Trust is the missing piece in the workforce retention puzzle

People just don’t want to work anymore…for outdated organizational structures that fail to recognize their value, lack opportunities for teamwork and engagement, and don’t actively involve employees in decision making. 

Healthcare employees, both clinical and administrative, are around 1.7 times more likely to leave their roles if they feel disengaged from their work and from the organizational culture, according to a new report from Press Ganey – and with workforce engagement scores on the decline in 2025, this could be a problem for leaders who are aiming to stabilize their staffing situations.  

Low engagement and lack of trust are driving dissatisfaction

The biggest problem is a lack of trust, the analysis of more than 2.3 million healthcare workers revealed. Employees don’t trust that their leaders are on their side when it comes to delivering efficient and effective patient care, which has led to significant drops in engagement scores, particularly among physicians, nurses, and advanced practice providers (APPs). 

Overall, just 69% of healthcare workers feel engaged in their jobs to any degree, with average engagement scores hitting their lowest mark in three years. 

Researchers found that clinician with low engagement scores feel excluded from decision-making that affects their daily workflows and are not getting the support they need to provide optimal care to patients.    

Nor are they convinced that their organizations care enough about the basics of making it home from campus in one piece. Only 78% of employees believe their organization does enough to ensure their personal safety when working on the front lines, a drop of 2 percentage points from the year before.   

Who is the most likely to leave for greener pastures?

The results of poor engagement and lack of trust are predictable: high turnover is poised to get even higher as frustration builds among the workforce. While turnover rates actually dipped slightly between 2022 and 2024 (from 20% in 2022 to 18% in the most recent measurement year), the acceleration of low engagement scores indicates that more workers are likely to start considering making a move soon and reversing the trend. 

For example, nearly a third of APPs (28%) reported exploring other job opportunities within the next three years, with APPs in particular voicing dissatisfaction with a lack of leadership responsiveness to feedback and widespread feelings of being excluded from decisions that directly affect their roles. They are broadly convinced that nothing they say will lead to real or meaningful change, which can be a major driver of disengagement.   

There’s also a generational gap to contend with, as younger workers are among the most likely to be driving the predicted exodus. For example, Millennials and Gen Z reported the lowest engagement scores (3.85 and 3.81 respectively), which are significantly below the average of 3.97 for all healthcare workers.    

Not surprisingly, the turnover rates are following suit. Gen Z workers exhibit a 38% turnover rate, compared to just 14% in the prepping-for-retirement Gen X cohort. Millennials were somewhere in the middle at 22%, as they strive to balance career stability with personal fulfillment. 

Building trust through teamwork and recognition

The antidote to the workforce crisis is something that even the most cash-strapped organizations can afford. Instead of raising salaries, which was only minorly correlated with better retention, organizations can focus on revamping their internal culture to prioritize teamwork, collaboration, and recognition of the unique value that every employee has to offer. 

This focus on building “social capital” and psychological safety among the workforce can have a direct impact on turnover rates, the report suggests. Staff are demanding opportunities to collaborate more effectively with their peers and work together to achieve shared goals. For example, RNs with high teamwork scores are 1.53 times more likely to stay in their roles compared to those with the lowest scores. 

And hospitals that prioritize prevention and reporting of incidents such as patient safety events – those that listen to staff and take their concerns seriously – are 3.5 times more likely to earn top patient experience scores for “staff worked together to care for me.” These same organizations are also likely to see 10% fewer falls with injuries and other positive patient safety outcomes, such as fewer pressure injuries and preventable infections. 

For leaders, the directive is clear: demonstrate respect and appreciation for staff members, create opportunities for teamwork and shared contributions to organizational goals, and put skin in the game in terms of commitments to worker safety, career growth pathways, and active involvement in decision-making for employees across the enterprise.  

By fostering trust and making a concerted effort to sustain engagement across job categories and generations, organizational leaders may be able to stem the tide of turnover and see more success with workforce retention in the near future.