How to prevent Absenteeism in the Healthcare Field (Case Study)

Employee attendance is an issue that affects all businesses, small or large. One way to solve this issue is to incentivize perfect attendance, as indicated in this case study, Case 12- A Lottery for Employee Attendance, (Buchbinder, Shanks, & Buchbinder, 2014).The Nursing Home Administrator was able to decrease absenteeism from 33% to 6% by incentivizing perfect attendance, (Buchbinder, Shanks, & Buchbinder, 2014). This did however result in a draw back of CNA’s showing up sick to work so they can get the incentive. This case analysis will analyze the method used by the Nursing Home Administrator and also provide evidence based suggestions on preventing CNA’s from showing up to work when they are sick. The paper will show the importance of collaboration and communication in solving issues that may arise.

Absenteeism On Weekends And Holidays

Absenteeism is a major problem in the healthcare field around the world. Employees will take days off around holidays and on weekends for a variety of different reasons. According to Ramadhan, & Santoso, (2015), the reasons for absenteeism in a study conducted in Indonesia have been found to be for valid medical reasons with a doctor note, other commitments, religious holidays, social interactions among others. In order to address these issue we must analyze these reasons for absenteeism.

At a given point in time, there will be a few employees that would be on a valid medical leave.  They would have a note from the doctor or other medical documentation. According to Hefner, Miley & Fikfak (2018), the most common medical reason that may affect health workers are musculoskeletal disorders. They are at an increased risk of developing musculoskeletal disorders due to long working hours and the ergonomics of the workplace (Hefner, Miley & Fikfak, 2018). The leadership team should ensure proper ergonomics of the workspace to reduce the number of people on medical leave. 

Companies usually have employees from a diverse background. People of different traditions and religions come together with a common goal of improving healthcare. With this diversity comes the issue of religious and traditional holidays that may not be incorporated in the company’s calendar. When individual religious and traditional holidays are not taken into account, employees tend to take these days off, resulting in absenteeism. Organizations should engage and communicate with employees to determine their preferred holidays. For example, many Muslim employees may be willing to work on Christmas, if allowed to take off on Eid, the Islamic equivalent of Christmas.

Another major reason for employee absenteeism is unwarranted absences. This can happen due to emotional exhaustion. Healthcare workers often work long hours of overtime and are expected to bear additional burden. This leads to mental exhaustion. According to Vignoli, Guglielmi, & Violante (2016), it can be concluded that there is a relationship between emotional exhaustion and absenteeism. Due to this reason, any intervention on the part of leadership should focus on the emotional health of employees as well as work life balance. 

Increased Dissatisfaction Among The Employees Who Pick Up The Extra Work Due To Absenteeism Of Others

As a consequence of absenteeism, the work is then picked up by the employees who are present. This added work on responsible workers leads to burnout of the employees that do show up to work.. According to George, & Reyes, (2017), a negative relationship has been established between burnout amongst nurses and  emotional exhaustion. This would reduce job satisfaction and good employees end up searching for other jobs (George, & Reyes, 2017). This negatively affects the company as they  not only lose good employees, but they also have to undergo increased cost to hire new employees, who will again go through the same problem. 

Another issue that arises with selected employees taking on work of absent employees, is the development of segregation and disharmony between employees, resulting in reduced communication and teamwork (Hartgerink, Cramm, Bakker, Eijsden, Mackenbach, & Nieboer 2014). In order to deliver better patient outcomes in the health field, collaboration and inter professional communication is essential. According to Hartgerink, Cramm, Bakker, Eijsden, Mackenbach, & Nieboer (2014), working with a variety of professionals to reshape patient care still remains a challenge. Since healthcare does require a multi disciplinary approach, it is important that this segregation among employees does not develop to maintain a high standard of patient care.

In the case study, the Nursing Home Administrator went with the strategy of incentivizing perfect attendance of the Certified Nursing Attendants. This step was taken after communicating with the Administrator in Training, demonstrating inter disciplinary communication. This consultation resulted in the development of the incentive strategy. The strategy resulted in an effective communication of the issue and was successful in addressing the issue. Taking into account the fact that the Nursing Home Manager reached out to the Administrator in Training to discuss the issue, it can be deduced that this leader is likely to maintain relationships with other leaders. It is evident that the leader is open and clear in communication. 

The first step that should be done in conflict resolution is open communication. According to Johansen (2014), having a work environment that lacks communication will result in conflict and stress. To counter this, it is necessary to promote an environment of open communication. In the case study, the Nursing Home Administrator uses the strategy of inter departmental communication, by reaching  out to the Administrator in Training and discussing the issue with that department.

  The leader in this case study approached the situation in a very positive and intellectual manner. Scholarly articles were consulted to find an appropriate solution to the issue identified. Consultations with other departments is definitely a strength and an area that needs growth is to study the complete outcomes of the suggested change as in this case, the implementation of the incentive, ended up creating another problem of employees showing up ill. The lesson that can be taken away from this case is the fact that by consulting other departments and utilizing scholarly articles and other information available, it is possible to resolve difficult  issues effectively with communication and collaboration. 

The scholar-practitioner model is a model in which a practitioner applies scholarly knowledge in their practice. It allows theories which have been extensively researched to be combined with the experience of the practitioner to solve problems or to increase and improve efficiency. This case study is an excellent example of how the scholar-practitioner model has been effectively used to address the issue of decreased attendance. The Nursing Home Administrator utilized research and scholarly articles to come up with a solution for absenteeism and was successful in achieving the outcome. 

The leader in this case came up with a very ethical approach. Instead of mandating attendance, the Nursing Home Administrator incentivized perfect attendance. This created a desire in the employees to be at work instead of the administration having to take adverse action against employees. A key lesson that this case provides for leaders is that with collaboration and communication across different departments and disciplines, effective solutions can be obtained for complex issues. 

This case describes a situation in a nursing home where the administrator introduced a lottery system to address the issue of absenteeism around weekends and holidays. The absenteeism was causing increased dissatisfaction among workers that had to pick up the extra work of the absent employees. The contributing factors of this absenteeism was analyzed and suggestions to overcome these issues were discussed based on scholarly evidence. The leaders approach using the scholarly-practitioner model is also reflected in this case study. The importance of communication and collaboration was established.


Buchbinder, S. B., & Shanks, N. H. (Eds.). (2012). Introduction to health care management (2nd ed.). Burlington, MA: Jones & Bartlett. (Buchbinder 46)

Buchbinder, S. B., Shanks, N. H., & Buchbinder, D. (2014). Cases in health care management. Burlington, MA: Jones & Bartlett Learning.

George, R., & Reyes, M. E. S. (2017). Burnout as a predictor of quality of life among selected filipino nurses. Indian Journal of Health and Wellbeing, 8(7), 691-696. Retrieved from

Hafner, N. D., Milek, D. M., & Fikfak, M. D. (2018). Hospital staff’s risk of developing musculoskeletal disorders, especially low back pain. Zdravstveno Varstvo, 57(3), 133-139. doi:

Hartgerink, J., MS, Cramm, J., P., Bakker, T., P., van Eijsden, A., MSc, Mackenbach, J., P., & Nieboer, A., P. (2014). The importance of multidisciplinary teamwork and team climate for relational coordination among teams delivering care to older patients. Journal of Advanced Nursing, 70(4), 791. doi:

Johansen, M. L. (2014). Conflicting priorities: Emergency nurses perceived disconnect between patient satisfaction and the delivery of quality patient care. Journal of Emergency Nursing, 40(1), 13-19. doi:

Know why your staff members are not at work. (2011, Jul 06). The Star Retrieved from

Ramadhan, A. P., & Santoso, D. (2015). Health workers absenteeism: Indonesia urban public health centres. Journal of Public Health, 23(3), 165-173. doi:

Revuelta, J. F. R. (2014). Nursing presenteeism. patient safety implications. possibilities of control and reduction/Presentismo en enfermería. implicaciones en seguridad del paciente. posibilidades de control y reducción. Enfermería Global, 13(3), 374-383. Retrieved from

Vignoli, M., Guglielmi, D., Bonfiglioli, R., & Violante, F. S. (2016). How job demands affect absenteeism? the mediating role of work-family conflict and exhaustion. International Archives of Occupational and Environmental Health, 89(1), 23-31. doi:

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s