Crowd-solving the employee retention crisis: Keeping nurses on the job and keeping them happy

Nurses are, in many ways, unsung heroes. They serve in one of the noblest professions, but in many healthcare systems they are overworked and underappreciated.

In hospital settings, they are at risk of injury and exposure to dangerous pathogens. The National Healthcare Retention and Staffing Report, produced annually by Nursing Solutions, Inc., found that turnover of registered nurses stood at 16.2 percent in 2016. The rate is much higher for Certified Nursing Assistants and in specific departments such as emergency care and behavioral health.

Meanwhile, the American Nurses Association (ANA) warns of an ongoing nursing shortage that “isn’t stopping soon.” Many factors contribute to the shortage, chief among them an aging population requiring more services, substance abuses crises, and increasing access to healthcare combined with a strengthening economy. The average RN vacancy rate in hospitals is 8.1 percent. Recruitment, contract labor, and overtime pay are expensive solutions, and not sustainable in the long run.

Lutheran Medical Center in Wheat Ridge, Colorado is owned by SCL Health and employs 1,500 nurses and other associates. We serve 74,000 Emergency Department patients and 16,000 inpatients annually and operate one of the busiest Emergency Departments in the state of Colorado. We know that the loss of one of our skilled nurses can cost upwards of $40,000. Looking beyond this concrete financial impact, there are many other consequences.

Staffing shortages, even when temporary, shift the burden onto remaining nurses. As the ANA points out, nursing often involves working long hours under stressful conditions. Added work responsibility and understaffing compound the stress, leading to burnout and job dissatisfaction. If overwork is chronic, the risk of injury and medical errors can increase.. When nurses feel they cannot take good care of their patients, they become disheartened — after all, that is one of the most rewarding parts of their job.

In order to address nursing shortages and the associated costs and risks, our Senior Executive team has been laser focused on employee retention and satisfaction. We feel this is essential to keeping our staff and system healthy while providing the highest standard of care to our patients.

Some methods of increasing job satisfaction are obvious, starting with keeping staff levels high enough to prevent chronic overscheduling. But we know that our nursing professionals have their own ideas about how to improve retention and satisfaction. The challenge is how to gather representational, open, and honest input. With 1,500 associates, walking the halls can reach only a small percentage of staff, could disrupt busy work routines, and might not be the best way to solicit frank feedback. Traditional surveys can be too limited — it is hard to engage enough respondents to get representational feedback, the communication loop stops at one set of questions and responses, and short or multiple-choice answers don’t capture nuances, details and ideas for improvement.

In an effort to obtain richer, more specific feedback and spark a dialogue with our associates, we deployed an innovative social collaboration tool, POPin. Using this tool has already helped to drive improvements in employee retention. Over the past year, Lutheran logged an employee turnover rate of 6%, well below the national average. We expect to realize another 2 percent decrease next year as we continue to use POPin and implement the changes inspired by this crowdsolving tool. We use POPin to anonymously survey the employee base, crowdsourcing answers to questions such as “How can we improve daily work conditions for you?, What can we do to improve work/life balance at Lutheran Medical Center? ” and “Tell us what support you need to improve the patient experience at our hospital?” Because the collaborative platform is online, anonymous, and interactive (everyone can see and comment on responses and survey metrics), this approach generates more feedback in a few hours than what we could get over months of walking the hallways. As we uncover what our employees are thinking and perceiving, we develop a better understanding of what they need from us. POPin allows us to do this quickly and thoroughly— no more guessing about the source of a problem, how important employees think it is, or what they’d like to see us do about it. We can then accelerate our efforts to make meaningful changes because we are confident we are spending time and money on the right efforts, the ones that will significantly increase job satisfaction and result in higher retention rates.

In addition to POPin, we have deployed additional on-campus efforts to retain valued associates. These include individualized professional development, mentoring, attention to recognition of outstanding care, engagement in innovation and addressing important needs for on campus food and wellness options. We celebrate successes and make sure to create a family-like atmosphere for care and caring.

At Lutheran Medical Center, keeping our nurses and other associates on the job is important to us. Better retention protects the wellbeing of our patients and maintains a functioning system overall. And yes, it protects our bottom line. Most important, keeping our nurses and their families happy and healthy is fundamental to our values and our mission to serve the community.

Christina Johnson, MD, FACEP, Vice President and Chief Operating Officer, Lutheran Medical Center, Wheat Ridge, CO

As Vice President and Chief Operating Officer of Lutheran Medical Center, Dr. Christina (Tina) Johnson oversees the Cardiovascular, Neurology and Oncology Service Lines, Patient Safety and Quality, Medical Imaging, Physical and Rehabilitative Medicine, Laboratory Services, Clinical Contracting, Care Management, Pharmacy Services, Clinical Informatics, Hospice and Palliative Care.

Dr. Johnson first joined Lutheran Medical Center in 1998 as an attending physician in the Emergency Department. Subsequently she served in leadership roles within the Emergency Department, then as Chief Medical Officer at Lutheran and most recently as Chief Operating Officer since 2015.

Dr. Johnson received her bachelor’s degree from Reed College in Portland, Oregon and she completed medical school at Columbia University, College of Physicians & Surgeons in New York. She did residency training in Internal Medicine at University of California, San Francisco and completed a second residency in Emergency Medicine at Denver Health. She is board certified in Emergency Medicine. Dr. Johnson currently is pursuing an MBA at University of Denver, Daniels School of Business.

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