Identify New Staffing Model For Appropriate Staffing and Improve Collaboration While Decreasing Burnout

Project Topic:

Identify new staffing model for appropriate staffing and improve collaboration while decreasing burnout

Hospital, City and State:

Children’s Nebraska, Omaha, Nebraska

Unit:

• Operating Room

CSI Participants:

• Madison Custard, BSN, RN
• Katelyn LaPoint, BSN, RN, CPN
• Kelsey Olson, BSN, RN

Project Goals/Objectives:

1. Improve Healthy Work Environment Assessment Tool (HWEAT) True Collaboration and Skilled Communication scores 10%
2. Decrease Oldenburg Burnout Inventory (OLBI) 20%
3. Increase employee satisfaction (operating room custom survey) 20%
4. Reduce overall and first year turnover, limit callback and overtime hours 20%

Project Outcomes:

1. HWEAT Scores
   • Skilled Communication score decreased 5.4%
   • True Collaboration score decreased 6.9%
2. Oldenburg Burnout Inventory decreased 0.12%
3. Employee Satisfaction Scores
   • Overall employee satisfaction scores increased 8% with questions referring to support by staff, and a sense of accomplishment in what they do
   • Burnout percentages also increased 4% with questions that refer to physical exhaustion, proper use of staff, and considering leaving due to stress
4. Turnover
   • RN turnover rate increased 60%
   • Scrub tech turnover rate decreased 50%
   • Callback increased 5.3%, and overtime increased 25.2%

Project Overview:

Burnout among operating room nurses and surgical technologists is at an all-time high, driven by inconsistent staffing, rising case acuity and unpredictable resource demands.

Due to the operating room increase in case complexity, staff burnout rates, patient acuity and becoming a level one trauma facility, it was decided to implement a new staffing model to help reduce burnout, increase staff morale and create safer, more efficient workflows.

During our project kickoff, we educated staff about the implementations that were going into place by instituting a new staffing model that leadership will utilize daily. This project utilization was limited due to lack of staffing, and lack of buy-in from charge nurses and leadership. We struggled to use the model to its fullest extent, which speaks for a lack of overall goals being met. One positive that was seen was that the scrub tech turnover decreased 50%, and our burnout, while small, decreased 0.12%. Unfortunately, our RN turnover increased 60%, along with the amount of callback and overtime for our staff, which led to a decrease in our HWEAT scores. Other factors played a part in these outcomes including increased hours, callback and overtime after Children’s Hospital became a Level 1 Trauma Center in the months when we were kicking off our project.

We had staff reach out and complement our staffing model and charge nurses comment on how it made it easier to put staff in better room assignments, but with a lack of staff it was a struggle to implement the model on a consistent basis. Model was utilized only about 42 days in 7 months (50-55% of time) since kickoff. We determined the model is effective when staffing is adequate. Breakdowns occur with variability and absences. The model will work well if the staffing challenges and buy-in from leadership can be resolved. Since we had limited time for implementation, we will need to utilize model (and make revisions) over the next year to impact outcomes, including unit HWEAT scores and burnout.