NYU Langone, a seven-hospital system based in New York City, reduced systemwide nursing support staff turnover rates from from 14.5% to 8.4% in eight months, according to research published in Nurse Leader.
The system linked the 40%-plus turnover reduction to its career ladder for nursing support staff. Many health systems and hospitals operate career ladders for nurses, but few offer the same to nursing support staff, or unlicensed assistive personnel such as nursing attendants, senior nursing attendants and patient care technicians.
Nursing support staff provide more than 70% of direct patient care, according to some estimates, but their turnover rates are higher than 60%. This high turnover is linked to “high patient ratios, lack of recognition, low pay and an absence of continuing education opportunities,” according to the study.
To mitigate this trend, NYU Langone implemented a career ladder for unlicensed assistive personnel at four inpatient hospitals that operate approximately 2,000 beds and employ about 1,400 inpatient unlicensed assistive personnel, collectively labeled as PCTs in the study. During the eight-month study period, 140 PCTs started the career ladder programs, and 113 successfully completed the program and/or were promoted.
The system coordinated collaboration among human resources, the nursing department and the collective bargaining unit representing UAPs to create the ladders, which “was complex given the variability of the titles and skills,” the study said.
“The overarching goal was to provide a process for career advancement with limited impact on daily unit operations and a lean fiscal burden to the organization,” researchers said.
The career ladders, which included in-person and online education courses, offered $2,000 a year to PCTs who maintained certification. Over eight months, PCT certification attainment across NYU Langone increased from 7.7% to 58% of the system’s 1,400 PCTs.
“By linking compensation to certification and advancement, the program provided existing staff with a certification pathway that supported competency validation and reinforced organization commitment to staff development,” researchers concluded.
“Additionally, nurses recognized the value of highly trained support staff as part of the patient care model,” the study said. “Ensuring a stable and highly skilled UAP workforce promotes top of license RN practice, enabling nurses to focus on professional responsibilities while fostering an environment that supports quality and safety outcomes.”
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