How DaVita Boosts Retention

Dialysis provider DaVita’s StarShaper training initiative was implemented to determine causes and interventions necessary to improve clinical teammate retention that also could yield a return on investment (ROI).

Edited by Margery Weinstein

DaVita Inc. provides dialysis in more than 1,700 locations in the U.S. and is divided into eight clinical operating groups. One group consistently had the poorest <180-day retention of nurses and patient-care technicians (PCTs). The StarShaper training initiative was implemented to determine causes and interventions necessary to improve clinical teammate retention that also could yield a return on investment (ROI). The objective was to build a world-class training program based on skill demonstration that could prepare new teammates to perform and succeed in their new role at DaVita.

Anticipated Outcomes

Short Term: Improve <180-day retention from 50.8 percent to 70.8 percent

Long term: Improve 12-month retention from 74.8 percent to 82 percent

Financial: Achieve 25 percent <180-day turnover, which could save approximately $6.1 million

Traditional Training Model

  • New teammates are paired with a certified preceptor in the facility where they are hired to work.
  • The preceptor is responsible for on-the-job training.
  • Workbooks are utilized to “marry” the skills being taught on the floor with didactic content and applicable policies and procedures.
  • The preceptor trains a new clinical teammate without previous dialysis experience for 90 days.
  • The orientee attends a theory class at a location off site taught by a nurse clinical specialist. Hands-on labs, interactive workshops, and critical thinking exercises are among the techniques used in these classes.

Analysis of the existing model revealed that teammates in this group were experiencing poor onboarding and lack of dedicated time for preceptors to train in local clinics, which led to lack of satisfaction and high turnover. Training delivered by the preceptor also was inconsistent.

The StarShaper Training Initiative

  • New teammates spend the first day working with Facility Administrators (FAs) for onboarding. Then they spend the first week with a dedicated RN or PCT Centralized Trainer (CT), learning basic dialysis technical skills.
  • Teammates from rural areas return to their home facility after week one to complete training with a qualified preceptor while the CT monitors remotely. Teammates in urban areas continue with the CT, rotating to various locations to familiarize them with different environments and machines.
  • Orientees then transition back to their home facility and complete the theory class during the remainder of their 90-day training period.


At the conclusion of one year, DaVita found that:

  • Centralized trainers were able to dedicate time to orientees by being scheduled out of staffing, leading to increased teammate satisfaction.
  • Teammate survey satisfaction scores increased.
  • Teammates were more prepared to float to multiple clinic locations.
  • FA involvement increased in the orientation process.
  • March 2012 year-to-date (YTD) data showed that <180-day turnover was reduced from 50.8 percent to 21 percent with a total cost savings of approximately $7 million.
  • <180-day first-quarter YTD retention rate for the program was 78.97 percent. Second-quarter YTD was 81.32 percent.

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