Fostering Engagement Is Vital to Improving Workforce Retention

For hospital and health system leaders, boosting retention and lowering turnover are more than achievable by addressing the biggest drivers of dissatisfaction in the workplace.

Lack of trust and low engagement are causing more and more healthcare workers to leave their organizations, according to a report from Press Ganey, putting the onus on hospital CEOs to commit to building social capital to ensure a sustainable workforce for the future.

The analysis, based on feedback from 2.3 million employees across more than 400 health systems and 15,200 locations, revealed that worker engagement is declining. After a slight improvement in 2023, employee engagement dropped 0.02 points on a five-point scale in 2024. Disengaged employees are 1.7 times more likely to leave their roles, especially early-tenure staff and younger-generation workers, Press Ganey highlighted.

While employee turnover dropped from 20% in 2023 to 18% in 2024, a dip in engagement, particularly among frontline staff, could reverse that trend.

The widest declines in engagement were seen in advanced practice providers (-0.08 points) and physicians (-0.06 points), indicating a need for organizations to create alignment with providers by involving them in decision-making and making them feel supported.

“In a time of uncertainty, trust is our most vital asset,” Patrick T. Ryan, CEO and chairman of Press Ganey Forsta, said in a statement. “Healthcare workers are telling us what they need—not just as individuals, but as teams. They’re asking to be seen, heard, and supported in delivering safe, high-quality care. The organizations that rise to this moment, by building cultures rooted in respect, shared purpose, and real partnership, won’t just retain their people. They’ll unlock the kind of workforce resilience and innovation that transforms care for generations to come.”

Generational differences

As millennials and Gen Z continue to make up a greater proportion of the workforce, healthcare leaders must recognize and act on younger generations’ motivations.

Millennials and Gen Z showed the lowest levels of engagement in Press Ganey’s report, with scores of 3.85 and 3.81, respectively. For comparison, the national average engagement score is 3.97.

The lack of engagement resulted in a turnover rate of 38% for Gen Z, the highest among all generations, and 22% for millennials. The turnover rates for Generation X and baby boomers were 14% and 19%, respectively.

Unlike older generations, Gen Z and millennials place more value on factors like career development, equity, relationships with managers, and work-life balance. Hospital CEOs should be mindful of shifting expectations and desires among their workers, and provide a wide array of benefits with far-reaching appeal.

How CEOs can respond

Hospital leaders need to look beyond compensation to improve retention and focus on drivers of engagement, like trust, respect, and belonging, Press Ganey stated.

Segmenting engagement data is another strategy that can benefit organizations, according to the report. Separating insights by role or generation can allow CEOs to identify and implement targeted solutions for better outcomes.

“The most resilient organizations are winning trust team by team,” said Thomas H. Lee, MD, CMO at Press Ganey. “They’re evolving how they listen—using real-time feedback from rounding, huddles, and digital tools—and they’re acting with urgency. When leaders engage directly with the front line and respond visibly to their needs, it builds connection, confidence, and commitment. These are proven strategies that enable organizations to work with their frontline to find solutions and drive improvement.”