Care Is Critical to Us

Project Topic:

Creating a healthy work environment through staffing model adjustments and meaningful recognition

Hospital Unit:

Cardiothoracic Intensive Care Unit (CTICU)

CSI Participants:

• Kendra Dunn, BSN, RN, CCRN
• Christy Laforet, BSN, RN
• Allison Zentgraf, BSN, RN, CCRN

Project Goals/Objectives:

1. Increase our aggregate score on the AACN Healthy Work Environment Assessment Tool (HWEAT) 15%, from “somewhat healthy” to moderately healthy”
2. Decrease RN turnover rate to less than 8% by increasing nurse satisfaction and meaningful recognition, boosting staff morale and improving overall workflow on the unit

Project Outcomes:

1. Increased HWEAT Appropriate Staffing score from 3.00 to 4.17
2. Increased HWEAT Meaningful Recognition score from 3.39 to 4.07
3. Decreased RN turnover rate to 2.7% year-to-date
4. These outcomes resulted in a positive estimated annual fiscal impact of $282,857.

Project Overview:

The Cardiothoracic Intensive Care Unit (CTICU) at South Shore University Hospital (SSUH) is consistently busy and experiences workflow challenges and low employee engagement. This situation, combined with morale issues and a high turnover rate amongst RNs, has led to staff being vulnerable to burnout and dissatisfaction. In the literature, RN burnout has been associated with lower patient satisfaction, reduced patient outcomes and higher healthcare costs.

Our CSI team administered the AACN Healthy Work Environment Assessment Tool (HWEAT) among CTICU nurses. Based on the HWEAT results, our team directed our efforts toward reducing RN turnover. Our strategy aimed to address staffing, communication and recognition with the goal of lowering turnover rates within the unit.

Our approach included enhancing nurse satisfaction through meaningful recognition and optimizing unit workflow by changing our staffing model. To help achieve these objectives, we established a swing shift RN role. The new role as intended to provide support for unit RNs, including covering breaks, transporting patients off of the unit, caring for post-op open heart patients, and assisting with unit projects and documentation.

The CSI team introduced the motto “4 East: Care Is Critical to Us” across the unit to emphasize the importance of caring, not only for our patients but also for each other. We also initiated staff engagement initiatives, such as the “Employee of the Month” program, to foster peer recognition among team members. Additionally, the team introduced the “Mindful Minute” practice to enhance communication during shift changes on the unit.

As a result of our work, we increased our unit’s HWEAT scores in two key areas and decreased RN turnover from 8.3% to 2.7%, with estimated annual savings to SSUH of nearly $300,000.