Moving to Magnet: Reduce RN Turnover
with CEO Jon Schandler and CNO Leigh Anne McMahon, RN White Plains Hospital Center, White Plains, NY
"Pursuing the Magnet designation for nursing integrates well with the Evidence-Based LeadershipSM tools and tactics we are using from Studer Group. They complement and build on each other," explains White Plains CEO Jon Schandler. "In 2008, we reduced RN turnover by 3% for $1.4 million in savings."
Since 2007, White Plains Hospital Center—a 293 bed facility in New York—has also moved inpatient satisfaction from the 9th percentile to the 56th percentile and ED patient satisfaction from the 13th percentile to the 77th percentile.
While still early in both the Magnet and operational excellence journeys, Schandler finds that together, the two processes have shifted the culture of accountability. "We're seeing a transformation in the nursing division," he says. "It was considered a cost center with the largest budget but there was no accountability. Now nurse leaders have financial goals in our leader evaluation system and are responsible for helping us to reduce turnover and agency expense over time."
CNO Leigh Anne McMahon rolled out the Magnet process in 2008, a year after White Plains had adopted Studer Group's five pillars and leader evaluation system for accountability. "I align everything," she says. "Patient satisfaction is outcomes for nursing in Magnet language. We can break down the patient satisfaction survey and equate "how fast was your call bell answered" to "patient trust."
"Nurses are also starting to look at strategy," she adds. "I was able to cut $750,000 which was budgeted for hiring sitters for patients. I sold it to nurses by sending emails that explained how ‘this is the salary of seven nurses.'"
What Nurses Really Want
"Nurses tend to say they want more money, longer lunch hours or more staff but what they really want is more autonomy," explains McMahon, who surveyed nurses using the American Nurse Association's National Database for Nurse Quality Indicators (NDNQI). "This dovetails perfectly with the transparency in our Leader Evaluation Manager. They can see my goals, their goals and have clear expectations and feedback. They know exactly why we are making changes in the organization or nursing division and support the changes."
Before the decision to achieve Magnet, White Plains didn't have shared governance in the organization, so this year leaders implemented the Magnet Nurse Councils and started CNO town meetings, both of which have received excellent feedback. These communication channels align well with the "Communicate At All Levels" principle White Plains adopted back in 2007.
McMahon says that what she learned about high, middle, and low performers also prepared her for what would happen with the councils. Twenty percent of nurses tend to be high performers who want to participate on councils so McMahon aligns her time with those.
"We launched both initiatives because of the external operating environment and financials," notes Schandler. "We needed to take the organization to the next level and now we're seeing progress and momentum."
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