Direct support professionals (DSP) provide invaluable services to people with disabilities. However, the DSP turnover rate is disturbingly high, adding considerable stress and expense to the health care system through high recruiting and orientation costs and liabilities associated with prolonged vacancies. These problems are compounded when shortages lead to unqualified applicants (e.g. high school graduates, recent immigrants) filling those positions. These individuals, however, have even higher turnover rates, making such a short-term solution ineffective. The goal, then, of Song Li’s Direct Care Personnel Recruitment, Retention, and Orientation is to offer suggestions for cost-effective DSP human resource management. In particular, Li identifies elements related to employee recruitment and retention, analyzes the efforts of other organizations, and provides strategies for improving staff recruiting and retention.
DSP’s perform a vast number of duties, including personal care, residential counseling, family advocacy, and employment assistance, in an equally vast number of settings, such as group homes, institutions, health care agencies, schools, and camps. Being a DSP necessitates possessing skills to provide the above services. However, the profession suffers from high turnover rates. Li identifies some of the more prominent reasons for this, such as low pay, limited opportunities for career advancement, workers returning to school, and inadequate work hours. Contrary to popular belief, a relatively low pay rate has not been found as a significant predictor of DSP job turnover. There are also several work environment issues that influence high turnover rates, including managers’ poor supervision skills, lack of worker autonomy, inefficient use of staff, and presence of casual and/or unqualified staff. Inconsistent funding and government policy towards DSP’s further inflames retention problems.
In response, Li offers a series of guidelines for improving DSP retention. Foremost, he suggests, employee loyalty begins in the orientation phase. An effective orientation strategy helps develop team spirit from the start and can minimize early burnout. Orientations should also be designed to address new hires’ particular skills and needs. Regular consultation in the early training period is another significant means of preventing early turnover. In general, on-going and meaningful discussion with new hires has been found to be a vital aspect in improving the DSP work experience.
Li’s analysis concludes with two case studies and several well-designed tables of recruitment, retention, and orientation strategies. The role that DSP’s play in our health care system and the current inadequacies that lead to retention problems demands that Li’s report be regarded by all with an interest in this issue.