Retention and Recruitment Strategies

Retention Strategies

Facilities that must recruit new staff on a yearly basis or who rely on hiring Clinical Fellows who leave after completing the clinical fellowship should closely examine the factors that lead to high turnover. Such facilities suffer a double impact because low staffing or prolonged vacancies tend to reduce morale of the remaining staff; in addition, word-of-mouth in the community may label the facility as an undesirable work setting because of the awareness of high turnover rate. In contrast, employees who feel supported and positive about their work setting can be strong recruiters for the facility.

The following are ways to enhance recruitment through your staff:

  • Encourage staff to participate in community professional activities
    • Attend local professional meetings (discussion groups, etc.)
    • Attend state association meetings
  • Develop a relationship with university SLP graduate programs
    • Offer opportunities for volunteer or observation hours at your facility
    • Become a student practicum site (note that staff may need support in terms of reduced productivity or advancement opportunities to obtain recognition for time devoted to student supervision)
    • Offer to speak to graduate students and give them real-world perspective on course work
    • Participate in university job fairs
    • Develop research partnerships
  • Increase visibility of your program and staff in the community
    • Celebrate "May is Better Hearing and Speech Month"
    • Offer free support groups for patients and/or families
    • Offer community in-service programs
    • Hold health fairs


Anecdotally, the most vulnerable settings for recruitment and retention are those that employ only a single SLP, particularly on a part-time basis. A Clinical Fellow or new clinician is likely to feel overwhelmed by the expectations for clinical expertise, documentation, and decision making. Lack of available mentoring for both clinical and professional issues may result in the clinician moving on quickly if another opportunity presents itself. One model that has been used in multifacility organizations is to hire a SLP mentor/supervisor to travel between buildings and be available by phone and/or e-mail to help the clinician develop new skills and to assist with problem solving and particular clinical challenges. Alternative models are peer mentoring or a buddy system, where SLPs feel that they have somewhere to turn for assistance. Additionally, offering refresher courses or training for transitioning into a new position can be helpful. Having existing Clinical Fellow programs in place can also be useful when hiring Clinical Fellows.

Graduate Student Supervision

Clinicians report many positive aspects about supervising students, including being stimulated to develop their own skills by working with students and staying current in the profession by having a relationship with a university program. Clinicians who have supervised students say that it is a personally rewarding experience and that they enjoy it.

ASHA's SLP Health Care Survey 2007 asked respondents to select the top three incentives that would encourage them to supervise a student. The top responses included:

  • Receiving CE credit for supervision (75%)
  • Receiving a financial incentive (59%)
  • Reduced caseload/productivity requirement (45%)

Overall, respondents to the 2009 Health Care Survey indicated that they supervised, on average, 1 student intern in the previous year. This increased to an overall average of 3 students in 2010 (as reported in the 2011 Health Care Survey). Those in pediatric hospitals supervised the most students, with an average of 5 reported for the year prior to the survey year.

SLPs in home health and skilled nursing facilities (SNFs) do not tend to supervise students as often as those in other settings. This is in part due to the nature of the work involved, particularly travel for home health, and the fact that SLPs in these settings do not always carry full-time caseloads and therefore find having a student challenging. Supervising a student in home health or SNFs is not impossible, however, and may be the only way that a student is made aware of these options as a potential work setting. Collaboration between the SLP and administration is vital to the success of a student supervision program.

Continuing Professional Development

Although salary and benefits are important factors in recruitment and retention, there are many other types of benefits and recognition that may be meaningful to clinicians that do not have as great a financial impact on the organization. Opportunities for continuing education are a significant benefit to SLPs. Many states require continuing professional education for maintenance of licensure, and ASHA requires CEUs for maintenance of certification. Facilities can provide continuing education opportunities that are both a financial and convenience benefit to staff by bringing in speakers, participating in ASHA's telephone seminars (which are available to groups), or purchasing ASHA's self-study products.

Resources and Equipment

Clinicians who feel that their work is supported by administration are more likely to stay with an agency or facility. One way of providing this support is to ensure that the facility is well-equipped with up-to-date materials, assessment tools, and technology. Using outdated tests or games, toys, or other therapy materials that are worn out or no longer fully functional decreases morale and may limit the clinician's ability to provide quality services. In addition, having access to technology, such as computers and the Internet, allows clinicians to research current information about patients and treatment options and provides a means of keeping data and producing professional reports and papers.

Promoting Retention Through Recognition

Management research has shown that different types of recognition and benefits are meaningful to different individuals depending on their individual circumstances and preferences. Managers can enhance retention and job satisfaction by customizing the following opportunities or means of recognition to the individual staff member:

Professional Advancement Opportunities

  • Providing in-service programs or presentations
  • Supervising students
  • Peer mentoring
  • Serving on or leading a clinical team
  • Serving on or leading an administrative team
  • Applying for Clinical Specialty Certification (Specialty Certification enables SLPs and audiologists with advanced knowledge, skills, and experience beyond the Certificate of Clinical Competence to be identified by colleagues, employers, referral and payer sources, and the general public) as a Board Certified Specialist [BCS] in a specific area of clinical practice.)

Personal Recognitions

  • Increased flexibility in work schedule
  • Public acknowledgement of performance
  • "Dress down" days
  • Gifts to recognize exceptional performance or customer service
  • Support for transportation or parking costs
  • Additional leave
  • An overall sense that what the clinician is doing is valued by the organization and the people served
  • Consideration of the clinician's suggestions and ideas about service provision, scheduling, staffing, etc.

Additional Strategies

No matter how well-managed and happy a staff is at any facility, vacancies will open and new staff will need to be recruited. Management needs to plan how to reach a broad pool of SLPs who may be interested in the position. In addition to local advertising, the following strategies should be considered:

  • Word of mouth recruitment (with incentives to current staff for successful hires)
  • Graduate programs at universities within the state
  • ASHA's website
  • ASHA's publication, The ASHA Leader
  • Career fair at ASHA's Annual Convention in November
  • State speech and hearing association publications and annual meetings

To compete with other facilities, advertising your position might feature the following:

  • Unique benefits (continuing education, flexible work hours, job sharing opportunities)
  • Unique clinical focus or opportunity of the position
  • Sign-on bonuses
  • Paid moving expenses
  • Reputation of the program or facility

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