Latest / Nurse Leadership Dumpster Fire / Team Metrics: The Army
Transcript
- speaker-0: Welcome to part three of our metrics series. We've already talked about the weapon, our quality metrics, and how we use that to fight executives to get what we need. Then in the next video, we talked about our shield and how we protect what we already have and support our team. But today, this one is gonna focus on the team health, the most important aspect, because without team health, you don't have anything. speaker-1: You can't just fix morale by doing a vibe check. You need hard numbers to put information to the story of what's happening. When you're trying to make an argument to your executive leadership that you're taking massive casualties on your team, you need data to support that. If you just tell them things are bad, that doesn't mean anything. Or better yet, what you can do with these metrics is take a hard look in yourself to measure how you're showing up as their team commander. speaker-0: Let's get into the numbers of the team health or our army. What is your desertion rate, aka turnover rate? That is gonna give you some key information. This metric is calculated by our rolling calendar year and how many people leave your area. This is usually viewed as a percentage. And on the battlefield, this looks like you're hemorrhaging blood everywhere. So how do you stop the bleeding? Are you losing your army before you even have the chance to build it? You need to dive into those metrics and determine is it your new nurses within one year that are leaving your area, you're bleeding and hemorrhaging out those new ones, and your experienced or your generals are no longer able to keep up with the training of the new people. So now their morale is starting to take a dive. speaker-1: Ask us what is a normal turnover rate? Because some turnovers actually healthy. Correct. So, in my opinion and in my research of looking at turnover, I would say if your turnover is above 40 to 50%, you're doing something wrong and you need to take a deep look and find out why your team is leaving. If your turnover rate is around 20 or below, I'd say your turnover rate's really good. If your turnover rate is zero, you actually might have a little bit of stagnation on your team. Some turnover is healthy. It's good to have a certain amount of pressure on your team so that you continue to make sure they're getting better. Usually not everyone on your team is going to continue to get better. So it's okay to have some of those team members leave and get in fresh new eyes so that you're always growing and becoming better. speaker-0: The second one is going to be that frontline burden. That's going to look like your nurse-to-patient ratio. What does that look like? And is it a healthy nurse-to-patient ratio? Now, in a battlefield realm, if you're outnumbered, how are you really going to provide the care that is needed and handle the onslaught of continuous pressure? Safe ratios are the foundation of troop survival. speaker-1: Metric number three is the boot camp survival rate. We're talking about orientation length. How long are you spending orienting your staff? Is it long enough to actually prepare them to be successful on the team? Are you having people who actually are ready to get off orientation early and forcing them to stay on orientation longer than necessary? Or are you sh cutting people's orientation short so that you can fill staffing holes? But you do that as a nurse manager, you may be shooting yourself in the foot by causing your staff to feel unsafe and unheard. And you may be actually feeding back into that first metric, which is your turnover rate. So are you sending raw recruits into the frontline staff without the proper preparation to be battle ready? speaker-0: Number four, the specialized training pipeline. This is going to be your nurse residency programs. This metric allows you to build more retention and support these troops so that they can get a solid foundation and have more success on the battlefield. So the other part of this metric is that it is an evidence-based program that supports increased retention and better prepared soldiers and/or nurses that can manage. the battlefield more efficiently and effectively. The battlefield reality is that elite armies don't just hire into them, they build them. So does your nurse residency program build a solid army foundation for you? A structured residency program is gonna support your new recruits with an emotional and clinical armor that they're not gonna get anywhere else. And it's gonna allow them to survive and thrive in their toughest year. speaker-1: Which is their first year. speaker-0: So, Cindy, how does your residency program run? Do you keep and retain your residence? speaker-1: So we have a residency program that runs for a whole year at our facility and it works very well. We have about a 95% retention rate. And those nurses tend to stay on the units and work for years and years to come because they feel prepared and ready to jump in and they immediately feel like they're capable of doing the job that we're asking them to do. Number five is the battle buddy system. We're talking about mentorships. So this metric can be a formal or an informal thing that happens on your facility. And sometimes these things happen naturally. But as a nurse manager, you have the ability to actually create formal mentorships and help partner up people, new nurses and experienced nurses who are good matches together so that they can get the best out of that experience. And that's going to improve the culture. Strong mentorships allow veteran nurses to bring in the new recruits and help them feel prepared and valued. And also help them deal with things like work-life balance and how to deal with the emotional baggage of dealing with challenging patient scenarios. In your facility, how many of your employees participate in mentorships? Drop a comment below and let us know. If your facility doesn't have a formal mentorship, why not? Could you bring that to your facility? speaker-0: Number six, the final one. So this is your soldier morale scores. The metric that you're gonna look at is your NDN QI. And why N DNQI? That's your quality index scores. That's our first one. Why would we talk about that? speaker-1: Is that metric? speaker-0: So the NDN QI is your quality index scores overall. So what that's looking at is are your troops actually carrying out the cares that deliver quality care? So we're looking at overall morale. The other aspect is your pulse check data. That information is gonna come from like your one-on-ones and just those individual moments of how are the staff feeling in general. You need to keep a pulse on how things are going in order to make sure you're you're steering your battleship in the direction it needs to go. speaker-1: And if you're wondering how to actually do a one-on-one, we have two videos on one-on-ones. One's for one-on-ones with large teams and one's for high achieving employees. So check those out if you want more information. speaker-0: The battlefield reality is this is your anonymous feedback loop. If your metrics are in the toilet, mutiny is brewing. speaker-1: Yikes. How well do you think that you're managing your team health metrics? Drop a comment below and let us know. speaker-0: Our turnover dumpster fire story is when we both took over in the ICU. It was at the height of COVID and we had a really high turnover rate, well over fifty percent. And what that led to was struggling ratios, dissatisfied staff, and just in general unhealthy culture. speaker-1: And we had a lot of people burning out. That first year that Teresa and I were nurse leaders on this ICU, we had a turnover rate of fifty-six percent. And we had lost at least two nurses who had over 20 years of specific ICU experience. So we had not enough staff. The staff that we had weren't prepared and we weren't allowed to close beds because COVID was rampant and all the beds and all of the hospitals in our city were full. So we dug in deep. We started doing one on ons with our staff and we looked at our all employee survey results and we asked our team what it was that they thought that they needed to feel like they wanted to stay on the unit for a longer length of time. The information that they gave us was that they didn't have any incentives to stick on our specific unit. There was no reason for them to stay in the ICU versus just going to a clinic. They weren't getting paid more, they had no preferential schedules, and they had nothing to look forward to. What they speaker-0: What they wanted was incentives and better support with training and options. speaker-1: So over the next several months, we hired, we developed training, and we came up with a plan on how to give incentives in a way that wasn't going to hurt us in the long run. We ended up throwing out a Hail Mary that actually could have backfired. We ended up allowing some of our staff to go part-time when we were already understaffed. That could have caused us a big issue and us actually taking a staffing problem we were having and making it worse. So we had to take a leap of faith and give them something to. that we knew that they wanted so that we could essentially stop the bleeding because we were hemorrhaging at that time. So speaker-0: In order to stop the hemorrhage, we had to collaborate with the team, with us giving them that incentive of going part-time. How could they support us in making sure that the team was staffed safely? We ended up with the training they needed and developed more support. speaker-1: And we actually did this by having a very big in depth comprehensive meeting that took a lot of planning before, during and after. If you want to know how to do that, go back and watch our video that we made earlier about how to not make a meeting feel like it could have been an email. speaker-0: Victory. We dropped our turnover rate to 9%. speaker-1: That is huge. That was a forty percent improvement. speaker-0: We won that battle. speaker-1: We took that unit from being one of the scariest places to work to being the safest place to work. We had three nurse residents who told us in the beginning of that year that they would never work in the ICU because it was too terrifying. To then saying they don't want to work anywhere else because the training that we developed and the incentives and the culture that we worked on actually made them feel like this was the only place that they could get what they needed to feel safe in the workplace. speaker-0: Employee satisfaction? Skyrocketed. speaker-1: In one year, we took one of the most dysfunctional units in the hospital and made it the unit that everybody wanted to work on, just by following these basic principles, engaging our team, asking them what they wanted, and then working with them collaboratively to make those things happen. speaker-0: In one video we talk about this and it's called AACN's Healthy Work Environment. We took those concepts and applied them. And when I say we, I mean Cindy. speaker-1: We used data, we used feedback, and we used that to drive the mission forward. We couldn't have made any of those changes without starting with the data and the evidence of what was happening so that we could use that to make informed decisions on what needed to happen to make the unit healthy again. speaker-0: Again, as a frontline leader, you cannot treat your army like infinite resources. You have to train, respect, and protect your army. You need speaker-1: To be the shield so that you can protect the resources so that your team maintains and has those things that they need to do their job effectively. speaker-0: And you need to wield the weapon. Use your quality data to get the resources you need and to communicate with your executives of what you need and why. speaker-1: And then make sure that you're using the data on your team health to make sure that your team is happy and effective so that they continue effectively using those tools that you're helping provide them so that you can have the most high functioning, well-rounded, super powered team that there ever was. speaker-0: When you align the weapon, the shield, and the army, you stop trying to put out dumpster fires and you create an elite tactical team. speaker-1: This wraps up part three of our series on metrics for new managers and why you need to know how to use them and how to use them to fulfill your mission. speaker-0: So drop a comment, how healthy is your unit right now? Do you speaker-1: Do you have strong mentorships and staff safe staffing ratios? Or is your team on the verge of mutiny? speaker-0: If you're dealing with any of those complex issues, watch all three videos, reach out to us. We're more than happy to walk you through some ideas and come up with some t tactical plans. speaker-1: If you like this video and you want to hear more about this, please like and subscribe and hit that bell so that you don't miss any more videos. Share these videos with another nurse manager who you see struggling with the same things so that they don't end up on that reaction dumpster fire hamster wheel themselves.