Development and evaluation of a prospective staffing model to improve retention

Abstract

Aims To improve predictability and accuracy of hiring using historical staffing data, quality improvement and workforce engagement. Background Twenty‐three per cent of newly licensed nurses leave their first job within one year, costing employers $52,100 per nurse replacement. Tools for anticipatory hiring strategies are not available in the literature. Methods We used retrospective, secondary data analysis to develop a Prospective Staffing Model and conduct a five‐year longitudinal evaluation of the implementation of the model in a convenience sample at a quaternary academic Cardiothoracic Intensive Care Unit. We used a team‐based, quality improvement approach to restructure recruitment and hiring strategies, standardize new graduate nurse orientation and implement AACN Healthy Work Environment standards. Results Over the five‐year prospective evaluation period (2014–2018), 388 nurses were hired and included in the evaluation cohort. Retention increased (n = 286 days) and turnover decreased (17.6%) between 2014 and 2018. Improvements in workforce stability were sustained at five years. Conclusions Use of a Prospective Staffing Model is associated with improved nurse retention and decreased turnover, and may improve workforce stability. Implications for Nursing Management Results suggest that an innovative tool can mitigate the deleterious effects of turnover, adding to current knowledge and providing a method for anticipatory assessment of local turnover.

The Surge After the Surge: Cardiac Surgery Post–COVID-19

“…Maximizing efficiency through early telemetry discharge, decreasing intensive care length of stay, level loading elective cases in the operating room, temporarily altering staffing models, and staggering cases can help increase throughput capacity. 9,10 Another possible solution is to relocate some noncardiac surgical patients temporarily to other facilities within a health system. In fact, maintaining the incident command center set up by many hospitals and using some of the same workforce and bed solutions employed during the pandemic may be valuable in delivering critical cardiac services in a timely fashion.…”

Implementing AACN’s Healthy Work Environment Framework in an Intensive Care Unit

“…19 Our local leaders practiced prospective staffing, which prevented periods of short staffing related to unexpected turnover or low hiring pools. 20 Additionally, a unit-based scheduling committee engaged bedside nurses in staffing and scheduling, ensuring that patient and nursing needs were consistently met. The charge nurses use a competency tool to ensure that patient needs are paired with a competent nurse.…”

Backlog to Surgery due to COVID-19 and Considerations to Address to Catch-up Safely

“…For patients in need of cardiac surgery, it is proposed that "maximizing efficiency through early telemetry discharge, decreasing intensive care length of stay, level loading elective cases in the OR, temporarily altering staffing models, and staggering cases can help increase capacity". 27 For elective surgical procedures, an effective strategy to reduce the backlog may be to switch to a single-entry model. 28 This is a system that, once a patient is referred to the hospital for a procedure, allocates an available surgeon to a patient, instead of a surgeon that is selected/ preferred by the patient and may be otherwise unavailable.…”