Why stability is the real quality metric
Patient experience improves when teams are predictable: fewer handovers, faster escalation, safer medication practice. Leaders need a small, high-signal dashboard that fits clinical reality—no vanity charts, just measurements that change decisions next week.
The stability dashboard (8 metrics, copy/paste)
1) 90-Day Retention (new starters)
Signal: onboarding quality.
Target band: ≥92% (role/setting dependent).
2) 12- & 18-Month Retention
Signal: culture fit + leadership.
Note: our benchmark placements sustain >18 months for 82% of roles—well above regional averages.
3) Vacancy Rate (by unit/grade)
Signal: workload risk and patient throughput.
Action: ring-fence time for interviews without stealing from safety training.
4) Agency/Locum Utilisation (%)
Signal: cost and continuity strain.
Action threshold: >12% triggers root-cause on rota and scope.
5) Rota Hygiene Index(simple composite)
Inputs: 4-week rota visibility, ≤3 consecutive nights, protected post-call, handover slot present.
Target: “green” ≥3/4 items every week.
6) Sick Leave & Short-Notice Absence
Signal: workload and morale.
Watch trend, not single spikes.
7) Line Manager 1:1 Completion Rate
Signal: support & early escalation.
Target: ≥85% completed on schedule.
8) Safety Micro-Audits Closed
Signal: learning culture.
Target: ≥1 change adopted/fortnight (e.g., IDC compliance, capnography use).
10-minute weekly review (run it the same way every Monday)
Open with two numbers: 90-day retention and rota hygiene index.
Escalation map: any unit red? agree one countermeasure due in 7 days.
Talent pipeline: 3 roles max; confirm interviews do not cannibalise training.
Close: owner + deadline on each action; publish to the leadership channel.
Leading indicators you can influence this week
Onboarding friction tickets closed within 72h (IT access, supplies, EMR templates).
Mentor contact logged by Day 3 and Day 10 for each new starter.
Handover quality: SBAR with two numeric triggers present in random spot-checks.
Room-turnover bundle adherence (clinic): contact times, sharps, IFUs, clean field.
How to use these metrics in hospital vs clinic vs domiciliary
Private hospital
Emphasise rota hygiene and advanced privilege sign-offs; reduce locum use by matching insurance + privileges + scope earlier.
Private clinic
Track room-turnover micro-audits and medication safety IDC; stability follows reliable flow.
UHNWI/home/hotel/yacht
Count transfer-ready visits (plan rehearsed, receiving hospital named). Domiciliary stability = coverage + clarity, not speed.
Red flags—and calm fixes
High 90-day exits → fix Day-0 access, mentorship cadence, and scope clarity (what the role does and won’t do).
Locum >20% → re-scope clinic lists; protect interviews; accelerate two hires that unlock most capacity.
1:1s missed → shrink format (15 minutes, same questions), protect slots in rota.
Handover variance → standardise SBAR with numeric escalation lines; audit 10 notes/week.
Copy-paste templates
Rota hygiene one-liner (lead nurse/physio/consultant)
“Rota green: 4-week visibility ✅ / consecutive nights ≤3 ✅ / post-call protected ✅ / 20-min handover ✅.”
Mentor ping (Day 3/10)
“Welcome check: access, supplies, first week wins, first blocker. Next check on Day 10—call me if scope feels unclear.”
Weekly stability note (for exec chat)
“90-day 94% (↑1), locum 9% (↔), two units amber—clinic flow and night cover. Actions due Friday: clinic IFU refresh, add one float RN to nights.”