Driving Action To The Most Local Level

Founded by veteran healthcare professionals in Brentwood, Tennessee, Renal Advantage, Inc. (RAI) is one of the nation’s leading providers of dialysis services. With over 135 freestanding centers nationwide, and additional centers developing rapidly, RAI operates as a center-focused organization in order to provide the best experience for both their patients and health care providers. Linda Meador, Vice President of Human Resources emphasizes their commitment to employee satisfaction, saying, "We believe our employees are a primary customer."

RAI was formed with the purchase of 73 freestanding dialysis centers when two dialysis service providers, DaVita Inc. and Gambro Healthcare, merged. After the merger, RAI leadership was interested to see exactly how their employees were affected. Meador explains, "We wanted to be able to understand our employees’ wants, needs and their perception of the organization at that time. We needed to get a really good feel for how well we did with the integration of two very different companies."

Senior Leadership at RAI recognized that while they were not the largest provider of dialysis services in the United States, they were going to differentiate themselves as a preferred employer; therefore, their competitive advantage would be their workforce. RAI chose to focus on two major areas – supply/demand and attraction/retention. With an aging nursing population, a predicted 20% gap in the supply and demand of nurses by 2020 and the knowledge that 17% of healthcare workers are dissatisfied, Linda Meador and her team understood just how costly turnover can be.

In order to reduce costs associated with employee disengagement and turnover, Renal Advantage Inc. partnered with The Work Institute (TWI) to conduct a baseline survey with their entire employee population. RAI needed to know the preferences, expectations, and intents of their workforce in order to drive action at the most local level. Keeping their finger on the pulse of the workforce provides the organization with the opportunity to address disengagement before employees walk out the door.

RAI focused on three key areas for improvement: the perception of RAI as an employer, the quality of supervisor performance, and overall turnover. For both the perception of RAI as an employer and the quality of supervisor performance, all supervisors were responsible for driving the percent of fair/poor responses below 15% and the percent of excellent responses above 30%. As an organization, Renal Advantage endeavored to have the total “intent to leave within one year” be less than 15%. The Human Resources (HR) Department at RAI served as the key driver of this process. With the support of the executive management team, HR worked with TWI to develop the questionnaire. To maximize RAI’s ability to set targets and measure the progress toward their goals, a 5-point rating scale question design (Excellent, Very Good, Good, Fair, and Poor) was used. Follow up questions such as “Why?” and “What would it take to get an excellent rating?” allowed TWI interviewers to probe employees for more detailed information. The qualitative data provided the organization with actionable data that drove evidence-based decisions to earn employee’s highest endorsement.

In February 2006, TWI surveyed the entire workforce, to gather baseline data, and goals were established based on the initial results. Then in October 2006, TWI interviewed 50% of the workforce to begin the bi-annual pulse surveys. Once the two data points had been collected and analyzed in early 2007, Meador and Christie Carlisle, Director of Human Resources, traveled to each RAI region to equip supervisors with the tools and techniques to build and execute action plans.

Following the initial training and goal setting, supervisors had three months to evaluate their own data and present action plans to their Center and Regional Directors. The quantitative rating scores coupled with verbatim responses allowed each supervisor to gain a robust understanding of his or her strengths, weaknesses, and opportunities for improvement. By the end of 2007, RAI’s Human Resources team had evaluated all interventions and celebrated the success of the evidence-based action planning initiative using data obtained from the employee pulse surveys.

Following the internal adjustments, employee pulse surveys indicate that satisfaction with RAI drastically increased between 2006 and 2008. The number of employees that rated their employer as 'excellent' increased by 22%; the number of employees rating their supervisors as 'excellent' improved by 10%; and the number of employees with an intent to leave within the first year at RAI decreased from 22% to 16%. RAI leadership came away "surprised that we were able to hit some of our targets so quickly."

In 2008, Renal Advantage, Inc. was designated as a five-star Certified Preferred Employer (CPE) by The Work Institute as a result of their dedication to continuous improvement. CPE is a brand that ensures employees, both current and potential, that RAI is constantly striving to better their employer-employee relationship. They have found the brand to be a beneficial marketing tool, noting that "it is something we can market, and a good way to recruit employees.' RAI and TWI refresh data with employee pulse surveys every 6 months.

About Renal Advantage Inc.

Based in Brentwood, Tennessee, Renal Advantage Inc. provides dialysis services to patients with chronic kidney failure, also known as end-stage renal disease (ESRD). Renal Advantage provides services to over 11,000 patients in 138 dialysis centers in 18 states across the U.S.

The Company also delivers laboratory services through RenaLab, a state-of-the-art independent clinical laboratory located in Jackson, Mississippi. Founded by veteran healthcare executives, the Company’s growth plan began with its acquisition of 73 dialysis centers in October 2005, which was financed in partnership with Welsh, Carson, Anderson & Stowe. For more information, visit the Company’s website at www.renaladvantage.com.