Clinician Turnover 2024
Stemming the Rising Tide
On the heels of COVID-19, the healthcare industry is facing a second epidemic—one of clinician turnover. Grappling with burnout and misaligned priorities between themselves and organization leaders, many clinicians are considering their options: do they stay with their current organization, seek employment at another hospital or clinic, or leave healthcare altogether? For healthcare organizations, failing to address these challenges will lead to high turnover costs and further frustration for clinicians who remain.
To better understand this epidemic, the KLAS Arch Collaborative is—for the first time—asking clinicians who report plans to leave their organization where they intend to go. This report examines the cost of clinician turnover, how burnout and the EHR experience affect staff retention, and best practices from organizations who have improved their clinicians’ satisfaction and reversed turnover trends.
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Defining “At-Risk” Clinicians
To gather data about turnover, KLAS asked clinicians how likely they are to leave their current organization within the next two years. Clinicians could choose from the following response options:
- Very unlikely
- Unlikely
- Neither unlikely nor likely
- Likely
- Very likely
Arch Collaborative data shows that clinicians in the latter three groups (bolded above) are the most likely to actually leave their organization. They are referred to collectively throughout the report as “at risk.”
THE STATE OF CLINICIAN TURNOVER
Potential for Turnover Is Higher than Ever—and the Cost Is Steep
Since 2019, the risk of clinician turnover has steadily increased. In 2024, nearly half of nurses and physicians are classified as at risk.
Of these at-risk clinicians, 21% of nurses and 13% of physicians actually leave.
This turnover results in steep costs for organizations—the average cost of turnover for a nurse and physician respectively is $56,300† and $500,000–$1,000,000‡.
† This calculation is based on data from a 2024 study by NSI Nursing Solutions, Inc.
‡ This calculation is based on data from a 2017 study published in JAMA Internal Medicine.
Drivers of Turnover Are Multifaceted—the EHR Doesn’t Have to Be One of Them
The good news is that over half of clinicians plan to continue practicing medicine. More than ever, these clinicians can be selective and choose organizations that prioritize their satisfaction and wellness.
While the factors that influence at-risk clinicians to leave are multifaceted, Arch Collaborative data indicates that burnout and EHR frustrations both play a part. In particular, these issues are key drivers for clinicians who report plans to leave not just their organization but the healthcare industry entirely.
Voice of the Clinician
“Symptoms of burnout within our division are primarily due to being understaffed and having inadequate time to address [inboxes] during the workday. We were just told that our division chief is leaving, and we already have four or five positions open within our group. EHR optimization in terms of improving inbox management efficiency could be extremely helpful, both in reducing burnout and in improving our ability to recruit additional physicians.” —Physician
“[The EHR] is my main barrier to quality patient care. It significantly contributes to my feelings of burnout as I have to choose between moving slowly and inefficiently or providing a lower quality of care.” —Physician
“It takes much longer to chart on patients here due to [the EHR’s] lack of user-friendly charting. I feel this is contributing to our low nurse retention as we spend so much more time charting and have less ability to take breaks.” —Nurse
HOW TO STEM THE TIDE OF TURNOVER
Some Clinicians’ Plans to Leave Have Changed Due to Reduced Burnout—Enhanced EHR Education Helped Change Their Minds
While the current state of clinician turnover may seem bleak, hope is not lost. At-risk clinicians’ plans to leave can be changed when healthcare organizations address their needs.
Of clinicians who have measured with the Arch Collaborative over time, those who were previously at risk and decided to stay at their organization report reduced burnout is the top factor that altered their future plans. The second-most impactful factor is enhanced EHR education, which is a successful way to improve clinicians’ lives and treat burnout symptoms.
Top Factors That Changed At-Risk Clinicians’ Plans to Leave
- Reduced burnout
- Enhanced EHR education
- Enhanced IT support
Lack of EHR education can be detrimental for at-risk clinicians. 40% of nurses and 59% of physicians who did leave their organization report they wanted improved education.
Voice of the Clinician
“Listen to physicians and fulfill their needs. The lack of accountability from leadership is astounding. There is also a clear problem with transparency between the medical group, which is only interested in finances, and the institution that purportedly values high quality and complex care. Fix leadership and support physicians adequately.” —Physician
“Take action when staff members speak up about problems in the office. I often think about leaving because there is no action and I feel as if my voice doesn’t matter. I feel like I work hard for others not to work at all. Often, I am assigned a task because other coworkers won’t complete theirs. There is no discipline for them, so I get stuck with the burnout.” —Nurse
“I know there is training available and that it would help. But every time I have tried to sign up for a session, something else comes up. There is no time for training because it is not prioritized. It takes time to personalize and set up the system, and workarounds become the norm rather than efficiency and improvement." —Physician
“There is a significant lack of standardized training in our organization regarding [our EHR]. One of the nice things about [our EHR] is that there are several different ways to accomplish the same thing, but a lack of a uniform training process leads to more confusion than efficiency most of the time for new hires, even at the supervisory level. I have been at [this organization] for a year and have never received any formal training or continuing education on how to use [our EHR]. I have just relied on the help of my coworkers and Google.” —Nurse
Some Organizations Have Reversed Predicted Turnover Rates—What Best Practices Do They Suggest to Get At-Risk Clinicians to Stay?
A few healthcare organizations have successfully improved their clinicians’ satisfaction and, thus, reversed predicted turnover trends. These organizations generally implement similar best practices, focusing on listening to clinicians, implementing their feedback, balancing workloads, and ultimately improving clinician well-being. See below for strategies that all organizations can implement at any time to improve the clinician experience and retention.
Listen better
- When making decisions, consider impact on patients—many clinicians feel their organization makes decisions to improve finances, not patient care
- Engage with clinical leaders to communicate reasoning behind organization decisions and emphasize focus on patients
- Enable lower-level managers to articulate why decisions are made and how they will improve the organization’s mission
Arch Collaborative Case Study:
Read here to see how Yuma Regional Medical Center addressed high burnout rates and improved organization communication by adopting a dyad leadership structure.
Improve technology experience
- Connect with clinicians to identify improvement opportunities and implement their feedback
- Communicate with clinicians about upcoming technology changes
- Offer personalized training for new tools or technology optimizations
- Adopt AI automation and measure results to see how it impacts clinician burnout
Arch Collaborative Case Study:
Read here to see how SUNY Upstate Medical University used their Arch Collaborative results to form the EPIC4Me initiative, thus fostering a more collaborative environment.
Enable autonomy
- Enable clinicians to control parts of their workload, allowing them to focus more on patients
- Manage staffing levels so that clinicians can have autonomy and flexibility with patient care
Arch Collaborative Case Study:
Read here to see how Novant Health built a culture of empathy and accountability by using metrics that encourage well-being and hold providers accountable for their performance.
Invest in wellness
- Implement a chief wellness officer (CWO) & staff resources
- Provide budget to wellness officers
- Consistently measure burnout symptoms to identify areas of concern
- Provide psychological resources, financial planning, and healthcare education to enable staff to deal with complex issues (e.g., terminal illnesses, bankruptcy)
Arch Collaborative Case Study:
Read here to see how Indiana Primary Health Care Association developed the Workforce Support Toolkit—a stress screening and resource guide—to address burnout among clinicians.
Other KLAS Resources
The Arch Collaborative Provider Guidebook and the Arch Collaborative Nursing Guidebook provide strategies for improving clinician satisfaction according to the Arch Collaborative EHR House of Success.
The following guides detail offerings from software vendors and services firms that can help address EHR education, efficiency, and governance challenges:
Clinician EHR Efficiency Software and Services 2023
EHR Education Software and Services 2023
Healthcare organizations that have adopted ambient speech technology report seeing decreased clinician burnout, increased user efficiency, and decreased turnover rates. To learn more about ambient speech purchasing trends, read KLAS’ recently published Decision Insights report.
Voice of the Clinician
“I love my job, but at one point, I was considering a change because I was experiencing burnout. . . . Everything that was most important to me was always on the back burner, and physical and mental fatigue were very apparent. I recently started using the [ambient speech product]. This has made a big difference. I am no longer looking for a change in my job. . . Thank you for caring enough to institute the [ambient speech product] to help providers with burnout.” —Advanced practice provider
What Is the KLAS Arch Collaborative?
The Arch Collaborative is a group of healthcare organizations committed to improving the EHR experience through standardized surveys and benchmarking. To date, almost 300 healthcare organizations have surveyed their end users and over 500,000 clinicians have responded. Impact reports such as this one seek to synthesize the feedback from these clinicians into actionable insights that organizations can use to revolutionize patient care by unlocking the potential of the EHR.
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Clinician Relationships and Communication, Clinician Wellness and Reducing BurnoutThis material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2019 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.