Effective Staffing Network
Boosting Retention and Doubling New Hires with Sun Health’s Nursing Education Transition Unit
1
Patricia Greene, MSN, RN
Patient Care Manager
Nancy Zismann, MSOL, RN
Assistant Vice President Patient Care Services
Moving From Thought to Reality
Background
– 2005 RN turnover in the first year of employment was 31% – Difficult to hire new graduate RNs
Problem
– How do we decrease first year turnover and increase hiring?
2 – Focus on decreasing turnover strategies
Purpose
– Create an environment that supports the new hire nurses and new graduate nurses
From Concept to Reality
Strategy
– Develop a program that would be feasible within our current limitations of budget and productivity while building a solid foundation of education, support and professional growth. Nursing Education and Transition Unit “NET-U”
Gather supporting evidence
3 – Review of literature
– Turnover rates: National and our own
Map the plan to address operational details
From Concept to Reality
Identify Stakeholders
– CEO
– CNO and AVP Patient Care Services – Patient Care Managers
Financial Stewardship
– Establish productivity goals • Total HPPD Actual and MEIOSota ctua a d OS • Staffing Plan
• Start up costs (new staff orientation) Stakeholder buy-in and unit support
From Design to Reality
Establish the Unit
Establish the Unit
Use existing unit
– No need to license new beds – Equipment in place
Determine timeline for opening
5
Determine timeline for opening
– Consider local school graduation time frames
From Design to Reality
Unit Staff “Core Staff”
– Preceptor selection: requirements and expectations – Behavioral interview
• Structured interview process
• Team building program for staff (include ancillary staff) • Go home free pass
New Hire Candidates for the Unit
6
New Hire Candidates for the Unit
– New graduate RN – Foreign nurse hires
– Experienced nurse hires selecting a new area for practice (Maternal-Child to ICU)
Preceptors
Preceptors are the key to the success of the NET-UPreceptors are the key to the success of the NET U
A good nurse does not necessarily make a good preceptor
Preceptors need support and education
Preceptors are partners in the development of the NET-U
7
NET-U
– Elicit their assistance to adjust the program – Allow freedom to modify matrix as needed
Preceptors
Education
Education
Organization Development class
– Adult learning theory – Role playing
Workshops for all NET-U preceptors
Reiterate standards (by the book) – Reiterate standards (by the book) – Review goals of unit (research)
– Examine orientation structure and paperwork – Discuss issues and problem solve
Preceptors
Support
pp
Nursing educator focus on NET-U
Grant application for preceptors – Incentives
• Conferences O i ti l d
9
• Organizational dues
Clinical ladder opportunity
Unit Matrix
Matrix developed to direct flow of orienteeMatrix developed to direct flow of orientee experiences
Goal to complete tier one orientation and
demonstrate advancement from novice to beginner
Matrix flexible to meet new graduate learning needs
10 Three parts to orientee experience
– Work with preceptor – Off unit experiences
Staffing and Orientation Matrix for Week II
(Includes staffing for 6 days of the orientation unit for a total of 16 Graduate Nurse Externs)
RN RN RN RN
GNE GNE GNE GNE GNE GNE GNE GNE
2 patients Total Care 2 patients Total Care 2 patients Total Care 2 patients Total Care 2 patients Total Care 2 patients Total Care 2 patients Total Care 2 patients Total Care 11
Each GNE works 3-12 hour shifts, with 4 hours of class per week.
Key: RN (Preceptor), GNE (Graduate Nurse Extern), TC (Total Care) Provides staffing for 16 patients.
Tiered Orientation
Tier 1 – Novice to beginnerTier 1 Novice to beginner
Tier 2 – Beginner to beginner/competent
Tier 3 – Competent to fully competent
Tier 4 – Full member of the team
M t th h ti di t t d b t t
Movement through tiers dictated by competency, not by time schedule
Off Unit Experience
Home unit manager provides list of what experiences the new graduate should have
Preceptor arranges experiences
Off unit experiences tailored to new graduate
13
Communication with Home Unit
NET-U PCM and educator meet with PCMs twice aNET U PCM and educator meet with PCMs twice a month
New employee hand delivers weekly evaluation to home unit PCM
Educator, preceptor and new graduate meet with home unit PCM in the middle of orientation toward
14
home unit PCM in the middle of orientation toward the end of orientation and with any issues
New employee invited to unit functions
Transition to Home Unit
Formal handoffFormal handoff
– Home unit PCM, new graduate, preceptor and educator meet and set date for transfer
– Home unit PCM designates home unit preceptor and gives schedule
– Preceptor from NET-U gives report to preceptor on floor Educator follow up
15 – Meet with new preceptor
– Ensure knowledge of tiers
– Follow up as needed with new employee
Goals
Research
– Objectives
• Increase retention • Enhance patient safety Safety
Satisfaction
Results
Retention of New Graduates
69% 2006
90% 2007
Hiring of New Graduates
17
Hiring of New Graduates
29 hires 2006
49 hires 2007
Thank You!
You can submit questions in the "chat" section
18
Effective Staffing Network
For additional information
19 Carrie Adams [email protected] 858-875-2583 www.bidshift.com Pat Greene [email protected] 623-876-6650 Nancy Zismann [email protected] 623-872-4825
