Make a Case for a Nurse Residency Program

Make a Case for a Nurse Residency Program

Nursing Executive Center Make a Case for a Nurse Residency Program Customizable Slides 4 Component #1: Quantified Problem New Graduate Nurses at [Our Organization] [45] [35%] New graduate nurses hired [last year] Percentage of new graduate nurses that turned over within their first year New Graduate First Year Turnover Nationally 20-40% 2017 Advisory Board All Rights Reserved advisory.com Typical first year new graduate turnover rates in the U.S. Source: Goode CJ et al., Lessons Learned from 10 Years of Research on a Post-Baccalaureate Nurse Residency Program, JONA, 43, no. 2 (2013): 1-7; Kovner CT, et al., What Does Nurse Turnover Rate Mean and What Is the Rate? Policy Politics Nursing

Practice, 15 no. 3 (2014): 464-71; Hofler L, Transition of New Graduate Nurses to the Workforce: Challenges and Solutions in the Changing Health Care Environment, NCMJ, vol. 77 no. 2 (2016): 133-136; Nursing Executive Center interviews and analysis. 5 The Financial Cost of New Graduate Turnover Quantifying the Cost of Turnover 1.5x Salary [$90,000] Conservative estimate of the cost of turnover for non-physician turnover1 Rough estimate for cost of one new graduate RN leaving the organization 1) Including replacement costs, onboarding new hire, and costs associated with vacant position. 2017 Advisory Board All Rights Reserved advisory.com Source: Nursing Executive Center interviews and analysis. 6 Ripple Effects Also Significant New Graduate Turnover: Creates More Work for HR And for Managers

And for Staff Recruit and screen new candidates Interview additional candidates Absorb extra work Onboard replacement staff Train new staff 1) Including replacement costs, onboarding new hire, and costs associated with vacant position. 2017 Advisory Board All Rights Reserved advisory.com Source: HR Advancement Center interviews and analysis, Nursing Executive Center interviews and analysis. 7 Turnover on the Rise A Clear and Troubling Trend Median Bedside RN Turnover Rate1 n=3052 12.0% 11.7% 11.1% 10.6% 9.8%

10.1% 8.7% 2010 2011 2012 2013 2014 2015 2016 1) Turnover rate is determined by dividing total number of separations among all full-time and part-time employees between January 1 and December 31 by the average of the total number of full-time and part-time employees over that time frame. Excludes PRN, per diem and casual employees. 2) N-value for 2016 benchmark cohort. 2017 Advisory Board All Rights Reserved advisory.com Source: 2016 Annual Turnover, Vacancy, and Premium Labor Benchmarks, HR Advancement Center. 8 Bedside RN Turnover Benchmarks Bedside RN Turnover Excluding PRN, Per Diem, and Casual n=308

19.1% 15.9% 14.3% 12.6% 11.7% 10.8% 9.5% 8.1% 6.4% 2017 Advisory Board All Rights Reserved advisory.com Source: 2016 Annual Turnover, Vacancy, and Premium Labor Benchmarks, HR Advancement Center. 9 Losing First-Year Staff at an Unsustainable Rate Percentage of Nursing Turnover Attributed to Employees with Less Than One Year of Tenure n=3001 26.9% 25.3% 24.0% 18.5%

2013 2014 2015 2016 1) N-value for 2016 benchmark cohort. 2017 Advisory Board All Rights Reserved advisory.com Source: 2016 Annual Turnover, Vacancy, and Premium Labor Benchmarks, HR Advancement Center. 10 Nursing Engagement Benchmarks Percentage of Engaged Employees, All Nurses1 n=866 facilities2 55.6% 46.6% 29.7% 22.6% 33.3% 36.4% 40.0% 25.7%

17.9% 1) Includes RNs and APNs. 2) Includes hospitals, clinics, and similar provider sites. 2017 Advisory Board All Rights Reserved advisory.com Source: Advisory Board Survey Solutions. 11 Why Turnover Is So High New Nurses Face Myriad Challenges Common Challenges Faced by Nurses Transitioning to Practice Increasing number of patients with complex conditions, multiple comorbidities Generational diversity in the workforce Lack of access to experienced mentors and coaches Performance anxiety Bullying Shifting EMRs and complex documentation 2017 Advisory Board All Rights Reserved advisory.com

Source: Hofler L, Transition of New Graduate Nurses to the Workforce: Challenges and Solutions in the Changing Health Care Environment, NCMJ, vol. 77 no. 2 (2016): 133-136; Nursing Executive Center interviews and analysis. 12 Component #2: Proposed Solution What Is a Nurse Residency Program? Valuable Program Elements Most Common Programs Nationally Educational sessions (didactic and simulation lab) 24% Preceptor 54% 22% Cohort debriefing sessions 1 Homegrown UHC 2 Other

3 Mentoring, career planning 1) State- and facility-based programs. 2) University HealthSystems Consortium, also known as UHC/AACN and Vizient/AACN. 3) This survey did not list the other major off-the-shelf residency program, Versant. 2017 Advisory Board All Rights Reserved advisory.com Source: Barnett JS, et al., A description of U.S. post-graduation nurse residency programs, Nursing Outlook 62 (2014): 178-184; Rosenfeld P and Glassman K, The Long-term Effects of a Nurse Residency Program, 2005-2012, JONA, 46, no. 6 (2016): 336-344; Nursing Executive Center interviews and analysis; Nursing Executive Center interviews and analysis. 13 Which Program Is Right for Us? Cost1 Ease of Implementation Expected Impact Versant [Insert quoted price] [Summarize by copying and pasting appropriate number of arrows from below]

[Summarize by copying and pasting appropriate number of arrows from below] Vizient [Insert quoted price] [Summarize by copying and pasting appropriate number of arrows from below] [Summarize by copying and pasting appropriate number of arrows from below] Homegrown Program [Insert cost estimate] [Summarize by copying and pasting appropriate number of arrows from below] [Summarize by copying and pasting appropriate number of arrows from below]

1) To make a cost estimate for a homegrown program, use the Residency Program ROI Calculator in the First Year Retention Toolkit. You can also consult The Financial Case for Nurse Residency Programs, Parts 1, 2, and 3, cited in that tool. 2017 Advisory Board All Rights Reserved advisory.com 14 Component #3: Expected Impact Outcomes We Can Expect [Picklist of] Outcomes to Consider Increase new graduate competence Decrease in frontline staff turnover Increase in new graduate confidence Decrease in manager turnover Improved retention of new graduates Less HR and manager time spent on hiring Increase in employee engagement

Lower spending on premium labor and overtime 2017 Advisory Board All Rights Reserved advisory.com Source: Nursing Executive Center interviews and analysis. 15 Component #3: Expected Impact Residency Programs Are Paying Off Improve Competence, Confidence, and Retention Confidence Residents perception of their ability to organize and prioritize their work, communicate, and provide clinical leadership showed statistically significant increases over the one-year program. 2017 Advisory Board All Rights Reserved advisory.com Competence Approximate 11% improvement in observed competency Retention Findings indicated a new

graduate residency program was associated with a decrease in the 12month turnover rate from 36.08% to 6.41%... These cost-benefit analyses suggest net savings between $10 and $50 per patient day when compared to traditional methods of orientation. Source: Goode CJ et al., Lessons Learned from 10 Years of Research on a Post-Baccalaureate Nurse Residency Program, JONA, 43, no. 2 (2013): 1-7; Ulrich B, et al., Improving Retention, Confidence, and Competence of New Graduate Nurses: Results from a 10-Year Longitudinal Database, Nursing Economics, 28, no. 6 (2010): 363-375; Trepanier, S, et al., New Graduate Nurse Residency Program: A Cost-Benefit Analysis Based On Turnover and Contract Labor Usage, Nursing Economics, 30, no. 4 (2012): 207-214; Nursing Executive Center analysis. 16 Impact of Residency Programs on Retention First-Year Turnover Rates, NYU Langone After Introduction of UHC NRP1 New Graduate First-Year Turnover Nationally n=987 new graduates 14% 12% 12% 20-40% 10%

Typical first-year new graduate turnover rates in the last five years 10% 8% 6% 6% 5% 4% 2% 0% 2003 2007 2008 2012 Turnover Rate 1) Nurse residency program; see Rosenfeld and Glassman citation at right.. 2) See Goode CJ et al, citation at right. 3) See Kovner CT, et al citation at right. 2017 Advisory Board All Rights Reserved advisory.com Source: Goode CJ et al., Lessons Learned from 10 Years of Research on a Post-Baccalaureate Nurse Residency Program, JONA, 43, no. 2 (2013): 1-7; Rosenfeld P and Glassman K, The Long-term Effects of a Nurse Residency Program, 2005-2012, JONA, 46, no. 6 (2016): 336-344; Kovner CT, et al., What Does Nurse Turnover Rate Mean and What Is the Rate? Policy Politics Nursing Practice, 15 no. 3 (2014): 464-71; Nursing Executive Center interviews and analysis.

17 Residency Programs Growing More Widespread Becoming Critical for Recruitment Prevalence of Nurse Residency Programs in the U.S. 48% Hospitals with residency programs in 20141 Former residents urge others to prioritize program over salary 73% Percentage of residency graduates who report they would advise a new graduate to Take the nurse residency program position, despite a second offer with a higher salary or better benefits2 1) Survey sent to the 1,011 U.S. hospitals with more than 250 beds. 2) The following question was posed in a survey of 425 former nurse residents: If a new graduate was given the choice to take position in NRP or take position in another institution for more money/benefits, what would you advise? Almost three-quarters (73%) of the respondents indicated take the NRP. 2017 Advisory Board All Rights Reserved advisory.com Source: Barnett JS, et al., A description of U.S. post-graduation nurse residency programs, Nursing Outlook 62 (2014): 178-184; Nursing Executive Center interviews and analysis.

18 Our Return on Investment Residency Program Will Be Financially Beneficial Projected ROI for First Year Projected ROI for Future Years 206% $xx,xxx 219% $xx,xxx 2017 Advisory Board All Rights Reserved advisory.com Source: Hansen J, The Financial Case for Nurse Residency Programs, Part 1, JNPD, 30, no. 6 (2014): 322-324; Hansen J, The Financial Case for Nurse Residency Programs, Part 2, JNPD, 31, no. 1 (2015): 51-53; Hansen J, The Financial Case for Nurse Residency Programs, Part 3, JNPD, 31, no. 2 (2015): 116-117; Nursing Executive Center analysis.

Recently Viewed Presentations

  • How can Santander help fulfil your International dreams?

    How can Santander help fulfil your International dreams?

    Santander and the flame logo are registered trademarks. Santander UK plc is a participant in the Jersey Bank Depositors Compensation Scheme. The Scheme offers protection for eligible deposits of up to £50,000. The maximum total amount of compensation is capped...
  • Empowering Excellence in CALS Graduate Programs

    Empowering Excellence in CALS Graduate Programs

    Develop assessment plan. Fellowships and Assistantships Coordinated by CALS. ... ($3,000 for first year, 1 available for CALS PhD) CALS Diversity Fellowship ($5,000 for first year, 1 available for CALS MS or PhD) CALS Assistantship Assistance Program (MS: $19,000 or...
  •  Rhabdomyolysis and Acute Kidney Injury Dr Fazel.FCCM Although

    Rhabdomyolysis and Acute Kidney Injury Dr Fazel.FCCM Although

    Although acute renal failure owing to crush injury after war wounds and motor vehicle accidents was described early in the 20thcentury(1941)Bywaters and Beall highlighted the syndrome in detail after the Battle of London. .during World War II
  • Conflicts of Interest Training State Ethics Commission

    Conflicts of Interest Training State Ethics Commission

    Maryland Municipal League Fall ConferenceMaryland's Revised Ethics LawOctober 18, 2013. Legislative Origins. ... Modification to the requirements of the Public Ethics Law for local ethics laws adopted by counties, municipalities, and boards of education .
  • VAT Made Simple - Directory of Social Change

    VAT Made Simple - Directory of Social Change

    VAT made simple. For a transaction to be within the scope of VAT as well as a supply there must be a fee or 'consideration' so there must be a two way transaction. If there is a payment but there...
  • Teaching and Learning with Visual Sources

    Teaching and Learning with Visual Sources

    The books are rarely available in the library; having access to them via blackboard has been extremely useful." "Scans of historical resources have been a great help as these would not be accessible as easily as other resources for the...
  • Training - Weebly

    Training - Weebly

    Chapter 1 in the Official FFA Manual, chapter 2 in the FFA Student Handbook and chapter 20 in AgriScience Explorations are recommended. Have the chapter officers talk to the class as to why the FFA is important. Have your students...
  • ISCA 2002 Dynamic Fine-Grain Leakage Reduction Using Leakage-Biased

    ISCA 2002 Dynamic Fine-Grain Leakage Reduction Using Leakage-Biased

    A good fine-grain dynamic technique Minimal transition energy: Same number of precharges (delayed precharge) Minimal transition time: Wakeup latency is only that of precharge phase Performance Issues for LBB Caches Subbank must be precharged before use Case 1 (best): subbank...