Workforce challenges, including staffing shortages and burnout, continue to top the list of health system CEO concerns, according to a survey from the American College of Healthcare Executives. The operational and financial ramifications are serious, with the average 350-bed hospital spending 6-10 million dollars a year on turnover-related costs. 50% of nurses report experiencing feelings of burnout, and the average RN turnover rate is 22.5%. Health systems across the country are seeking new strategies to engage, support, and retain their staff.
Laudio recently co-hosted a webinar with Becker’s Healthcare featuring three health system leaders – Simmy King, Chief Nursing Informatics & Education Officer at Children’s National Hospital; Kelly Vaughn, Chief Nursing Officer at Nebraska Medicine; and Ingrid Jones, System Director, Culture, Engagement & Retention at UNC Health – who have significantly improved how their teams work together and stay together.
Mitigating employee burnout: a data-driven approach
At Children’s National Hospital, Simmy realized that the organization needed to ensure their nurses had the capacity to achieve the desired outcomes of care. That meant finding ways to understand their needs and providing resources to support their well-being to enable them to better connect, commit, and be compassionate. It also meant finding a way to more effectively recognize the signs of burnout and intervene early to support nurses and get ahead of turnover.
Simmy's approach at Children’s National was to use real-time data pulled from multiple existing solutions to identify nurse stressors grouped into three main categories: role ambiguity, role conflict, and role overload. Related pressures included uncertainty about roles, moving to unfamiliar departments, and trying to handle too much. Nurses must not only take on the clinical role but also, in some instances, the role of preceptor or of charge nurse. Sometimes, they must support the overall workforce by floating to other units and working in different environments.
Using the Laudio platform, nurse leaders identified and assessed the stressors nurses might be experiencing. They then used that actionable data to intervene at an individual level and support their team members by finding proactive strategies to reduce workload, ambiguity, and/or conflict. Historically, data had been stored in disparate systems, making it difficult to access and aggregate. The Laudio platform pulled the data from these systems into a dynamic dashboard for managers, flagging vital points and suggesting actions at the individual nurse level. The data can also roll up to the unit level to reveal trends for senior leadership, which can result in sustainable change for the whole unit
Types of data analyzed include the amount of floating, the amount of precepting, unscheduled absences, and frequency of overtime. The Laudio system also drew attention to metrics like an unusual number of nights worked recently versus past patterns. Most nurse managers at Children’s National have anywhere from 78 up to 200 direct report FTEs, making it difficult for them to spot such trends, let alone address them in a timely manner. Meaningful insights from the Laudio platform positioned managers to touch base with nurses on situations they may not have otherwise noticed, and so in a timely way.
Reducing frontline turnover: a focus on the first year
Nebraska Medicine, like so many other health systems at present, faced challenges with first-year nurse turnover. CNO Kelly Vaughn explained that nurses coming out of school are passionate about the profession and excited to start their career, but then experience on-the-job stressors that can drive them to leave. These young professionals are often new to the workforce and need support beyond the clinical components of the job; they need both professional and personal coaching. Kelly was determined to do whatever she could to identify problems, provide support, and set these nurses up for success.
Nurse managers play a critical role in nurse engagement and retention. A core challenge is all the competing priorities they face as managers, including balancing responsibilities around safety and quality, staff and patient satisfaction, engagement, and financial performance. These demands on frontline leaders can get in the way of providing support, mentorship, and guidance to first-year nurses. Large spans of control also limit their ability to engage regularly and in a personalized way with team members.
In the past, Nebraska Medicine had to use manual workflows and siloed databases across the health system to welcome new people and recognize great work. With Laudio, they were able to aggregate the information in a useful, efficient way to help frontline leaders act on important issues and have purposeful interactions with nurses. In the first six months of using Laudio, in conjunction with their onboarding and orientation processes, Nebraska Medicine reduced first-year nurse turnover by an extraordinary 47%. Managers recorded 27,000 purposeful interactions in Laudio during those six months.
Nebraska Medicine has been successful in reducing first-year nurse turnover because the organization has enabled managers to be highly engaged on an individual level, listening and building trust despite their workload and competing priorities. Technology made the impossible possible.
Implementing a system-wide retention strategy
At UNC Health, leaders have addressed retention and resiliency by developing an overall people strategy that supports their staff – known as teammates – at every step along their career path. The effort began with a board-led commitment to amplifying their focus on people. They developed the people strategy based on input from leaders and teammates with the goal of making UNC Health a place where people want to come and work and where their teammates want to stay.
Ingrid Jones explained that the framework for the strategy, branded as “UNC Health for Me,” rests on six pillars. The first is Engage Me, focused on making sure that teammates feel connected to the organization. The second is Welcome Me, creating a positive and inclusive environment where new teammates feel welcome. Develop Me is about growth and training the next generation of leaders. Value Me ensures that teammates feel valued, recognized, and equitably compensated. Care for Me focuses on professional and personal health and well-being. And finally, Include Me is foundational to all the pillars, and is about building an equitable and inclusive community that reflects the patients UNC Health serves.
UNC Health then launched a program called Retention Starts with Me. The focus is on providing resources and strategies that frontline leaders can use to help retain teammates. They sought technology that would support their frontline leaders, making it easy for them to connect with and recognize teammates. By empowering frontline leaders, with Laudio as the foundation, UNC Health was able to streamline leader workload and reduce administrative burden; standardize and scale proven leader best practices; and boost frontline team engagement and retention.
Through a combination of these efforts, UNC Health for Me has generated remarkable results: a 20% increase in nurse retention rate, $5.4M annual savings from lower turnover helping them avoid RN replacement costs, and 94% of managers reporting higher capacity.
Using technology to bring people together
All three healthcare leaders in this discussion focused on creating a sense of belonging at their organizations to help retain their teams – leveraging technology to achieve their goals.
Children’s National used the Laudio platform to identify at-risk nurses and intervene early using a person-centered approach.
Nebraska Medicine focused on reducing first-year nurse turnover by implementing practices and systems to help managers efficiently identify issues and meaningfully connect with their staff.
And UNC Health used technology to support their strategic framework for making teammates feel connected and cared for as one great team.
These proven strategies can help health systems get ahead of burnout, implement people-centric approaches, and drive engagement and retention. Did you miss the live webinar? Watch it on-demand.