Headshot of nursing expert Amy Stewart

Q: What is the difference between staff retention and turnover, and how can I use these metrics in our Quality Assurance Performance Improvement (QAPI) meetings? 

A: While many use these terms interchangeably, they track different concepts. Staff retention is the number of employees who remained employed in a period. In contrast, turnover is the proportion of employee separations in a given time. Retention counts employees who stayed; turnover, the number who left. Many facilities calculate retention on an annual basis, and turnover monthly, though turnover rates averaged across a year also might be relevant. 

How do you calculate these different metrics? For retention, divide the number of employees who stayed by the total number of employees; multiply by 100 to express in percentage. Turnover is the number who separated, divided by the total number. If you start with 100 employees and 60 remain employed, while 40 separated, you retained 60% (60 divided by 100 total employees). You also had a 40% turnover rate (40 who separated divided by 100).

If turnover rates are high, investigate the cause and consider if turnover affects other areas of care. For example, the infection preventionist may need to assess whether infections increased as staff retention decreased.

Monitor both retention and turnover and report them at the QAPI meeting. Report not only the rates, but also their impact and a plan to identify root causes. 

When presenting, use graphs or charts to communicate data visually. Consider the impression of a slide that starts with 10 people icons, but 9 disappear. A picture is worth 1,000 words — and meaningfully conveying these important concepts is key to managing them.