Horizon Health Network Launches 60 Feedback-Driven Initiatives to Cut Voluntary Turnover from 9.6% to 7.6% Across 15,000+ Employees

What Was the Opportunity?

Horizon operates in one of the most competitive labor markets in Canadian healthcare. By August 2023, voluntary employee turnover had reached 9.6%, creating operational strain and increasing the urgency to strengthen long-term commitment across the workforce.

The organization recognized that retention could not be improved through generic programs or assumptions. Horizon needed precise, timely insight into what employees were experiencing, where expectations were falling short, and which friction points were quietly eroding trust. This was particularly critical during onboarding and early tenure, where administrative and operational gaps (equipment readiness, access to information, benefits understanding) can undermine an otherwise strong first impression.

Managers also needed better tools. Traditional annual surveys alone were not sufficient to support the responsiveness required to retain talent in a complex, multi-site healthcare system. Leaders needed the ability to run targeted surveys, explore root causes behind results, and validate whether their actions were working.

Employee feedback surfaced additional challenges specific to frontline and deskless staff: many did not have regular access to computers or email, which meant communication gaps were actively undermining connection and inclusion. In response, Horizon positioned its Our Promise initiative as the organization’s retention strategy and committed to building a comprehensive listening program with Perceptyx to move from reactive problem-solving to proactive, evidence-based experience design.

What Was the Solution?

Horizon’s retention strategy, Our Promise, is built on four pillars: Listen & Act, Recognize & Appreciate, Health, Safety & Belonging, and Learning & Development. Listening is the foundation for all of them.

Improving Onboarding and New Joiner Retention

Perceptyx lifecycle surveys identified a specific friction point: new hires consistently rated “My access/equipment was setup when I arrived” significantly below industry benchmarks. The score stood at 54.9% in 2023 against a benchmark of 77.5%. This data gave HR and IT leaders objective evidence to act, leading directly to the launch of the Horizon Day Zero Project, an initiative designed to ensure equipment, systems access, and workspace readiness are in place before an employee’s first day.

Perceptyx tracking data confirmed the intervention was working, as equipment setup favourability rose from 54.9% in 2023 to 61.4% in 2025. The platform continues to provide a feedback loop to validate progress and justify continued investment until the score meets or exceeds the 77.5% benchmark. Meanwhile, 92% of new hires report they feel they made the right decision joining Horizon, and manager welcome favourability stands at 95.1%, indicating the cultural foundation of onboarding remains strong.

Strengthening Manager Effectiveness

Perceptyx became a direct tool for managers, not just HR. Over the past year, Horizon managers created approximately 120 point-in-time departmental surveys to uncover gaps, identify emerging themes, validate assumptions, and measure whether their actions were achieving results.

Eight leaders were recognized for demonstrating excellent year-over-year improvements in engagement results. One standout example came from the Community Health Centres: following the 2024 annual pulse survey, leaders developed targeted action plans. In the 2025 survey, participation increased from 38% to 73%, and engagement rose from 48% to 65%. That kind of local, manager-driven impact reinforces a culture of continuous improvement and demonstrates the direct link between insight-driven leadership and team performance.

Retaining Frontline and Deskless Employees

Feedback from frontline and deskless staff highlighted that emails were often missed and many team members did not have regular access to a computer. In response, Horizon created the Ambassador Program, a peer-driven communication network that ensures important updates, recognition, and resources reach frontline teams in ways that work for them. Ambassadors help close communication gaps, strengthen connection, and support retention by helping employees feel included, informed, and valued.

Turning Feedback into Initiatives at Scale

Nearly 60 initiatives have been created directly from employee feedback through Our Promise. In 2025 alone, leaders launched 20 Our Promise Initiatives, representing more than one-third of all initiatives across the organization. Examples include Blue January Comedy Month (a recognition initiative), the One Year Service Pendant, the Menopause Works Here program, and Strength, Stretch & Movement sessions. Each exists because employees asked for it.

What Was the Impact?

Voluntary turnover dropped from 9.6% to 7.6%. Between August 2023 and January 2026, Horizon reduced voluntary turnover by 2 full percentage points, placing the organization 4.3 points below the national benchmark of 11.9% (Mercer Survey, 2024).

Intent to stay climbed from 82% to 84%. The 2-point increase between 2024 and 2025 reflects growing confidence in the organization and a stronger sense of belonging driven by visible action on employee feedback.

New-hire equipment readiness improved 6.5 points. The Day Zero Project lifted “My access/equipment was setup when I arrived” from 54.9% to 61.4%, with continued tracking toward the 77.5% industry benchmark. Meanwhile, 92% of new hires feel they made the right decision, and manager welcome scores sit at 95.1%.

Managers adopted the platform as their own tool. Approximately 120 manager-created departmental surveys in a single year, with eight leaders recognized for standout year-over-year engagement gains. At the Community Health Centres, participation jumped from 38% to 73% and engagement from 48% to 65% after targeted action planning.

Nearly 60 initiatives launched from employee feedback. Twenty of those came in 2025 alone, accounting for more than one-third of all organizational initiatives. Each was rooted in what employees specifically asked for through the listening program.

For a healthcare organization with 15,000+ employees, 12 hospitals, and 100+ facilities operating in one of Canada’s most competitive labor markets, these results demonstrate that a listening-driven retention strategy can produce measurable, sustained improvement in turnover, onboarding, manager effectiveness, and frontline connection.