How to Strengthen Your Nurse Retention Strategy

Nursing workforce issues are at an inflection point. The supply and demand of nurses shifted rapidly during the COVID-19 emergency, and the need for the existing number of nurses to care for high-acuity patients overwhelmed the health care system.

Even as the pandemic began to abate, the delta between nurses returning to the bedside versus those remaining home or opting to work in an alternate profession reduced the number of nurses available to work in hospitals and health systems. In fact, staff retention and recruitment were cited as the No. 1 challenge by respondents to an American Organization for Nursing Leadership longitudinal study.

These trends and other data point to the need for health care leaders to develop effective nurse retention strategies, even as some data show that more nurses are returning to the field.

What Nurses Want

A new AHA Market Scan Trailblazers report, “How to Strengthen Your Nurse Retention Strategy,” identifies common reasons why nurses leave their positions and how to build a robust nurse retention strategy.

To improve nurse retention, sources in the report note that organizations must provide:

• More resources to support new-to-practice nurses.
• More resources and education to help nurses practice at the top of their licenses.
• More clinical decision-making authority.
• More career-advancement opportunities.

Continuous Learning Fuels Improvement

Forward-thinking organizations are building more resilient, effective and robust nurse retention strategies in the wake of their COVID-19 experiences. They are also adopting a continuous improvement approach to make retention efforts more nimble and more responsive to the changing needs of their nursing workforce.

The reasons why nurses leave their employers and the order of those reasons change. Also, the reasons and their rank order may be specific and unique to a given hospital or health system. Nurse retention strategies should address those issues so that employers can respond quickly and appropriately.

This requires organizations to adopt an omnichannel approach that continuously takes the pulse of all nurses on staff. The approach can include surveys, standing committees, regular meetings, employee evaluations, exit interviews, social media, job boards, online communities, feedback loops, conversations with informal leaders and other clinicians and organizational self-assessments.

Two Health Systems Blaze a Continuous Learning Trail

Peoria, Illinois-based OSF Healthcare always has tried to communicate effectively with the nursing profession. The 16-hospital integrated delivery network enjoys a unique vantage point in this regard. It operates two nursing colleges in the state. Yet, OSF is not immune to the same challenges of nurse turnover and vacancy rates affecting other provider organizations.

One differentiator for OSF, however, is its approach to continuous learning. It has developed a corporate university to oversee staff education and training. A team of 12 system educators run the enterprisewide program, which OSF launched last year with its nurse retention partner Relias.

The corporate university opened learning paths, or “paths to competency,” for thousands of the system’s employees, including nurses. Prior to the corporate university, OSF offered education and training but in a less structured and less self-directed format.

OSF’s educational objectives for the university range from supporting practice changes to optimizing policies and procedures. Programs include nursing and technical orientation, critical care courses, workplace violence and global training programs. The initiative has led to a threefold increase in courses completed — from 7,977 in 2021 to 28,452 in 2023.

The corporate university structure has been particularly helpful to new nurses. The nurse orientation and onboarding learning modules dramatically reduce time to practice for new hires. That, in turn, fills open positions more quickly on hospital floors and units, much to the appreciation of nurses working on those floors and units. Nurses also benefit from training modules that enable them to fulfill licensing and continuing education requirements easily and more efficiently.

Getting Nurses on the Same Page

PAM Health, a system in Enola, Pennsylvania, has taken a slightly different path to its continuous learning initiatives for nurses and other clinicians. It operates long-term acute care hospitals, inpatient rehabilitation hospitals, outpatient rehab clinics, inpatient behavioral health hospitals, home health and hospice services at more than 60 sites in 17 states.

PAM Health’s diversity of services, disparate locations and explosive growth over the past three years have created a unique challenge — getting all its nurses on the same page in terms of policies, procedures, staff education and training, skill sets, competency levels and corporate culture.

That objective extends to new nurse hires, current nurse employees and nurses from newly acquired PAM Health care sites. In less than three years, PAM Health has grown from 41 care sites to 63, and recently announced plans to build four freestanding physical medicine and rehabilitation hospitals in four different states.

PAM Health’s rapid expansion has brought thousands of additional patients and employees into the system. With its rapid growth, the organization needed automated, user-friendly human resources and training processes.

It partnered with Relias to build an automated platform with a specific learner portal for clinicians, including nurses. Through the portal, nurses easily can access online onboarding, orientation, and training and education modules.

Nurses also can search the platform for their specific state licensing or continuing education requirements and find training and education modules tailored to meet those requirements. In addition, nurses can complete those modules at their own pace, work toward meeting their certifications and document that they’ve completed their course work.

PAM Health also offers annual training plans for all employees through the platform. The system divides each annual training plan into four quarters with each quarter devoted to a specific theme. Examples of quarterly themes include regulatory compliance, internal compliance, job-specific training and new training needs that arise during the year.

To date, nearly 11,000 PAM Health employees, including nurses, have used the platform with an average of 31 completed training modules per user.

Download the full Trailblazers report now!