UAB Medicine maintains its Magnet designation through the American Nurses Credentialing Center (ANCC), which recognizes organizations for excellence in nursing and improved patient outcomes. Only about 10% of hospitals are Magnet-designated, and UAB Medicine is one of only 21 health care facilities worldwide to have achieved Magnet designation five consecutive times.
UAB is engaged in valuable research with our Magnet peers to identify and address challenges to nurses’ well-being. Through a new initiative called Magnet4Europe, we are working with the University Hospital of Düsseldorf, a German hospital “twinning partner”, to make similar research-driven improvements. UAB Medicine nursing leadership meets with this partner every 1-2 months to help them establish a Magnet nursing culture.
Identifying causes of burnout
The prevalence of job-related burnout, depression, anxiety, sleep disorders, and other mental health issues is higher in health care than among workers in other industries, with nurses most often facing the highest burnout rates among clinical staff. COVID-19 exacerbated the problem, but it predates the pandemic. Creating a good work environment means addressing excessive workloads, declining autonomy, bad management, poorly implemented electronic documentation systems, systemic breakdowns that require workarounds, and excessive bureaucracy.
UAB Hospital participated in a U.S. Clinician Wellbeing Survey of RNs at Magnet-designated hospitals to guide improvements. The survey highlighted the factors central to burnout, mental well-being, work environment satisfaction, and overall satisfaction.
The survey also assessed the percentage of clinicians who responded “very important” to priority interventions to improve clinician well-being. The table below shows RNs’ responses to key items in the “priority interventions to improve clinician wellbeing” section of the survey.
| RN Results on the U.S. Clinician Wellbeing Survey: Priority Interventions to Improve Clinician Wellbeing | ||
|---|---|---|
| Percent Reporting Item as “Very Important” | UAB Hospital | CWS Magnet Hospitals |
| Improve nurse staffing levels | 92 | 86 |
| Support for all clinicians to take breaks without interruption | 79 | 81 |
| Improve team communication | 59 | 62 |
| Reduce clinician time spent on documentation | 45 | 52 |
| Not having to routinely work unscheduled hours | 49 | 50 |
| More resources to support new-to-practice clinicians | 56 | 52 |
| Right to decline reassignment to other clinical units | 67 | 48 |
| Conduct a clinician wellness survey annually | 40 | 41 |
| Provide resilience training | 35 | 39 |
| Create times and places for meditation and reflection | 40 | 36 |
| Establish a clinician wellness committee | 29 | 34 |
Best practices and recommendations
The results of the survey were used as evidence to help develop wellness programs for nurses, advanced practice providers, and physicians at UAB Medicine. Nursing leadership also used the data to develop best practices and recommendations. We are implementing many of these interventions, as is our twinning partner – University Hospital of Düsseldorf – in Germany, for the benefit of global improvements to health care. Some of these efforts are highlighted below:
- Recruitment and Retention Council: Comprised of nurse leaders and clinical nurses, the council was established to help ensure that clinical nurses have a voice in stating what would make them want to work at UAB and remain at UAB.
- Staffing needs:
- We implemented an internal travel program that allows nurses to “travel” within the hospital for higher pay.
- In partnership with HR, nursing leadership implemented a significant and organization-wide salary adjustment for clinical nurses, nurse managers, and nursing professional development specialists.
- Several women’s units created a way to reallocate nurses to their areas of comfort.
- New RN and LPN hires are now automatically enrolled in our Nurse Residency Program.
- Student nurses:
- UAB Medicine and the UAB School of Nursing established a dedicated education unit to better develop the nursing team.
- A nursing student graduate aide role was established to employ nursing students to work with seasoned clinical nurses and gain hands-on job experience to ease the transition into clinical practice after school.
- A nurse apprenticeship program was created to give nursing students an opportunity to work in a health care facility and receive credit for hours worked.
- EHR documentation changes: A workgroup was established to embark on a major, multi-year electronic medical record conversion that will allow nurses to work more efficiently and create mechanisms to help nurses maximize patient safety.
- Just Culture training: Three staff nurses attended Just Culture training to become certified in conducting such training for UAB Medicine staff.
- Wellness: UAB Medicine Nursing launched a multi-year, grant-funded Nurse Wellness Program through an academic practice partnership among UAB Medicine Nursing, the UAB School of Nursing, the UAB Medicine Office of Wellness, and the UAB School of Health Professions. This WE CARE program embeds nursing professional development specialists into the organization using a “train the trainer” methodology, with the goal of implementing evidenced-based wellness programs throughout nursing services to address burnout, suicide, mental health conditions, and substance use disorders.
This story is part of the Nursing Annual Report 2022. Click here to view the report.