By Jennifer Dixson Hoff and F. Patrick Robinson
In our previous article, we explored some emerging trends that have been discussed by Capella University’s School of Nursing and Health Sciences Advisory Board – including the generational evolution and the importance of connecting with millennial nurses for the benefit of the entire hospital. By taking strides to understand these types of workforce dynamics, hospitals and health care organizations can address important priorities like nursing engagement and retention.
Today, many of the organizations we work with are calling for more evidence-based strategies to retain nurses. In this article, we will provide a forward-thinking approach to incorporate learning and professional development across the career spectrum for their nurses in 2018 and beyond.
Nursing retention by the numbers
An inadequate strategy for developing and retaining nursing talent can potentially jeopardize patient satisfaction and harm an organization’s reputation. In Aberdeen Group’s research, Managing and Leading Human Capital in 2015 and Beyond: A Healthcare Perspective, 86 percent of 100 health care organization leaders interviewed said that talent plays and important role in determining satisfaction scores they receive from patients.
Unfortunately, quick-burnout and turnover of nurses remain pervasive problems in the industry today. Consider the statistics highlighted in the 2017 NSI Nursing Solutions National Health Care Retention & RN Staffing Report:
- The national average turnover rate for bedside RNs was at 14.6 percent in 2016. More than a quarter (25.6 percent) of all new hires left their position within a year – accounting for approximately one-third (29.4 percent) of all turnover.
- The average cost of turnover for a bedside RN ranges from $38,900 to $59,700. This results in the average hospital losing $5.13 – $7.86 million annually.
With so much on the line, from driving quality care to maintaining operating budgets, hospitals and health care organizations must take a strategic view of their workforce in alignment with their overall organizational objectives.
Development as a driver
According to the NSI survey referenced above, lack of career advancement remains one of the top drivers for nurse turnover. In the nursing profession, one way to potentially unlock career opportunities is through obtaining an advanced degree. Degree programs may help nurses take the next step in their careers, while certification and training resources can help them keep their skills up-to-date.
It’s not uncommon for health care organizations today to use tuition assistance programs as part of their nurse development strategy. While employers have often viewed these programs as a benefit, similar to health insurance or paid time off, they may not realize the potential value these programs can deliver in building nursing competencies and improving retention.
While there is still a pretty wide gap in our understanding of the true value these programs offer on this front, the Lumina Foundation recently conducted a series of surveys to measure the return on investment (ROI) of tuition assistance programs covering a gamut of industries, including two well-developed studies in health care. Those two studies revealed some wide-ranging results:
- A case study on Cigna reveled the health insurer’s employee education reimbursement program generated 129 percent ROI in the form of avoided talent management costs from 2012 to 2014. Participants had more than an eight percent higher retention rate than non-participants, and they were promoted ten percent more often than non-participants.
- An analysis of Advocate Health Care’s tuition assistance program noted a slight 4.3 percent ROI from 2011 to 2015. However, specific to RNs, the study indicated a negative ROI of 33.5 percent. The RNS that participated in the employer assistance program did see a six percent higher performance rate as compared to those who didn’t. Employer assistance program participants saw a 46 percent increase in wages over non-participants. as compared to those who didn’t. Employer assistance program participants saw a 46 percent increase in wages over non-participants.
These studies reveal some interesting dynamics that will hopefully lead to more research and understanding as an industry. While the reports suggest there is an association between retention and education, they point towards a need for more strategic alignment between the needs of health care organizations and the nurses they employ.
Supporting the lifelong learner
Despite the demand for lifelong learning in nursing today, traditional education programs weren’t designed to support the busy schedules and priorities of today’s nurses. Thankfully, the tides are changing.
Adaptable models of higher education have come a long way in just a short time period. Employers today can offer tuition assistance for online competency-based programs that build practice-relevant skills within their nursing workforce, while also helping nurses achieve education milestones on their own timeline.
A few key areas that hospitals and health care organizations could consider when evaluating nursing education partners include:
- Competency focus – Going beyond competency-driven development, organizations today are seeking the ability to measure practical and cognitive skills gained through nursing education. Key drivers for nursing leaders today include competencies in communication, interprofessional collaboration and the ability to effectively coordinate care.
- Flexibility – Meeting the needs of today’s adult learners requires flexible education models where learning can be successfully integrated into busy personal and professional lives.
- Cost effectiveness – Cost, along with its alignment to available tuition assistance is an important consideration for every organization. Leaders should be mindful of the full value of the educational program including the availability of academic and other support services.
Looking to 2018, nursing leaders should consider forging a closer relationship with their academic partners to measure the ongoing results of their tuition assistance program and improve ROI. In this vision, the academic partner would act in a consultative role – providing guidance not only on degree programs, but also on robust professional development services to help address specific skills gaps.
Both the health care organization and academic partners stand to benefit when they come together like this to find the right solutions. This alignment can help to generate a platform for the development of nurses that aligns closely with overall organizational objectives. That’s good news for hospitals seeking to advance their missions and ultimately provide the best possible care for the patients they serve.
Jennifer Dixson Hoff is Vice President and General Manager of the College of Nursing, Health, and Behavioral Sciences at Capella University. F. Patrick Robinson, PhD, RN, FAAN serves as Dean of the School of Nursing and Health Sciences at Capella University.