Growing hospital addresses retention and recruitment


Over the past three months, concerns have been raised about retention and turnover rates within the Upper San Juan Health Service District (USJHSD), which includes the Pagosa Springs Medical Center (PSMC). The SUN contacted the district to obtain information about employment, which is outlined below.

Turnover statistics

PSMC provided a breakdown, by position and year, of employees no longer working for the district from June 2010 to June 2, 2014. USJHSD has not historically kept track of why employees left if they chose to self-terminate. The information given to The SUN listed a termination date, but did not indicate if the positions were self-terminated or if an employee was asked to leave.

Through June 2 of this year, 16 employees left the hospital district. Broken down by department:

  • Ambulance — three.
  • Medical Records — three.
  • Rural Health Clinic — two.
  • Operating Room (OR) — two.
  • Ultra Sound — two.
  • Emergency Room (ER) — one.
  • Recovery Room — one.
  • Housekeeping — one.
  • Medical/Surgical — one.

Data reported for 2013 showed 64 employees leaving the district. The top five areas to lose staff members are as follows:

  • Clinic — 12.
  • Radiology — seven.
  • Medical/Surgical — six.
  • Ambulance — five.
  • Housekeeping — four.

Fourteen other departments lost three employees or fewer in 2013.

In 2012, 37 staff members left or were asked to leave the district. Twenty-five staff members in 2011 and six staff members in 2010 were no longer employed by USJHSD.


As reported in earlier editions of The SUN, the topic of employee turnover and recruitment has been discussed at several USJHSD board meetings. CEO Brad Cochennet informed the board at the May 27 meeting, that much of the turnover experienced recently coincides with loan-repayment contracts coming to an end.

In the past, the district entered into contracts with professionals coming out of medical school that offered loan-repayment assistance. Once contracts ended, some of those professionals chose to relocate, leaving vacancies within the district.

Now, recruitment efforts to fill those positions and others are focused on bringing in mid-career professionals to work for PSMC. By bringing on established professionals, the CEO hopes to avoid high turnover rates in the future.

Board treasurer Karl Irons also addressed the issue of employment during the May meeting, attributing the loss of some personnel to the implementation of the electronic health records system, Cerner.

Irons wrote in his financial report, “Productivity due to Cerner has taken a serious hit. We’ve lost personnel, in part due to the software installation ... Our comptroller quit after returning from a Cerner training session. Our Pharmacy manager has resigned his position as manager and is working part time. Our Facilities manager is retiring at the end of May. Our Clinic Manager is reconsidering her position as manager but would stay in another position. Our longest tenured Clinic Doctor has resigned. And it’s probably not over.

“While change is inevitable in any business, there is a short-term cost while replacement personnel learn our systems. Until they do, their productivity will be sub-optimal and worse, the productivity of those responsible for training them will suffer. Consequently, we have ceased to be optimistic about our chances of meeting our year-end goals without additional help.”

While positive updates about recruitment and staffing efforts have been given since the May 27 meeting, The SUN contacted Claire Bradshaw, PSMC’s director of marketing and development, to get a more in-depth explanation about current turnover rates and the district’s response.

Bradshaw informed that USJHSD has very recently decided to track key metrics related to recruitment and retention and has also established a retention committee comprised of employees from several departments.

The director wrote in an email, “Our plan is to formalize a retention strategy, which will include establishing measurable and trackable performance objectives, clear and confidential employee surveys and exit interviews, an effective whistleblower/ombudsman policy, and a strong set of employment loyalty incentives ...”

The hospital reports that they are now “tracking at a 50% increase in patient visits compared to 2013.”

Bradshaw commented,

“Our challenge today is how to manage this growth while continuing to provide excellent patient care and a supportive and rewarding environment for our employees.”

The director continued, “our successes over the past couple of years have not been without costs and challenges. Namely, implementing an organization-wide electronic health record system, launching new women’s health and orthopedics programs, creating a live phone reception team in our primary care clinic, and grappling with an extreme space shortage, which sees our physicians currently using office space in what was previously ‘Housekeeping 6.’”

The district has been in the process of drafting and getting public feedback and support for an expansion project to help remedy the fact that they are out of space. More information about its plan is available with the 2013 annual report online at

Additionally, the district has hired its first-ever chief operating officer, Kyle Kellum, “a proven professional with a focus on customer service, not just for our patients, but for our ‘internal customers’ — our employees,” Bradshaw informed.

The marketing and development director summarized USJHSD’s position by writing, “The on-going challenge will be to recruit and retain experienced healthcare professionals for our changing population and for our unique location ... It’s been a lot to handle and we know the pressure it has exerted on our employees.”

Because data is just now starting to be collected, Bradshaw stated that the district will share more information related to recruitment and retention as it becomes available.


PSMC is eagerly awaiting September, the month when many of the newly hired staff will begin work.

Cochennet gave the board of directors an updated list of recruitment efforts during the July 22 meeting. Joining the team in September will be the following staff members:

  • Dr. Mike Gruber, a family practice doctor with 25 years of experience, will be in the clinic full-time starting Sept. 2.
  • Dr. Robin Richard, board certified in internal medicine, will begin work as a part-time hospitalist and clinic provider.
  • Dr. Tiffany Fonte-Ordonez, board certified in internal medicine, will be working as a hospitalist.
  • Tim Bewley, with 25 years experience as a PA-C (physician assistant-certified), will fill roles as a hospitalist and clinician.
  • Dr. Kent Aikin, with more than 30 years experience, will work part-time as a hospitalist.

Recently hired, Dr. Lynn Nauman, board certified in emergency medicine, began this month working part-time in the emergency department.

Joining the team in January 2015 will be Dr. Jeff Levison, board certified in internal medicine, to work full-time in the clinic.

Though it was a rough start, the CEO reports that recruitment efforts are going well, with several other providers being interviewed and considered for both full-time and part-time positions.