Cultivating Gratitude: Thanking iN Real Time

Oregon Health and Science University, Portland, Oregon

Nov 20, 2024

CSI Summary

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CSI Presentation

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CSI Toolkit

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Project Topic:

Encouraging gratitude and peer recognition. Also, adding shift huddles to foster better communication in a geographically challenged nursing unit

Hospital, City and State:

Oregon Health and Science University, Portland Oregon

Unit:

Emergency Department Observation Unit

CSI Participants:

  • Courtney Bambusch BSN, RN, CMSRN
  • Alyson Johnson BSN, RN
  • Ryan McIntosh Med, BSN, RN

Project Goals/Objectives:

  1. Increase HWEAT Meaningful Recognition score 80%, scores in a 4.0-4.99 range
  2. Decrease registered nurse turnover by 10% when compared to total nurse turnover in 12 months
  3. Foster a culture of positive recognition among staff members and leadership
  4. Implement the daily practice of in-person shift huddles
  5. Celebrating moments of gratitude and peer recognition with monthly and annual recognition

Project Outcomes:

  1. Increased HWEAT Meaningful Recognition score to 3.29 (N=12/47 staff)
  2. All HWEAT standard scores increased
  3. Decreased registered nurse turnover 60% (from 5 to 2 RNs)
  4. Potential annualized savings $253,350

Project Overview:

We recognized that we have had high nurse turnover in our Observation Unit. Based on the low HWEAT Meaningful Recognition score of 2.98, we realized that we may also have less engaged nurses on our unit. To decrease burnout and reduce our staff turnover rates, we implemented a project to begin in-person shift huddles at the beginning of each shift. The purpose of these huddles was to foster better communication and encourage peer-to-peer recognition in real time.

We educated staff about the purpose of the huddles and held our first huddle in March 2024. We collected feedback from our staff in the following months to improve our processes. The first nurse was formally recognized in September 2024 due to delays with staffing and leadership availability.

We have encountered obstacles while implementing our project including lack of staff participation with surveys, leadership disconnect, and staff members who are unwilling to participate. We did encounter positive outcomes throughout our process. The goal is to sustain and scale our efforts through our Unit Based Nursing Practice Council.

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Disclaimer
The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.