedness workforce, I conducted a survey on employee satisfaction with a target audience of

emergency preparedness professionals (Appendix A). I disseminated the survey via email and shared it on

several social media groups for preparedness professionals. 63 individuals completed the survey. Of these

individuals, 60 reported that they found their work meaningful. 27 reported that they have considered

looking for another job, with 13 of these saying they were looking within the next month. 54 survey

responders indicated that they feel secure in their current positions. The top three (potential) reasons for

leaving their current positions are: work-life balance (43), lack of career development opportunities (38),

and compensation and benefits (16). The final survey question asked: If you are considering leaving your

position, what is one thing that your employer could do to help you reconsider? 11 participants selected

increase compensation and benefits; 18 selected provide opportunities for advancement and promotion;

21 selected provide opportunities for learning and growth; 13 selected improve company culture and

environment.

The American Journal of Public Health found the main correlates of job satisfaction to be pay

satisfaction, organizational support, and employee involvement (Leider et al., 2018). Their research found

that public health staff largely believe that their jobs are meaningful and they enjoy the work, but pay

dissatisfaction is high. The survey that I conducted also backs this up as compensation and benefits was

one of the top three potential reasons for leaving a current position.

Recommendations

Employee Retention Strategies

Retaining good employees within the Preparedness Program requires cooperation and support

from the whole system, but it must start at the policy level. “Policymakers, funders, and educators also

have significant roles to play in supporting the governmental public health workforce into the 21st
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century, including creating (and funding) a shared workforce development agenda and creating robust

programs to recruit and retain the next generation of public health practitioners” (Leider et al., 2018).

The Work Institute found that 77% of the employees who quit “could have been retained by

employers” (Nelms, 2018). The main factors in employee retention are: 1) focusing on a “strategic intent”

by maintaining a clear vision, mission, values and policies, 2) establishing transparent and effective

communication between leadership and employees, 3) maintaining a diverse, inclusive, and integrated

workforce, 4) understanding employee credentials and job compatibility, and 5) offering training and

development opportunities to employees (Cloutier et al., 2015).

These factors apply to a whole system more than individual components, and as such, it might

seem overwhelming to try and change all of them at once. Given that the Preparedness Program is part of

a large, governmental organization, it is important to remember that change takes time to implement and

must be done strategically. One way to strategically implement change in large systems is through

leverage points, or “places in the system where a small change could lead to a large shift in behavior”

(Meadows, 2008). The leverage points below impact one or more of the main factors in retention as

identified by Cloutier et al.

Methods

Step One

One leverage point that can be addressed in this system is information flows. Information loss is one of

the biggest issues with employee turnover in the preparedness program, “missing information flows is one

of the most common causes of system malfunction” (Meadows, 2008).

Actionable Step: Create a feedback loop at the of meetings to ensure that information flow is

consistent between leadership and employees.

Step Two

Another leverage point that can be addressed is goals. Oftentimes people within systems do not

understand the goals of the whole system, which impacts their commitment and overall effectiveness

(Meadows, 2008).
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Actionable Step: Engage employees in goal setting of the whole program throughout the year,

and review the annual goals for the agency in a team meeting. Ask employees what their interests and

strengths are and integrate employee ideas with organizational goals.

Step Three

The last leverage point is the organizational paradigms, or looking at what is believed about the system—

what can and cannot be done—how the program can and can not function, how employees can and cannot

do their work (Meadows, 2008).

Actionable Step: Engage employees in actively creating new processes and procedures; provide

training opportunities to encourage growth.

Conclusion

Through literature analysis and a survey disseminated to emergency preparedness professionals, this

report has identified why employees leave their jobs, how this affects their workplaces, and how

employers can improve their retention rates. This report also provides three actionable steps that the

Preparedness Program can take to start improving employee retention rates.

References

Barbacci, K., … Leep, C. (2012). State Public

Health Agency Classification: Understanding the Relationship Between State and Local Public

Health. www.astho.org. https://www.astho.org/Research/Major-Publications/ASTHO-NORC-

Governance-Classification-Report/#:~:text=State%20Categorization,-

After%20receiving%20information&text=Based%20on%20this%20classification%20syste

m,remaining%20five%20states%20are%20mixed.

Bureau of Labor Statistics. (2021, May 7). The Employment Situation - April 2021. BLS.gov.

https://www.bls.gov/news.release/pdf/empsit.pdf.

Bureau of Labor Statistics, Riley, K., Nezamis, E., & McCarthy, M., bls.gov (2020).

https://www.bls.gov/opub/btn/volume-9/job-openings-and-labor-turnover-trends-for-midwestern-

states-in-2018.htm.

Cloutier, O., Pemberton-Jones, E. J., Hill, C., Felusiak, L. (2015). The Importance of Developing

Strategies for Employee Retention. Journal of Leadership, Accountability and Ethics, 12, 119–

129.

Department of Administration. Phillips, M., State of Kansas. Workforce Report 2016 (2016). State

of Kansas. https://admin.ks.gov/docs/default-source/ops/workforce-

reports/workforce16.pdf?sfvrsn=a5d2b3c7_4.

Doheny, K. (2021, February 23). Top Challenges for Managers in 2021. SHRM.

https://www.shrm.org/resourcesandtools/hr-topics/people-managers/pages/manager-challenges-

2021.aspx.

Kansas Department of Health and Environment. (2021). Administration. KDHEKS.gov.

https://www.kdheks.gov/administration/. Meit, M., Kronstadt, J., Brown, A., Pearsol, J., Katie,

Leider, J. P., Harper, E., Shon, J. W., Sellers, K., & Castrucci, B. C. (2016). Job Satisfaction and
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Expected Turnover Among Federal, State, and Local Public Health Practitioners. American

Journal of Public Health, 106(10), 1782–1788. https://doi-

org.ezproxy.fhsu.edu/10.2105/AJPH.2016.303305

Meadows, D. (2008). Thinking in systems: A primer (D. Wright, Ed.). White River Junction, VT: Chelsea

Green Publishing. ISBN: 978-1-60358-055-7

Nelms, D. (2018). (rep.). 2018 RETENTION REPORT Truth & Trends in Turnover. The Work Institute.

Retrieved from

https://www.montana.edu/mmec/documents/reports/2018%20WorkInstitute%20Retention%20Re

port.pdf

Tarallo, M. (2019, August 16). How to Reduce Employee Turnover Through Robust Retention Strategies.

SHRM. https://www.shrm.org/resourcesandtools/hr-topics/talent-acquisition/pages/how-to-

reduce-employee-turnover-through-robust-retention-strategies.aspx.

Weisbord, M. R. (2012). Productive workplaces dignity, meaning, and community in the 21st century.

San Francisco, CA: Jossey-Bass.

Appendix A

Job Satisfiers in Emergency Preparedness Survey Questions

1. How long have you worked in the field of emergency preparedness?

2. Do you find your work meaningful?

3. Are you inspired by the purpose and mission of your organization?

4. On a scale of 1-10, with 10 being optimal, how would you rate your work-life balance?

5. Do you feel valued at work?

6. Do you find your work challenging?

7. How often do you feel stressed at work?

8. Are you considering looking for another job outside of your organization?

9. Do you believe that there is an opportunity for individual career growth and development within

the company?

10. How likely would you be to refer someone else to work at your organization?

11. Have you interviewed for another job in the past three months?

12. How secure do you feel in your current position?

13. If you were to leave your position in the near future, what do you think would be the most likely

reason?

14. If you are considering leaving your position, what is one thing that your employer could do to help

you reconsider?