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Caring for Nursing Staff Improves Engagement

By Jennifer Thew RN  
868彩票邀请码   March 06, 2020

A workplace culture built on love and empathy improves organizational outcomes.

Today's healthcare industry is one that focuses on data, metrics, and outcomes. But to achieve success that influences profit margins, clinical outcomes, and reimbursement, healthcare leaders also need to create a healthy organizational culture and work environment.

For example, at in Greenville, North Carolina, leaders are using an innovative foundation for their organizational culture—working relationships structured around love and empathy.

"We embrace the definition of love used by Dr. Martin Luther King Jr. … love is 'an understanding, redeeming goodwill for all men, an overflowing love that seeks nothing in return,' "says , DNP, RN, chief experience officer at Vidant Health.

This type of love involves creating a safe, welcoming place where team members care about each other, she says.

"We talk a lot about the importance of empathy. Empathy put into action is compassion, which is one of [Vidant's] values," says Oehlert. "We have decided that if we design educational offerings and leadership development [around] love, and stress that empathy is of key importance in relationships, that even those times that are difficult in the health system or on the unit will be easier with love and empathy."

She continues, "it is very simple: How we treat each other is how we treat our patients, and how we experience each other is how our patients will experience us. We do not look at patient experience and design a good experience for them without thinking about how the providers feel or how the team members feel. When you look at experience in this way, you can positively contribute to both patients and care providers, which helps prevent burnout and shows that the relationship between the two is valued."

Embrace love, improve outcomes

According to Oehlert, systemwide team engagement has been improving steadily since implementing love and empathy into the workplace and has risen 5.4% over the last four reporting cycles, according to the and Pulse Surveys that Vidant uses to measure employee engagement. From 2017 to 2019, the organization has seen the following increases in engagement:

  • Clinical team member: 1.5% increase
  • Non-clinical team member: 0.2% increase
  • Clinical leader: 11.2% increase
  • Non-clinical leader: 4.7% increase
  • Supervisor, non-clinical: 12.4% increase
  • Supervisor, clinical: 14.2% increase
  • Manager, non-clinical: no change
  • Manager, clinical: 4.7% increase
  • Director, non-clinical: 1.1% increase
  • Director, clinical: 10.8% increase
  • Executive/VP: 4.7% increase

868彩票邀请码From 2015 to 2019, the questions pertaining to manager effectiveness saw "problematic" ratings decrease by 4.1%, and managers rated as "excellent" increased by 6.2%.

From 2015 to 2017, physicians rated as "engaged" increased by 6.5%.

Additionally, reporting of near misses has almost doubled over the last few years, Oehlert says. In FY 2019, 19,120 patient events were reported, a 7% increase from FY18. Of these, 4,849 were safety catches, up from 2,760 safety catches in FY18.

868彩票邀请码Improvements have also been seen in the two questions regarding non-punitive response to error. These questions ask whether team members feel like their mistakes will be held against them, and whether when an event is reported it feels like the person is being written up. The AHRQ question, which highlights a non-punitive approach to safety reporting, is the single most-improved question in the last reporting period of the AHRQ survey.

"If you can take the fear and blame out of your culture, what's left is all the good things about healthcare—love, compassion, empathy, shared decision-making, interprofessionality," she says.

Patient experiences continue to trend upward as team engagement improves, Oehlert says.

Also, the nurse turnover rate at Vidant Medical Center for FY19 is 16.33%, compared to the national average of 17.4%.

"We realize that our culture and our engagement impacts turnover. Right now, our RN turnover is below the national average. We had traditionally recruited and hired locally (North Carolina and Virginia), and now we are confident in our strategy and are attracting nurses from a wider demographic," Oehlert says. "Last year, we hired nurses from 10 different states. Our newest RN recruitment campaign (#carelikecrazy) ties together our intention of love and caring right in our recruitment."

Create a 'strategy around culture'

To help measure success, says Oehlert, organizations should create standard definitions of the components of their mission, values, and goals.

"If you don't know how the organization defines something, it's hard to measure it. We measure our definition of engagement on our engagement survey, and we also define culture in a specific way," she says.

For example, at Vidant:

  • Culture is defined as, "How relationships are structured."?
  • Empathy is defined as, "Recognizing and appreciating the feelings, thoughts, and stories of others by connecting and being sensitive to what, how, and why people feel and think the way they do."
  • Engagement is defined as, "Our shared commitment and partnership in shaping a positive, motivating, and relationship-focused culture where we can all thrive."

"What that does for the organization is it [allows us to] agree so we know what we're going for. I think that is important if you're [creating] strategy around culture," she says.

868彩票邀请码Additionally, when creating developmental offerings, Vidant leaders rely heavily on design thinking, which Oehlert says includes engaging people, getting their feedback, and trialing ideas and innovations.

"A lot of the wicked problems in healthcare today can be healed when you have a strategy that includes love and empathy. You will not have good quality outcomes if you don't have love and empathy within the culture in good measure, because people will be afraid to report quality and safety issues. You will not have excellent patient experiences unless the teams that care for patients are supported and loved. You will not be successful with recruitment and retention if your team members will not recruit for you and may not choose to stay at an organization that does not care about them," she says.

Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.

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