Leadership for Resilience

    CREATING SUSTAINABLE RESULTS IN HEALTHCARE

    NURSING RETENTION IN COLORADO

    The purpose of this program was to address the challenge of keeping trained nurses in the workforce. The nursing shortage in Colorado was severe. Our state was projected to have 17% fewer nurses than needed by 2020 (Projected Supply, Demand and Shortages of Registered Nurses: 2000-2020, DHHS, HRSA, Bureau of Health Professions, July 2002). The increase in demand for nurses in Colorado in the decade from 2002 to 2012 was projected to be the 5th highest in the country. The Regional Institute for Health and Environmental Leadership (RIHEL) conducted a year-long leadership development fellowship for health care provider teams to address this challenge.

    resilienceslidescoversmall View a brief slide show of pictures from the 2009 Program.



    THE TEAM APPROACH

    Five interdisciplinary teams of about five persons per team (all five from the same organization/ community, each team including at least one nurse) were be recruited. The interdisciplinary team from one organization would likely comprise a physician, a nurse, another patient care professional who is not a physician or a nurse (such as a psychologist or a social worker), a non-clinician (such as a human resources professional or administrator), and a fifth teammate of their choosing from their workplace or community, who may be another nurse. To successfully handle the difficult challenge of nurse retention may require the group approach. The propensity to take risks is increased in the presence of collective action, and small groups act less conservatively than individuals. The innovations required to address intractable problems require the leaders involved to take risks. Health care system reform, including strategies for nurse retention, will also involve taking some risks or trying out some new approaches. The solitary nurse working in a health care hierarchy to affect system change simply has the decks stacked against her. Conversely, when a group of interested, diverse professionals comes together by choice to affect a change that is important to them all, it is more likely that there will be an impact.


    THE PROGRAM

    resiliencefacultystaffThere were three major elements of the fellowship: (1) Leadership Didactics: The ~25 fellows came together at retreat-like settings four times for three days each during the course of the fellowship year. During these four “on-site events”, RIHEL facilitators conducted a total of about 60 contact hours of leadership training. (2) The Team Project: All teams were required to conduct a leadership project which they must accomplish as a team (although they were encouraged to involve additional people in their project). The goal of the project must have related to the retention of nurses (likely at their own worksite or in their community). The teams operationally defined “nursing retention”, and there was a reward for the successful accomplishment of the project goal. Teams were awarded implementation funds of $10,000 upon the approval of their project plan by a Panel of Advisors. (3) Coaching: An experienced executive team coach coached each team twice per month. Coaching was focused on the development and implementation of the Team Project. The team dynamics were also addressed, as well as insights that the individual teammates achieve about leadership, about themselves, and about the nursing shortage.

    esjhcoversmall Read an article about one of our 2009 teams.



    REQUIREMENTS

    An agency, organization, department or group that participated in this program needed to provide:

    • Time away from work for up to five employees in different positions for 12 days during the year
    • Reliable internet access to post information and updates to the RIHEL website
    • Senior level engagement in the project goal of the team and conceptual support for the project
    • Participation in the evaluation of the impact of the program and the team members’ project. Teammates who participate in the fellowship will need to commit:
    • Twelve working days of active participation in educational workshops
    • Time to read three books and complete short assignments related to the training workshops
    • Time to implement a team project
    • At least two hours of team coaching per month
    • Participation in the evaluation of the impact of the program and the team members’ project.

    RIHEL provided:

    • Leadership training: faculty, coaches and nearly all materials
    • All lodging and nearly all meals during the four 3-day retreats
    • Two of the three required books
    • Executive coaching
    • $10,000 project implementation funds, upon the approval of the team project
    • Evaluation

    No tuition was charged for this program.

    SUPPORT FOR THIS PROGRAM

    This Leadership for Resilience program was funded by the Robert Wood Johnson/Northwest Health Foundation Partners Investing in Nursing’s Future (PIN) initiative to address the nursing shortage. The Colorado Health Foundation (CHF) matched the support provided by the PIN program in an innovative way with a Colorado-specific approach to the nursing retention issue (i.e., through this leadership development fellowship.) RIHEL is grateful to the PIN program and to the CHF for their generous support, for their wisdom and courage in taking on this challenge, and for supporting an innovative approach to meeting it.

    Dates for the Leadership for Resilience program were:

    • December 15, 2008 – Orientation in Denver, CO
    • February 23-24-25, 2009 – Garden of the Gods, Colorado Springs, CO
    • May 11-12-13, 2009 – Nature Place, Florrisant, CO
    • August 10-11-12, 2009 – The Stanley Hotel, Estes Park, CO
    • November 18-19-20, 2009 – Devil’s Thumb Ranch, Tabernash, CO