In January 2023, Philadelphia-based Jefferson Health had more than 1,000 open nursing positions. Today, there are less than 290 open RN positions across the system's 17 hospitals — progress an innovative "Nursing Seal Team" helped drive, leaders say.
In 2022, the health system unveiled the SEAL Team program, which stands for service, excellence, advocacy and leadership, as a way to deliver on nurses' flexibility demands and foster more consistency in staffing levels across units. When it first launched, the program counted 25 members, which has since grown to more than 150 full-time nurses who support medical-surgical, critical care and emergency department units.
"Throughout the expansion of the program, [SEAL team nurses] have cited that they really like the flexibility and the difference in their work from a shift to shift basis," Andrew Thum, DNP, director of nursing workforce operations at Jefferson Health, told Becker's.
The results
The program is part of the health system's broader integrated nursing strategic plan, which also includes a virtual nurse program. While the SEAL effort isn't the sole driver of recent recruitment and retention gains, it's played a significant role, leaders say. The health system has been able to reduce its reliance on agency nurses by 95% over the past two years.
It's not uncommon for systems of a similar size to have a full-time equivalent travel agency nurse workforce of 200 or more, though Jefferson Health has been able to cut this number down to the 20s, said Daniel Hudson, MSN, RN, the system's vice president and associate chief nurse executive.
Leaders have seen engagement and satisfaction levels of bedside staff who are not part of the SEAL Team improve in tandem with the program's expansion, since SEAL nurses are deployed to units of greatest need. In units where vacancy rates are high, for example, nurses can be deployed to stabilize staffing levels until new nurses are hired.
"Even after they hire some of those new nurses, our team has an average of nine years of experience," Dr. Thum said. "So we're there as they transition new nurses into practice and can help fill that knowledge gap in the unit."
Currently, more than 60% of SEAL nurses are deployed on rotating or night shifts.
Navigating growth, challenges
Initially, SEAL Team nurses were only deployed on a two-week basis. In recent months, the system has adjusted deployment practices to be more proactive in using data to identify units and shifts of greatest need, and is exploring forecasts further out than two weeks. The program also recently hired its first weekend only nurse.
To maximize the team's effectiveness, Dr. Thum and Mr. Hudson said program leaders are constantly collaborating with professional development colleagues and regional senior leaders across the system to identify and provide upskilling opportunities, as well as ensure deployment practices are efficient.
One of the main challenges faced in getting this program up and running has been addressing variations in nursing practice across campuses, given Jefferson Health is still a newly integrated system, leaders said. In 2015, Abington Health merged with Jefferson Hospital to form Jefferson Health. In May, Jefferson and Allentown, Pa.-based Lehigh Valley Health Network also signed a definitive agreement to merge into a 30-hospital system.
"We had to train, orient and deploy this team to, in some cases, practice a little bit differently at one campus versus another," Dr. Thum said. "It's just those nuances down to things like equipment on the units and knowing how to use one piece of equipment to accomplish a piece of care versus a different vendor that supplies the equipment at another campus."
At the same time, that challenge has been an opportunity for the system to identify what to standardize across campuses, such as scheduling.
For other systems considering a similar model, leaders said it's critical to invest in the right technology that gives full visibility into resources.
"You've got to have the operating procedures and the software that allows you to be able to see the resources, move the resources and automate those processes," Mr. Hudson said.