Maintaining morale

Hospitals taking steps to counter rising job dissatisfaction

Nurses at Mercy Hospital & Medical Center in Chicago were frustrated that they had to search through supply closets to find supplies and equipment such as cuffed blood pressure monitors and syringes. Lacking an efficient system to track inventory, they felt they were wasting time that could be better spent caring for patients, they complained to hospital leaders.

In response, Mercy administrators implemented the BlueBin system, which cost about $700,000. The system uses computer software and scanners to improve tracking of supply levels. Nurses no longer need to hunt or beg for supplies. They’re also making fewer trips to the supply closets, as cabinets or nurse servers stocked with the supplies they need most are located in the middle of their hospital floors. Hospital officials say it has created better organized supply rooms and boosted nurses’ morale.

“We’ve taken the burden off the nurses,” said Mercy Chief Operating Officer Richard Cerceo. “They don’t have to ever order supplies, it does it automatically for them. It was designed around their needs.”

Maintaining a happy and healthy workforce of nurses and other staff is becoming more of a priority as hospitals face budget cuts and staff reductions that can alienate tenured workers who have grown comfortable with the traditional ways of doing business and now face a more stressful, cost-conscious healthcare environment. There’s also a growing awareness of the need to provide personal support to treatment staff who sometimes forget to take care of themselves in the rush of caring for patients.

Staff input requested

Mercy’s action is just one example of the various ways hospital and medical group leaders across the country are working to improve morale, as frustration levels among caregivers rise. Providers are requesting more staff input to make sure their needs are met. They’re using new tools to measure employee satisfaction, and also trying to ensure better patientto-staff ratios. Some are establishing more training programs that could lead to promotions, while some have even created incentive-driven wellness programs, which reward staff with prizes like extra vacation days for healthy behavior. About 86% of hospitals have established workplace wellness programs, according to the American Hospital Association.

Yet recent surveys show the effectiveness of these morale-boosting measures still have a long way to go. Though career satisfaction among nurses remains high with 90% happy with their choice of profession, fully 35% say they feel like quitting their current position, up from 33% in 2012, according to a soon-to-be published survey from the AMN Healthcare consultancy. The number expecting to be at a different job a year from now ticked up a percentage point in the past year to 33%, which is significantly higher than the restlessness registered among nurses in 2010, the first year AMN did its nurse survey. Another troubling indicator: Fully half say they worry about their jobs affecting their health.

Among nurses, many voice frustration that they are working longer shifts without breaks or vacation time, said Zenei Cortez, a co-president of the California Nurses Association and a registered nurse at a Kaiser Permanente medical office in San Mateo, Calif. Low morale can make even basic tasks such as responding to a patient call light difficult. “Nurses’ morale is plummeting because they feel like they can’t do their jobs given what’s going on,” she said.

California is the only state with a law that mandates specific nurse-patient ratios, and that law helps preserve morale, Cortez said. But the union still feels they don’t have enough nurses on duty and that resources are spread too thin.

Ensuring staff isn’t overworked is just one key trait of a successful organization. Other signs of a positive workplace environment include job security, respectful treatment of employees, confidence in management, and a culture of high-quality patient care, Cortez added.

Research from Press Ganey also links morale and engagement with quality of care, readmission rates and performance of hospital core measures, concluding that “employee engagement has very real financial implications.”

“Passionate and visible” leadership is a common thread for successful organizations, said Deborah O’Brien, senior vice president, consulting and education services for Press Ganey. Leaders need to plan out their departmental rounds with goals. They need make their time seeing staff count— whether that’s delivering a message or looking at a particular concern. That also breeds

an environment of accountability and trust.

“It’s not just walking the halls, but it’s about actually bringing the information back and sharing it with the others out at the hospital and then acting upon it,” O’Brien said.

Press Ganey’s data tied higher CMS Hospital Consumer Assessment of Healthcare Providers and Systems scores, which reflect hospital performance, to high employee engagement. Hospitals with a high average engagement ranking scored 16 points higher in overall hospital ratings, compared with facilities with low engagement ranking.

Avoiding burnout

While Mercy’s redesign of the system for ordering supplies may seem like a simple task, its impact on morale and even quality of care shouldn’t be underestimated. Stress and low morale could lead to burnout, which leads to medical errors. Research conducted at the University of Pennsylvania School of Nursing published last year showed a link between nurses suffering from burnout and higher incidents of catheter-associated urinary-tract infections and surgical site infections.

“The reaction to short staffing or burnout is nurses aren’t going be able to pay attention to details,” said Cheryl Wagner, the associate dean of graduate nursing programs at American Sentinel University in Birmingham, Ala. “You’re going to see more errors. The error can be a higher infection rate on the floor, medications errors—all kinds of these things happen when the nurses aren’t paying attention.”

Thanks to the new BlueBin system, the nurses at Mercy said they spend much less time sifting through supply closets to find what they need, which frees up more time to spend with patients. Mercy estimates the system saves 18,000 staff hours annually.

Nurses said they appreciated administration listening to their input and addressing their concerns. Other staffers are pleased that the new system has lessened tension and improved communication between departments.

“We tried to form a partnership at the beginning” with the nursing staff, said Quincy Stanley, Mercy’s supply chain manager. As a result, he said, the nurses feel a sense of ownership over the new supply system because they helped design it.