Decreasing Turnover on Trauma Unit

Project Topic:

Meaningful Recognition, Staff Engagement, and Retention

Hospital, City and State:

The University of Alabama-Birmingham Health System, Birmingham, Alabama

Unit:

• Trauma Recovery Unit (TRU)

CSI Participants:

• Kimberly Collins, LPN
• Kendra Jones, LPN

Project Goals/Objectives:

1. 75% Staff participation in providing feedback
2. Increase Healthy Work Environment Assessment Tool (HWEAT) Meaningful Recognition score to 4.4
3. 10% less vacancies and nursing turnover

Project Outcomes:

1. 92% staff participation in providing feedback
2. HWEAT Meaningful Recognition score increased to 4.09
3. Decreased vacancies from 14 to 6
4. Decreased nursing turnover from 8 to 2 (22.9% to 5.7%)
5. Potential annual fiscal impact $628,560

Project Overview:

The Trauma Recovery Unit (TRU) at the University of Alabama at Birmingham (UAB) Hospital implemented the “Strong Teams Build Strong Recoveries” project to address challenges with staff retention, engagement, and workplace culture. The 20-bed unit cares for trauma, orthopedic, gastrointestinal surgery, and recovery patients, and leadership recognized that strengthening team cohesion and meaningful recognition could improve both employee satisfaction and patient outcomes. The project focused on creating a culture of appreciation, support, and positivity to help retain staff and foster stronger care teams.

To achieve these goals, the team introduced a Kudos Board and Prize Cart initiative that encouraged peer-to-peer recognition across all shifts. Staff were invited to acknowledge coworkers for teamwork, compassion, and excellence in patient care through written kudos notes, while weekly gift exchanges, appreciation activities, snack and coffee bars, holiday celebrations, and other recognition efforts helped maintain engagement. The initiative was designed to make recognition visible, meaningful, and accessible while promoting a positive work environment for both staff and patients.

The project produced significant improvements in staff engagement and retention. Staff participation exceeded the initial goal, with 92% of staff providing feedback and actively engaging in project activities. Meaningful Recognition scores on the Healthy Work Environment Assessment Tool (HWEAT) improved from 4.01 to 4.36, surpassing the project goal of 4.4 and demonstrating a highly positive perception of workplace recognition. Team members reported improved morale, stronger collaboration, and a greater sense of connection within the unit.

The initiative also had a measurable impact on workforce stability. Nursing vacancies decreased from 14 positions to six, while nursing turnover dropped from eight nurses to two, reducing the turnover rate from 22.9% to 5.7%. Based on national estimates for nurse replacement costs, the team projected approximately $366,660 in savings during the seven-month project period, with potential annualized savings exceeding $628,000. These results demonstrate the value of investing in recognition and team-building strategies as a workforce retention tool.

One of the most meaningful outcomes was the unexpected involvement of patients in the initiative. Patients not only read the Kudos Board but also contributed notes and heartfelt letters recognizing staff members. This strengthened relationships between caregivers and patients while reinforcing a culture of kindness throughout the unit. The project demonstrated that simple, low-cost recognition strategies can create lasting positive change, improve staff satisfaction, enhance retention, and contribute to a more supportive healing environment for both patients and caregivers.