Decreasing Turnover Through Meaningful Recognition

Project Topic:

Increase staff satisfaction through positive recognition with hopes of increasing retention and decreasing burnout

Hospital, City and State:

Atrium Health Wake Forest Baptist Lexington Medical Center, Lexington, North Carolina

Unit:

• Critical Care Unit

CSI Participants:

• Nicole Benscoter, BSN, RN, CCRN
• Jennifer Benson, BSN, RN
• Allie Burns, BSN, RN
• Nathan Carter, BSN, RN
• Kyndall Estep, BSN, RN
• Coach: Christian Mayes, BA, ADN, RN

Project Goals/Objectives:

1. Increase Health Work Environment Assessment Tool (HWEAT) Meaningful Recognition score 5%
2. Decrease overall turnover 35%
3. Decrease first year turnover 50%
4. Achieve 80% of the staff participation in recognition tool

Project Outcomes:

1. Increased HWEAT Meaningful Recognition score by 16.8%
2. Decreased overall turnover by 28.5%
3. Decreased first year turnover by 80%
4. These outcomes resulted in a positive estimated annual fiscal impact of $523,714

Project Overview:

The Critical Care Unit (CCU) at Atrium Health Wake Forest Baptist Lexington Medical Center identified a positive feedback loop of workforce challenges. A cycle of turnover and decreased staff satisfaction was exacerbated by low levels of meaningful recognition among team members. Baseline Healthy Work Environment Assessment Tool (HWEAT) results demonstrated that Meaningful Recognition was one of the unit's lowest-scoring domains, with a score of 4.10. The unit experienced 7 RN turnovers during the preceding 6 months, including 5 nurses within their first year of employment. In response, our team launched the "Culture Shock" project to increase staff experience through positive recognition with the goal of improving satisfaction, retention and strengthening our work environment.

We developed and implemented a recognition program centered on gratitude and peer-to-peer acknowledgement. Interventions included establishing a Culture Shock recognition station within the unit, creating QR code access for staff to submit recognition messages, and displaying teammate shout-outs on a monitor for the entire team to view. The project launched in January 2026 following planning, staff engagement efforts, and baseline data collection. Our goals were to improve HWEAT meaningful recognition scores, decrease overall turnover by 35%, decrease first-year turnover by 50%, and achieve participation from at least 80% of staff members.

Since implementation, the project has generated positive engagement across the entire hospital and has fostered stronger connections among teammates. One of the most encouraging outcomes has been increased interaction and relationship-building between dayshift and nightshift staff, along with growing interest from other disciplines.

The results of the final HWEAT survey exceeded our goal of increasing meaningful recognition by 5% and showed a 16.8% increase. We were just shy of our goal to reduce overall nursing turnover by 35%, achieving 28.5%. However, we did achieve our goal of reducing first year nursing turnover by an astounding 80%. Due to limitations of the software and mostly anonymous submissions, we were unable to analyze how many teammates engaged with the Culture Shock project.

The Culture Shock recognition board has become a visible and meaningful way for staff to celebrate one another's contributions, helping cultivate a culture of gratitude and appreciation. The team plans to sustain the initiative through onboarding, Nurses Week celebrations, quarterly recognition events, interdisciplinary involvement, and expansion to other units throughout the organization.