Staff Recruitment & Retention in the Operating Room Team Members: Jo Quetsch Meg Kim

Opportunity Statement Historically Loyola’s Operating Room has experienced prolonged vacancies, resulting in an average agency utilization of 9.2 FTE. Staff surveys indicated that trust had been negatively impacted by several leadership changes. The purpose of this project was to create a culture of responsiveness to staff that would reduce OR staff turnover rate and agency utilization.

Most Likely Causes for Staff Turnover Rates Limited manager/supervisor availability to staff Inconsistent communication Inflexible scheduling and on-call sign up process Limited staff involvement in decision-making Lack of recognition

Retention Initiatives Implemented Manager availability Moved office location to inside the OR Internal communication Monthly meetings Email access Additional Supervision Improve work flow & staff accountability Assistant Nurse Manager - evenings SST-1 Supervisor -days Staff involvement in Loyola committees: RN Recruitment & Retention Employee Information Exchange Hospital Products Committee Staff involvement in OR committees: Scheduling Quality OR Recruitment & Retention

Retention Initiatives Implemented Recognition of Magis behaviors Individuals acknowledged at staff meetings Quarterly letters sent to staff regarding good attendance and timeliness Recognition thank you notes Department celebrations On-call scheduling New process managed by staff Off shift bonus contracts Exit interviews by the Manager or Human Resources

Recruitment Initiatives Implemented Partnership with Human Resources Monthly meetings with HR Surgical services recruitment brochure Monitor average days to fill positions Focused recruitment of experienced staff: Referral bonus Flexible work schedules Loyola student nurse lunches Orientation Improvements: Peers meet new staff for lunch on HR orientation day Streamlined orientation process Created feedback loop for new staff

2004 Loyola OR staffing statistics are better than national averages OR Measure Loyola 2004 National 2004 OR Manager, 2004 Vacancy rate 3% 10.1% Average # open positions 2.29 FTE 4.5 FTE Average # days to fill positions 61 days 86.1 days Agency use - % of total FTE 1% 7.7%

Agency staffing has decreased significantly OR Staffing Agency FTE UCL = 11.49 UCL = 10.36 10 Mean = 8.5 Mean = 9.2 8 LCL = 6.83 Agency FTE LCL = 6.68 6 Project Started 4 2 Jun 03 Jul 03 Aug 03 Sep 03 Oct 03 Nov 03 Dec 03 Jan 04 Feb 04 Mar 04 Apr 04 May 04 Jun 04 Jul 04 Aug 04 Sep 04 Oct 04 Nov 04 Dec 04 Jan 05 Feb 05

Actual OR FTE’s have increased by 7.1 FTE Actual FTE OR Staffing Jun 03 Jul 03 Aug 03 Sep 03 Oct 03 Nov 03 Dec 03 Jan 04 Feb 04 Mar 04 Apr 04 May 04 Jun 04 Jul 04 Aug 04 Sep 04 Oct 04 Nov 04 Dec 04 Jan 05 Feb 05 65 70 75 80 85 UCL = 83.26 Mean = 74.5 LCL = 65.70 UCL = 86.89 Mean = 81.6 LCL = 76.38 Project Started

OR staff turnover rate has decreased by 2.2%

Next Steps Create a clinical ladder program for Scrub techs Implement formal preceptor training for OR staff Staff participation in interview process of new staff Revitalize buddy/mentor system for new employees Continue cross generational and conflict resolution training for staff