ROAD TO RETENTIONThelma Baker RN, MSN, OCN

Angela Adjetey-Appiah MSN, MPH, MA, RN, FAACMBetsy Collins RN MSN AOCN

Session ObjectivesDiscuss issues and trends related to retention

Evaluate barriers to rewards and recognitions

Develop strategies for retaining staff by reward & recognition

Learn methods to develop reward and recognition resources and tools

ROAD TO RETENTIONThelma Baker RN, MSN, OCN

Manager Medical & Surgical OncologyMedical City Dallas Hospital

Dallas, TX thelma.baker@hcahealthcare.com

Recognition & Reward Impacts RetentionNew Graduate Nurse Turnover

– disillusionment about scheduling– lack of autonomous practice– lack of intrinsic and extrinsic workplace

rewards– dissatisfying relationships with peers,

managers and interprofessional colleagues– insufficient time with patients

Twibell, et al., (2012). Tripping over the welcome mat: Why new nurses don’t stay and what the evidence says we can do about it. American Nurse Today. 7 (6). Retrieved February 2014 from http://www.americannursetoday.com/Popups/ArticlePrint.aspx?id=11182

Job Satisfaction• Three out of four American Association of Critical-

Care Nurses’ members rank recognition for their contributions as a central element of a healthy work environment.

• lack of recognition leads to discontent, poor morale, reduced productivity and suboptimal care outcomes.

• Recognition of one’s contribution to an organization’s work is essential to job satisfaction.

• Inadequate recognition is cited as a primary reason for turnover among employees.

American Association of Critical-Care Nurses. AACN Standards for Establishing and Sustaining Healthy Work Environments: A Journey to Excellence. Aliso Viejo, CA: 2005. Retrieved March 23rd 2014 from http://www.aacn.org/WD/HWE/Docs/HWEStandards.pdf.

WHY IS RETENTION SO IMPORTANT?

Cost of TurnoverStaff Replacement

Lewin Group. (2009). Evaluation of the Robert Wood Johnson Wisdom at Work: Retaining Experienced Nurses Research Initiative. Retrieved February 2014 from: rwjf.org.

TURNOVER RATES

National Comparisons Predicted Rates

NSI Nursing Solutions, Inc., (2013). 2013 National Healthcare & RN Retention Report. Retrieved February 2014 from www.nsinursingsolutions.com

COST OF TURNOVER

Fiscal implications Patient Outcomes

Needleman, J., Buerhaus, P., Pankratz, S., Leibson, C., Stevens, S., & Harris, M. (2011). Nurse Staffing and Inpatient Hospital Mortality. The New England Journal of Medicine. 364 (11), 1037-1045.

NSI Nursing Solutions, Inc., (2013). 2013 National Healthcare & RN Retention Report. Retrieved February 2014 from www.nsinursingsolutions.com

STAFF REPLACEMENT CHALLENGES

Nurse Shortage & Finding the Right staff Shortage of Nursing School Faculty Changing Demographics will Require More Nurses Significant Percent of Nursing Workforce Nearing

Retirement

Rosseter, Robert. Nursing Shortage Fact Sheet. American Association of Colleges of Nursing. January 2014. Retrieved February 2014 from https://www.aacn.nche.edu/media-relations/fact-sheets/nursing-shortage

REWARD & RECOGNITION

Improved staff Satisfaction Improved Retention

KOUZES, J., & POSNER, B. (2003). ENCOURAGING THE HEART. WILEY, JOHN & SONS, INCORPORATED.

Power of Teamwork!

HAPPY STAFF

HAPPY PATIENTS

KOUZES, J., & POSNER, B. (2003). ENCOURAGING THE HEART. WILEY, JOHN & SONS, INCORPORATED.

Power of Motivation

IMPROVED PATIENT SATISFACTION

IMPROVED STAFF SATISFACTION

IMPROVED RETENTION

Reap the Reward of Motivation

Reward & RecognitionAngela Adjetey-Appiah

MSN, MPH, MA, RN, FAACM

Director of Nursing

Oncology Services

ana9099@nyp.org

NewYork-Presbyterian

Weill Cornell Medical CenterThe University Hospital of Columbia and Cornell

Engagement equals satisfaction, rewards, and recognitions

https://www.youtube.com/watch?v=y4nwoZ02AJM&feature=player_embedded

Permission granted to NYP for usage.

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EMPLOYEE ENGAGEMENT….

Authentic & True Appreciation

Always match the reward to the person.

Take timing into consideration

Match the reward & recognition with the achievement

Celebrate & Exemplars

Different Ways to celebrate

Unit/departmental Councils

Organizational

National

Motivational Tips

Call an employee into your office just to thank him or her. Don’t discuss any other issue.

• Post a thank-you note on the employee’s office door.

• Wash the employee’s car in the parking lot during lunch.

• When discussing an employee’s or a group’s ideas with other people, peers or higher management, make sure you give credit.

• Create a Hall of Fame-wall with photos of outstanding employee

(Dickey P., Tenn Med. 2008 Mar;101(3):31)

Survey Outcome

How do you recognize your staff?

Does your organization have a program?

Describe your program

Reward & Recognition: What does your organization/unit do for reward/recognition?

Which recognition do you prefer? Thank you card, public recognition (like newsletter), bulletin board, in staff meeting, small gift , ceremonies, food? Provide detailed exemplars below

What resources do you have that promote and support retention, rewards, and recognition?

Checkout the outcomes on the Management and program development S.I.G virtual community site: http://management.vc.ons.org/file_depot/0-10000000/0-10000/3374/folder/14790/MGT+SIG+ONS+Survey+Questions-Outcome+3+14.pdf

NYP Way

Exemplars:

NewYork-Presbyterian Reward & Recognition Programs

Reminder: staff anniversary

NYPress July/August 2013. Page 9.

https://nyp.performnet.com/nyp/images/client/pg9.pdf

NYP WAY-CONT.

Awards & Recognition Programs

2011 Physician of the Year Awards

C.A.R.E. Award (Westchester): Established to recognize Courtesy, Attitude, Respect and Enthusiasm

CARE Award-Cornell: Exemplifies our motto of “We Put Patients First” as well as the NYP Values: Respect, Teamwork, Excellence, Empathy, Innovation and Responsibility

Employee of the Month

Falcon Awards

Nursing Awards

NYP WAY-CONT.

Awards & Recognition Programs

Nursing Excellence Awards for LPNs and Support Staff

Patient Centered Care Awards

Physician Assistant of the Year

President's Circle Award

QPStar Recognition Program

Retirement Recognition Program

Service Recognition Programs

Shining Star Program

Social Work Awards

NYP-AMAZING People Recognition Program

An online, Hospital-wide program, allows managers to easily recognize staff, enables staff to recognize their co-workers, and offers employees a wide array of gift choices. The AMAZING People Program includes the following NYP awards:

Employee of the Month

Resident of the Month

Falcon Award

Shining Star

Congratulations!

Flexible Floater Recognition

NYP-AMAZING People Recognition Program

Great Catch

Thank You Program

Work Safe

Applaud a Teammate: A new award enables staff to recognize their co-workers

Together, these programs allow the Hospital to celebrate the ongoing commitment to excellence demonstrated by NYP employees.

NYP Way-Continued

Center for Professional Nursing Practice

Sponsor the following- Nursing Excellence Awards

Nurses Week: Recognition of nurses and nursing support staff members who exemplify excellence in patient care at our Nursing and Nursing Support staff ceremony-all campuses including our CAN

Retention, Recruitment, Recognition (R3) Council on all campuses

NYP Way-Continued

Nurse Excellence Awards categories

● Rookie of the Year/ Advanced Beginner Award ● Clinical Excellence in Nursing Award 

● Nurse Leader Award● Advanced Practice Nurse Award● Friend of Nursing Award● Nursing Excellence Award for Nursing Support Staff● Helen S. Tanenbaum Award-Only Weill Cornell● Nurse Preceptor Award

http://nyphwcnursenominations14.weebly.com/

PATIENT CENTERED CARE

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Annual Patient Centered Care Award (PCC)

Patient Centered Care (PCC) Awards: Presented on each campus to recognize excellence and achievement in service and patient satisfaction. The Award program is designed to support NYP’s We Put Patients First effort. 

Comprises of several different awards

Include awards that are based on nominations from employees

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Annual Patient Centered Care Award (PCC)

Staff are asked to nominate candidates for one or more of the multiple award categories described below:

a. Team Achievement Award

b. Leadership Award

c. Physician Champion Award

Staff submit nominations electronically

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Annual Patient Centered Care Award (PCC)

d. Highest Rated Unit or Department

e. Most Improved Percentile Ranking

f. Most Improved Mean Score

g. 90th Percentile

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Patient Centered Care Award: Improve the patients’ experience of care-EQUALS STAFF RECOGITION AND REWARD Patient Centered Care Grants

a. Volunteer Services Department sponsors various fund raising events. In addition, the Hospital matches these donations. Patient Centered Care Grants are awarded to improve patient service and satisfaction.

b. 2012: 21 projects were funded. These grant-funded projects have contributed to our progress in improving the patient experience at NYP.

c. 2013: Grants availability of $100,000 for the 2013 Patient Centered Care Grant Awards. Two grants were available in the amount of $12,500. The remaining $75,000 were awarded in grants of up to $5,000 per award. Minimum submissions must be at least $1,000.

d. Successful grant applications propose programs that enhance the patient experience by providing compassionate, responsive, and sensitive patient care and service.

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HOW DOES PATIENT CENTERED CARE FIT IN REWARD AND RECOGNITION?

If our patients are cared for and satisfied with the care we deliver it equates to staff and organizational rewards and recognitions

Committed to ensuring that all patients and their family members receive outstanding, compassionate care and excellent service from every member of our Hospital team

Measures of our success- Service Excellence

a. Relates to improving our Press Ganey

b. Staff Engagement and satisfaction survey

c. Making care or It Better plans

d. Leadership bootcamp

Hospital Consumer Assessments of Healthcare Providers & Systems-HCAHPS

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Best Practices for Recognizing Your Employees

Making It Better for Employees Plans.

The importance of saying thank you can not be underestimated

Recognition Resources

Big Bang for Your Buck!: These ideas may cost a little more than the suggestions found in the Frugal Manager’s Guide to Recognizing Employees

Employee Preference Sheet: Ask your staff to complete this document so you know how each person prefers to be recognized

Certificate Templates: To recognize large staff accomplishments in a more formal way, use organizational templates to create a special certificate to present to your employee.

Recognition Calendar: This easy-to-use calendar will enable you to document the employees you’ve recognized each month

http://infonet.nyp.org/Awards/ManagerRes/Shared%20Documents/FrugalMgrsGuide.pdf

NYP Way-ContinueExample of nomination form process

Electronic nomination:

Nursing Excellence Award for Nursing Support Staff Nomination Preview

The first section of the nomination form will require you to clearly identify and provide contact information for the Nominee so please have the following information ready when beginning the nomination:

§ Name of Nominee

§ Email contact information for the Nominee

§ Unit of the Nominee

§ Job Title

Please keep responses under 1,500 words total

Question 1: Please cite specific examples of how this employee has made a difference in impacting the delivery of excellent care, teamwork, and putting patients first. (include the employee's achievement(s), any awards, any volunteer service, inspiration or support to others and performance) When writing the nomination narrative use "my/our nominee" rather than his/her name.

The last page of the nomination form is reserved for the contact information for the Nominators and Supporters of the nomination. In this section please be sure to list the name and email for all of the supporters and nurse nominators.

DAISY AWARD

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THE DAISY AWARD

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THE DAISY AWARD

Nurse Excellence and DAISY

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Oncology Nursing Certification Corporation (ONCC)

ONCC Awards and Recognition

a. Honors the achievements of outstanding oncology certified nurses, recognizes an employer for exceptional support of oncology nursing certification, and provides certification opportunities to nurses who want to attain or renew certification.

b. Free recognition plaques

c. Credential pins

d. Chapter Grants

e. Roberta Scofield Memorial Certification Award

f. Oncology Certified Nurse of the Year Award

g. Advanced Oncology Certified Nurse of the Year Award

h. Certified Pediatric Oncology Nurse of the Year Award

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Unit Specific-Example Team player of the month

Because we work night shift or day shift

Oncology Nurses Day

Recognition plaques

Certification Day or Certified Nurses Day (March 19th)

Recruitment/Retention/Recognition Council (R3)

Unit Practice Councils

Welcoming new staff (breakfast etc.)

Cutting the cord day-staff getting of orientation

Celebrate Nursing: Stories of Caring

Preceptors Day/recognition

Charge Nurse Recognition

The Nurse Leader’s Role: Reward and Recognition

Lead by example: Initiating, facilitating, and supporting formal and informal group morale-building activities, and being seen to do these things, cannot be underestimated.

Welcoming and retaining employees : Public recognition of individuals’ achievements and exemplary performance, and private acknowledgement of their personal stresses and issues when appropriate.

Organizations needs to support the manager

Manager Thank You Cards

A simple Thank You goes a long way. Research shows that effective managers consistently recognize employees for a job well done. An essential part of leadership is recognizing your staff and co-workers. (NYP PCC)

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The Nurse Leader’s Role: Reward and Recognition

Transformational Leadership

a. Gain staff support and commitment by inspiring and encouraging them with an organizational vision. Motivate others to do more…more than they thought possible. Set more challenging expectations and typically achieve higher performances

Advancing Care

Quality and Safety

Technology and Resources

Partnership and Community

Shared Governance model

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The Nurse Leader’s Role: Reward and Recognition Every employee wants to be magnificent

Best motivator is manager initiated

High-use recognition managers look for opportunity to recognize staff when they do good work.

Ask questions: what’s important to your employees?

Overworked and under appreciate? Review why.

Money is a motivator, but people leave due to lack of recognition

What gets recognized gets repeated

Recruit, retain, recognize, reward, and inspire people

The best way to motivate employees is to set clear standards and expectations

Celebrate the wins

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Reward & Recognition

Improve patient outcomes

Improve staff satisfaction

Improve retention

Improve employee engagement

Improve morale

Improve teamwork and collaboration

Impact patient satisfaction

Reward & Recognition: What happens when staff are recognized and rewarded?

Personal benefits for nurses

– Nominees: Someone took the time to tell their story

– Honorees: Nominated by patient/family, chosen by peers

– All who attend presentation: Uplifting celebration

– Nurses who run The DAISY Award: Leadership development,

inspired by nominations, have fun

Recognizing Our Shining STARS

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RECOGNITION

Betsy Collins RN MSN AOCNDirector of Nursing

Augusta Health Cancer Center and Infusion Servicesbcollins@augustahealth.com

No Money?

• Does your organization provide a budget for reward and recognition?– Do you use it?

• With or without a budget, recognition needs to be:– Personalized– Specific– Timely

Personalized

• Know your team– What are their likes/dislikes?

• Handwritten notes– Not e-mails– Consider mailing to home address

No Budget – Simple• Immediate praise when possible• Food always works• Recognize those mentioned in thank you

cards, patient satisfaction comments or by patients

• Notice when team is having a particularly difficult time

No Time – Find the Time

• Block your calendar• Recognize during rounding• Talk with them• Begin all meetings with positive feedback to

team and individuals

Find A Way

• You can’t afford not to!!!

• Focus on the positives and work on the negatives!