 The New
England-Style Town Meetings Help Union Memorial Address Nursing Shortage
If you think that town hall meetings with their grassroots
approach to problem solving happen only in small-town New England, please think
again. The town hall concept is alive and well in the urban setting of
Baltimore’s Union Memorial Hospital. Furthermore, one of these quarterly
open-ended meetings with employees became the launching ground for a
collaborative nurse-senior management effort to lower the hospital’s nurse
vacancy rate — and quite a successful effort at that.
According to Rosalie Most, Union Memorial’s vice
president of patient care services, the hospital already had a supportive
environment for nurses when several of them spoke up at a hospital Town Hall
Meeting in October 2002. “They asked what management was doing about the
nursing shortage, and they offered their help in finding solutions.”
The nurses’ offer got taken seriously, with hospital
president Harrison J. Rider III working with the facility’s directors of
nursing to pull together a large group — about 70 representatives drawn
from nursing and hospital management — to create the President’s
Council on Nursing Initiatives. While members work in sub-groups focused on
such areas as recruitment and marketing, retention, pay options, and nursing
education, solutions are also brainstormed at the unit level and then brought
to the council.
This grassroots approach to identifying what will work in a
particular area is a great strength, says Most. “It allows each unit to
diagnose for themselves what will work. For one unit, it might be bringing in a
new piece of equipment. For another, it will be a new patient care model. In
another, it might be creating a new staff position.”
The latter approach has worked well in the emergency
department, which is the source of nearly half of the Union Memorial’s
inpatient admissions. The busy ER had a fairly high nurse turnover rate. One
issue was the time it took to move patients that needed to be admitted up to
the floor. The problem was addressed by creating a new “admissions
facilitator” position for the ER. With several of these new positions now
filled, patients are moved more quickly.
How, exactly, does presenting a nurse recruitment or
retention idea to the council work? It takes preparing a one-sheet proposal
that sums up the idea and reflects the expected costs and benefits.
“Preparing the proposal is a good exercise in building the skills of nurse
managers,” says Most. “The proposals can’t be phrased simply as
‘We want. . . .’ Instead the idea has to be presented in the larger
context of its impact – not just on staff, but on patients, and on
physicians.”
The majority of proposals have been accepted, says Most. And
they have clearly had an impact: In the fall of 2002, the hospital had 89 nurse
vacancies. It now has 28, which translates into about a 5 percent vacancy rate.
Use of agency nurses is down significantly.
Most is clearly pleased about the drop in agency use, and
how the hospital’s own nursing staff often serves as recruiters. “If
an agency nurse has been coming primarily to our hospital, one of our staff
nurses is likely to say, ‘If you like it here, you should go and talk to
human resources. With so few agency openings, you don’t want to lose the
opportunity to work here.’”
Contact:
Rosalie Most
Vice President of
Patient Care Services/
Chief Nursing Office
Union Memorial Hospital
Phone: 410-554-2275
E-mail: Rosalie.i.most@MedStar.net (Back to the top)
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