Getting From Red to Green: A Story of Change

BACKGROUND: The turnover rate (employee separations) of healthcare workers has created a cycle of exhaustion and discontent. High turnover affects the institution's ability to consistently provide high-quality care and increases institutional costs related to the recruitment, orientation, and lower productivity of newly hired staff. METHODS: This is an Oklahoma University Medical System (OUMS) performance improvement educational intervention study. We will use a 5-year longitudinal design with repeated measures to examine the effect of diffusion of the HeartMath Healthcare Program Revitalizing Care techniques within OUMS. The variables include pre and post training scores on the Personal and Organizational Quality Assessment questionnaire (POQA-R), scores on the independently administered OUMS Annual Employee Engagement Survey, and separations from OUMS as reported by the human resources department as turnover rates. Employees of the OUMS were trained in cohorts of less than 20. The training sessions included a 5-hour presentation with a 2-hour follow-up program provided 2 or more weeks later. Participants received an EmWave2 training reinforcement device to use during the time period between the first training and the follow-up training. Data from the emWave2 will provide personal reinforcement to the user and will not be collected or analyzed by the investigators. RESULTS: The most significant measured result noted after training 90% of the nursing leadership, vice presidents, directors, and managers and 93% of the oncology staff was the continued decline of the turnover rate to < 14% for the overall oncology OUMS service line within the first year of the program being instituted. This was an improvement from a 2009 high of 73% for one of the oncology service lines with a 34% at the time of training, when newly hired people were beginning to leave again, plateauing and even increasing the rate at that time. Engagement scores for the Oncology Unit improved from the previous year, and the POQA scores for both the leadership group and the oncology group showed many significant improvements during the time of measurement.