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Nursing News:
Michigan hospital program eases its nursing shortage

Flexible schedules help cut turnover

A new nursing recruitment and retention initiative at St. John Health System is paying off.

Since its launch just over a year ago, the program has helped St. John attract nearly 250 new nurses, 200 of them to a flexible new internal pool of contingent nurses.

It's also helped the system score a 28 percent improvement in job satisfaction among nurses, a 26 percent reduction in voluntary nurse turnover and a registered nurse vacancy rate of just 5.5 percent during fiscal 2007, versus 9.5 percent in 2006.

“We've got the perfect storm here — a shortage of health care providers just when the mass of our population is going to require health care services,” as it ages, said Maria Strom, chief nursing officer for St. John Macomb-Oakland Hospital.

“We knew we needed to do something different.”

According to a statewide workforce study by the Detroit office of Watson Wyatt Worldwide for six local health care systems, the state can expect to see a shortage of 18,000 nurses by 2015, Strom said.

The six local health care systems looked at in the study — St. John, Detroit Medical Center, Henry Ford Health System, William Beaumont Hospitals, Oakwood Health System and Trinity Health — will have a combined shortage of 10,000 nurses, she said. And St. John Health will account for 3,000 of them.

It is “absolutely imperative” that hospitals in Southeast Michigan look at recruitment and retention of nurses, said Dave Finkbeiner, vice president of advocacy at the Michigan Health & Hospital Association in Lansing.

To help stave off the shortages, in May of 2006 St. John began taking a closer look at three areas affecting nurses: recruitment, retention and bedside care.

A new, internal contingency nurse pool, dubbed FlexChoice, has helped St. John attract more than 200 new nurses who would have otherwise gone to a contract agency, said Strom.

Under the program, the more flexible a nurse is in their work schedule, the more they can earn. As a side benefit, St. John has nearly ended its use of contract nurses, saving $2 million in agency fees, Strom said.

St. John also has established a nurse residency program to provide hands-on orientation for nurses and is working to recruit nurses from places such as Taiwan, China, India and the Philippines through an intensive, two-year process. So far, the effort has brought 48 new nurses to St. John, Strom said.

And St. John is working with local colleges like Madonna University and Oakland University to recruit nurses who've returned to school to refresh their skills and to train college students in their last year of school, minimizing the amount of on-site orientation needed.

To increase retention, St. John has also created a senior nurse consultant position for veteran nurses who can't meet the physical demands of bedside care, through a pilot program at Providence Hospital in Novi. In the new role, they serve as mentors for new nurses.

The health system is incorporating a safe-lifting program from its parent Ascension Health, in an effort to reduce the number of back injuries nurses suffer, Strom said.

Several Six Sigma projects underway at the system are targeting more efficient processes for bedside care.

For example, up to 60 percent of a nurse's time typically is spent hunting for and gathering equipment, supplies and lines, Strom said. St. John Hospital in Detroit hired four “runners” about six months ago to track down equipment for nurses and deliver it within a specified time, investing about $250,000.

In its first year, St. John estimates the new “equipment on demand” program will save an estimated 13,104 hours of nursing time, the equivalent of six nurses, St. John said.

“The nurses say this is the best thing we've ever done in years, so we know it's working,” Strom said.

Like St. John, the University of Michigan Health System uses an internal, central pool of nurses to fill both full-time and contingent positions, said Juanita Parry, director for nurse recruitment and retention. Nurses are attracted to the flexibility of those programs, and the fact that they reduce the need for overtime.

UM Health System doesn't yet have a nurse residency program like St. John, but it's recognized as a best practice in the nursing community, Parry said. UM did receive a $700,000 grant recently from the U.S. Department of Health and Human Services, to create a Center for Professional Development and Mentoring for nurses.

The system hired 700 nurses last year as it opened its new cardiovascular center, Parry said.

UM has managed to keep voluntary turnover rates at 8.2 percent through a number of initiatives such as substantial funding for professional development for nurses, offering an on-site bachelor's degree completion program where faculty come to the nurses at the hospital, and the launch of “lift teams” and more ceiling lifts in patient rooms to help cut down on back injuries.