Hospital leaders are acutely aware of the fragility of the nation's nursing workforce, with findings from a survey analysis published last spring showing 800,000 nurses intend to exit the field by 2027.
To limit this forecast from materializing, healthcare leaders are expanding their focus beyond hiring efforts and homing in on redesigning care delivery models as a long-term strategy to optimize the nurse workload and support them in working at the top of their license.
At Houston Methodist, a key priority in 2024 will be "unburdening" the workflow for nurses, according to the organization's senior vice president and chief nursing executive, Gail Vozzella, DNP, RN.
Becker's recently caught up with Dr. Vozzella to learn more about Houston Methodist's nursing goals for this year.
Question: Picture your 2024 year in review. What top priority or challenge in nursing do you hope to have made the most progress on at Houston Methodist?
Dr. Gail Vozzella: A lot of 2023 was spent in two areas of focus. One is stability coming out of the pandemic and having big shortages, so a lot of investment in hiring, training, right-sizing your workforce and in retention. Heading into 2024, we are in much different shape than we were through the pandemic and immediately after — we are more stable. Now is really a point in time that we have to focus on our model of care because we know the nursing shortage is … not going away and we also know that even if you are staffed appropriately, nurses report fatigue. They report high burnout rates. So it's the perfect time to look at the model of care. At Houston Methodist, a lot of our focus is on acute-care nursing, which is an area nationally that has the lowest job satisfaction and the highest turnover rate because it's a lot of work to make sure a patient is transitioned home appropriately. It's hard work. [There are] higher ratios compared to what the ICUs have.
Part of the model of care focus started in 2023 with innovation strategies and technology utilization to decrease that burden of care. The two we've focused on most are the utilization of virtual nurses and the utilization of a bio button that helps us to track heart rate and respiratory rate over time. Now that we've integrated those technologies and integrated the virtual support of our nurses, this year it's really about nurses feeling, and us having the vision, that no longer will a nurse say, "OK if I'm talking about my care team, it's myself and a patient care assistant." It's more that they see the virtual nurse as part of the care team and that ancillary support for phlebotomists & other roles are triggered appropriately so that nurses feel those members are part of their care team, too. We believe that's really the only way nurses are going to feel that we've truly right-sized their support, especially in a nursing shortage. That's really been our focus this year. If we just keep adding technologies then nurses just walk around with 100 devices, and we really haven't done anything to help them. So we really want to have the vision of unburdening the workload and have nurses focus on why people typically become nurses in the first place: to listen to [and care] for patients.
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