Central Iowa Health System, a 1,132-bed, three-facility system located in Des Moines, Iowa, used innovative programs to drop its vacancy rate from 12% in 2000 to 4.3% by the end of 2002.
Julie Ploessl, as the Chief Nurse Executive at Central Iowa Health System, oversees nursing practice and patient care coordination throughout the organization. She's also chair of the Professional Nurse Practice Model and the recruitment and retention committee in collaboration with human resources. These efforts have resulted in excellent practices and programs that positively impact nurse retention. Review highlights and details of these effective initiatives in the following Q and A.
Q: What pressing nursing issues did you face within your system in 2000?
A: We had a high vacancy rate and we needed to take a careful look at the goals for our nursing practice and how we were going to achieve them.
We used a Professional Nurse Practice Model (PNPM), a shared governance model that involves staff nurses in making decisions about nursing practice via participation in a committee structure. Issues include nursing quality, nursing policy and procedure, nursing research, resource utilization, and professional growth. Nurse representatives from these committees also participate in other hospital committees to collaborate and integrate the work of the organization. Some of the accomplishments of the PNPM over the past two years include the development of a model for evidence-based practice, a clinical advancement program that recognizes clinical excellence at the bedside, and nursing grand rounds.
In addition to the PNPM, we convened a recruitment and retention committee that closely examined work environment concerns and pay practices. The committee is involved in pay practice issues, providing recommendations to the senior administrative team during annual budget discussions on such issues as benefits, incentive plans, and market increases.
We work closely with human resources to evaluate overall compensation practices. Specifically, we developed a benefits statement to communicate total compensation to employees, including health care, continuing education, and disability benefits.
Our retention efforts focus on reviewing scheduling practices, shared positions, and weekend-package positions. We recognize senior staff with initiatives such as fewer weekends, straight shifts, and no floating to other departments. We also emphasize the importance of orientation and our preceptors. We offer a competency-based orientation program and pay our preceptors an additional incentive for the time they precept new employees. In collaboration with human resources, we've conducted our first health care career fair for high school students to garner interest for careers in the field.
Q: What other programs have you had success with at Central Iowa Health System?
A: We learned many valuable lessons about the challenges nurses face. The ready availability of supplies was a big issue, so we worked to establish well-stocked supply rooms for every unit; it may seem small, but it was a time-saver for busy nurses. We're also investing in equipment to tackle the issue of an aging workforce physically moving patients.
The Patient Service Associate (PSA) program is a well-established success. The associates work closely with our nursing staff to help with environmental services, passing food trays, and providing a consistent and attentive face to patients. As a result of this collaborative effort, patients feel cared for, their rooms are clean, and their food is fresh. PSAs serve as an additional resource for us from the standpoint of answering call lights and acting as our eyes and ears when interacting with patients.
We also have zone managers responsible for designated areas within the hospitals. They make rounds with nurse managers to determine the needs on each floor and directly impact the unit's environment. In particular, zone managers focus on safety issues, room cleanliness, and supply and equipment availability.
When we focus on removing barriers for nurses, we all win: Administrators witness low vacancy, high retention, and happier nurses; nurses undertake what they're passionate about-patient care; and most of all, patients receive the best care possible.