Reducing Annual Hospital and Registered Nurse Staff Turnover-A 10-Element Onboarding Program Intervention
Reducing Annual Hospital and Registered Nurse Staff Turnover-A 10-Element Onboarding Program Intervention
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DOI：
10.1177/2377960817697712
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发表时间：
2017-01-01
影响因子：
2
通讯作者：
Channell, Lesley
中科院分区：
文献类型：
--
作者：
Kurnat-Thoma, Emma;Ganger, Mary;Channell, Lesley
在评估任何医疗保健设施的财政和业务有效性时，员工流动率都是一个关键的衡量标准和业绩指标。本文概述了一个营业额分析和入职计划的性能改进倡议所使用的187张病床的社区医院在华盛顿大都市区，以减少员工流动率。使用循证方法，我们评估了设施人员统计数据，退出调查数据，研究文献和行业范例。我们发现，雇用不到一年的医院和护理人员（新员工）存在严重的流动性，2009-2012年年度新员工损失从28.8%到49.6%不等。离职调查数据显示，只有50%至62%的新员工认为：医院的定位为成功就业提供了必要的信息;他们有担心的人;他们对自己的工作有现实的理解。因此，设计了一个10要素的计划干预措施，以加强和标准化新员工入职流程。该计划的内容主要集中在重新调整的入职沟通上，包括新员工与经理的频繁互动，以及来自指定的高绩效同事的定期支持。项目实施后，医院整体年度流动率从18.2%下降到11.9%，新员工流动率损失从39.1%下降到18.4%，其在测量期间之间具有统计学显著性（Wilcoxon符号秩检验，Z =-2.06，p=.04）。实施专门为支持新员工而量身定制的标准化入职格式，使我们的医院能够迅速扭转不可持续的营业额增长。我们成功地减少了医院和护士的流动率，这源于机构利益相关者的多学科参与、跨部门的管理协作以及医院领导层的大力支持。
Employee turnover is a key metric and performance indicator when evaluating the fiscal and operational effectiveness of any health-care facility. This article outlines a turnover analysis and onboarding program performance improvement initiative used by a 187-bed community hospital in the Washington DC metropolitan area to reduce staff turnover. Using an evidence-based approach, we evaluated facility staffing statistics, exit survey data, research literature, and industry exemplars. We identified presence of severe turnover for hospital and nursing staff employed less than one year (new hires), with 2009-2012 annual new-hire losses ranging from 28.8% to 49.6%. Exit survey data identified only 50% to 62% of new employees who felt that: hospital orientation provided necessary information for successful employment; they had people to go to with concerns; and they had a realistic understanding of their job. Therefore, a 10-element program intervention was designed to strengthen and standardize the new employee onboarding process. Program elements focused heavily on retooled onboarding communications, including frequent new-hire interactions with managers and regular support from assigned high-performing colleagues. Post program implementation, overall annual hospital turnover decreased from 18.2% to 11.9% and new-hire turnover losses decreased from 39.1% to 18.4.%, which was statistically significant between measurement periods (Wilcoxon signed ranks test, Z = -2.06, p=.04). Implementing a standardized onboarding format that was specifically tailored to support new-hire employees allowed our hospital to rapidly reverse unsustainable turnover increases. The successful reduction in hospital and nurse turnover we achieved was rooted in multidisciplinary engagement of institutional stakeholders, managerial collaboration across departments, and strong support from executive hospital leadership.