Chicago-based CommonSpirit Health has achieved an 81% jump in new-hire nurse retention over the past year, alongside double-digit reductions in registered nurse turnover and resignation rates.
The system’s first-year registered nurse turnover for beside nursing units with its virtually integrated care model was reduced by 43%.
“We have about 50,000 nurses across the entire system, ” Dr. Sanford said in an upcoming episode of “Becker’s Clinical Leadership Podcast.” “But we’ve done a lot of things to try to make sure that we could mitigate turnover as much as possible, and that we could keep nurses working for us.”
The gains follow the first five-year cycle of a strategic plan to support retention and ensure nurses have a voice at every level of the organization through a shared governance model. The system is now developing its second strategic plan after surveying 30,000 nurses on which of 11 priorities should shape it, with the goal of becoming what Dr. Sanford called “the employer of choice for nurses.”
Among the initiatives from the first plan, Dr. Sanford pointed to two as especially influential: a virtual integrated care model and a redesigned nurse residency program.
Under the virtual care model, experienced nurses remotely support admissions, discharges, medication reconciliation and real-time consultations with bedside staff and physicians. Virtually integrated care nurses also serve as mentors to new RNs.
“That’s just transformed our workload equation at the bedside,” Dr. Sanford said. Nurses have told CommonSpirit they feel less alone and more supported with a virtual nurse on the team, and the virtual role has become a way for nurses fatigued by the physical demands of bedside work to stay in clinical practice, she said.
The nurse residency program, meanwhile, has been rebuilt around three changes: extending it to a full year, giving nurses on any shift virtual access to more experienced colleagues, and a career coach was also used in the past. The program is built on evidence-based frameworks, and preceptors are specially trained to support new nurses’ clinical learning as well as “the emotional needs that they have when they come into a new job like this,” Dr. Sanford said.
The coach role was modeled less on a clinical mentor and more on a high school guidance counselor — someone new nurses can talk to about where they want to take their careers long-term, not just how to get through their first shifts.
“The nurses who complete the residency have significantly higher rates of retention in the first year, but also in the second year,” Dr. Sanford said.
Even so, she cautioned against crediting any one program for the system’s retention improvements.
“You have to look at everything together, the entire picture of what you’re doing to make the nursing environment a better place to work,” she said. “You can’t just single out one or two things, because they all work together.”
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