1. Doucette, Jeffrey N. DNP, RN, CEN, CENP, NEA-BC, FACHE

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Is your reward program rewarding enough?

Q My employee engagement survey scores for "reward and recognition" are low. How can I improve them?

Managing employee engagement is one of our most important roles as nurse leaders. Here are five things you can do to enhance reward and recognition within your team.

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1. Rounding every day is one of the easiest ways to increase face time with employees, physicians, and patients. Use this time to connect with staff in a meaningful way and look for opportunities to catch people in the act of doing great things.


2. Send handwritten thank-you notes. In this era of electronic communication, the art of the handwritten note seems to have been lost. Take time each week to send a note to an employee's home thanking him or her for a job well done or going above and beyond in support of the team.


3. Use "on-the-spot" recognition. Keep a supply of small gift cards or meal passes for the cafeteria and use them while rounding. Catch people doing things right and provide a reward in the moment.


4. Consider formal recognition programs. At my organization, we've partnered with the Daisy Foundation to hold a monthly nurse recognition day. In addition, we recognize a non-nurse caregiver and physician colleague once a quarter. This peer-nominated and peer-reviewed process for recognition has become the cornerstone of our positive recognition scores and a source of pride for award winners.


5. Know how your team members want to be recognized. Not everyone wants an award or public recognition. At our organization, managers ask employees how they prefer to be recognized. The simple survey includes a list of "favorites," such as candy bars, movie tickets, and restaurant gift cards, so the leader can customize recognition to each employee's preferences.



There's never too much that you can do to recognize and reward your team members. These suggestions will help you set the course for increasing your scores and, more important, give your team the kudos they deserve.


This way to successful ACOs

Q What will be expected of nurse leaders in Accountable Care Organizations (ACOs)?

Leading care across the continuum will be the key for nurse leaders in the ACO model. Managing the "white spaces" between the traditional areas of care (acute, home, skilled nursing) will become critical to ensure patients are receiving care in the most appropriate setting. In addition, nurse leaders must be the voice of the patient in system decision making. No one is better positioned to represent patient needs than nurses, and frequently the patient's voice is missing when organizational decisions are made.


Another competency will be the ability to manage complex systems to produce, interpret, and communicate key informatics to drive clinical decision making and transformation. With the proliferation of clinical information systems, organizations find themselves with easy access to more data than ever before. Taking these data and turning them into useful information will drive change throughout the healthcare system.


Nurses will also need to be comfortable managing and leading other disciplines in the provision of care. Here again, nurses are in the best position to coordinate the care of patients across the continuum. Leading other disciplines in this process will be crucial to success in the ACO model.


We must also advocate for "next generation" nursing school curriculum development. The current model continues to prepare new graduate nurses to care for one to two patients on day shift in the acute care environment and we hire them to take care of six to eight patients on the night shift. In the near future, we'll be hiring new graduates into ambulatory care, home health, and other nonacute specialties as patient volumes continue to shift to these areas.


Finally, one of the biggest challenges is navigating these changes in two worlds. We're working toward a model that's based on value while we're primarily still being paid based on a volume model. This makes the transition even more perplexing for today's nurse leader.


These are some of the most challenging times to be a healthcare leader, but no one is better positioned than nurse leaders to lead organizations to a truly patient-centered model.