FOR IMMEDIATE RELEASE
Friday, March 21, 2003

Nurse Turnover Is Reduced While Patient Satisfaction Increases

The implementation of a new nursing care model has produced significant results in improving patient care and increasing both patient and nurse satisfaction at Coney Island Hospital.

At a time when other hospitals and medical centers are experiencing serious nursing shortages, nurse turnover at Coney Island Hospital has been very low – about 2% to 3% compared to a national average of 6% to 9%. Advance directives compliance, a measure of care mandated by the Joint Commission on Accreditation of Health Care Organizations (JCAHO), has jumped from 40% compliance to 100% compliance since the hospital’s new “Enhanced Continuum of Care” (ECC) plan was initiated.

“We’ve experienced promising results from ECC,” said Terry Mancher, RN, CNA, MSA, Chief Nurse Executive of Coney Island Hospital. “Nurses are now able to focus more of their attention on the patient, and less on paperwork. Yet the hospital’s documentation compliance rate has improved. Emergency Room wait time has decreased significantly and discharge time for inpatients has been decreased from over two hours to 30 minutes.”

The work redesign included assigning registered nurses to work in the Emergency Room to transition patients to the units and help complete paperwork, thus maintaining continuity of care and freeing time for nurses on the general units to spend with patients and patients’ families. The new ER admitting nurse interviews patients and develops a care plan, explaining hospital procedures and answering patient questions.

“A patient satisfaction survey taken before the new care plan showed that 73% of patients thought nurses spent too much time on paperwork,” said Ms. Mancher. “In the most recent survey, only 6% of our patients felt the same way.”

Another aspect of ECC takes place at the end of the hospital stay. Special discharge RNs ensure that each patient leaves the hospital expediently. This avoids delays with the discharge nurse giving the patient instructions regarding medication, do’s and don’ts, and follow up appointments.

“A call is placed to the patient the next day to ensure that all instructions were understood and to get feedback on the overall hospital stay,” explained Ms. Mancher. “The personal attention and follow up gives patients a better impression of the hospital.”

According to the American Hospital Association’s Trendwatch, 126,000 nurses are currently needed to fill vacancies at American hospitals. And by the year 2010, more than one million new nurses will be needed, projects the U.S. Bureau of Labor Statistics. According to a study in Health Affairs, more than 40% of nurses working in hospitals reported being dissatisfied with their jobs.

“One of the priorities of the ECC model was staff satisfaction,” said Ms. Mancher. “We wanted to utilize the nurses more efficiently and give them what they wanted – more autonomy and more control over patient management.”

Coney Island Hospital involved nurses from all levels and departments in developing the new model. One of the items learned from internal surveys and interviews was the nurses’ interest in ongoing education. Coney Island is now offering accredited courses at no cost to nurses. The hospital has also eliminated mandatory overtime, which kept nurses away from their families and increased nurse “burnout.”

“The new nursing plan has really paid off in keeping both our patients and staff happy,” said Ms. Mancher. “There was no additional cost involved because we redefined certain roles to accommodate the new admission and discharge RNs. And we started a redesign process that looks toward the future.”