Extinguish the Burnout

Methodist Hospital (San Antonio, Texas)

CSI Summary

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CSI Presentation

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CSI Toolkit

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Project Topic:

Decreasing burnout and nurse turnover

Hospital Unit:

Med/Surg Medicine 1

CSI Participants:

  • Amanda Constancia, ADN, RN
  • Jessica Ellis, ADN, RN
  • Brenda Hernandez, ADN, RN
  • Briana Ladson, BSN, RN
  • Alexis Ramos, BSN, RN

Project Goals/Objectives:

  1. Increase morale on the unit
  2. Build an atmosphere where staff can work together as a team and feel comfortable with their work duties and asking for help
  3. Plan outside-of-work events and have 80% of staff attend at least one of the events
  4. Increase nurse retention 10%
  5. Increase employee engagement 10%

Project Outcomes:

  1. Decreased turnover rate 5% in one year
  2. Increased employee engagement 10%
  3. Increased AACN's Healthy Work Environment Assessment Tool (HWEAT) aggregate score from 3.14 to 3.8
  4. These outcomes resulted in an estimated annual fiscal impact of $138,300.

Project Overview:

In 2021, the turnover rate for our Medicine 1 unit was 22%. Our CSI team chose this challenge for our innovation project to increase morale and retention in the unit. We developed our strategy and held a kickoff with staff in month three of our project.

Our team decided to conduct AACN's Healthy Work Environment Assessment Tool survey (HWEAT) as a baseline measure. Then we introduced monthly events to bring staff members together and allow them to get to know each other. We hoped that by forming a "family bond" and encouraging each other to work as a team, staff would feel comfortable and safe enough to approach one another, not only in a hospital/nursing setting but in their everyday life as well. To increase participation, we surveyed staff about the types of events they would like and those who attended were eligible to win a raffle prize.

Our CSI team also encouraged and supported staff in furthering their education and/or becoming certified as another way to be recognized and rewarded. We urged Medicine 1 nurses to apply for the Med/Surg Certification Exam and to consider registering for a Med/Surg certification review session to help them prepare. We also implemented multiple recognition boards.

Toward the end of our project, we resurveyed staff using HWEAT. Survey results indicated that our HWEAT score increased to 3.63 and other data showed our turnover decreased as well.

Feedback about the project has been positive. Staff members have asked when there would be another event and have suggested ideas for future events. Positive feedback has also been acknowledged by nurses outside of the Medicine 1 core staff. Nurses from other units have signed up to work shifts on Medicine 1 and travel/agency nurses working in our unit have renewed their contracts multiple times. In addition, a number of resource float nurses shared that our unit culture is described as, "They are like a family here. They are always willing to help one another."

Permission to Reuse Materials
The materials associated with this AACN Clinical Scene Investigator (CSI) Academy project are the property of the participating hospital noted above, not AACN. Requests to use content contained in the CSI team’s summary, presentation or toolkit should be directed to the hospital. We suggest reaching out to the hospital’s Communications, Marketing or Nursing Education department for assistance.

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.