N 5430 Six Sigma Proposed Steps In DMAIC Discussion

Application Exercise: Plan-Do-Check-Act (PCDA) Ugonma Darling Anyanwu RN. BSN. University of Texas at Arlington College of Nursing and Health Innovation N5430 Management Seminar Cynthia Plonien, DNP, RN, CENP July 4th , 2020. Name of Organization: HHSC Regulatory Services; Region 6 Date: 07/04/2020 City: Houston TOOL: Questionnaires and emails STEP: Improve recruitment of Nurses and increase morale of current nurses to enhance retention CYCLE: 1st Attempt PROBLEM: My region being in a Houston metro area is surrounded by many hospitals and is home for a renowned medical center- Houston Medical center. It is hard to recruit nurses as most of the nurses prefer to work for the private sector where they are paid better. This competition results in high licensed nurses’ turnover for my agency. We are frequently losing licensed nurses while unable to recruit new ones . With the increase in the number of skilled nursing facilities and assisted living facility in region 6 , it is extremely tasking and impossible to accomplish organizational goals timely as nurses continue to see better work opportunities and benefits to meet individual needs . In most of the states, the demand for nurses is higher than the supply as shown below from random centers (Haddad, et.at., 2020). Estimated no. of patients daily No. of nurses RN-to-Patients Hospital A 100 20 1:5 Hospital B 150 25 1:6 PLAN: I plan to meet with our nurses to discuss their thoughts on how to improve our staffing problems especially with retention of current nurses . Nurses were also asked to complete a current work situation questionnaire and return to me. I also plan to meet with regional management which included regional program managers the assistant regional director and the regional director to discuss the problem and possible solutions. I also plan to disclose my intention to meet with nursing staff and to gather their perception of the problem as well as approaches that can mitigate the problem. I plan to suggest location stipend for our nurses in the Houston metro area which can help keep our nurses and reduce turn over. This can also be in the form of merit award for nurses. The following data collection tool will be sent to all nurses in region 6 regulatory division . They will be asked to complete questions and return to me via email within 48 hours . This will help to determine employee morale in relation of current work situation . Their responses will be complied for analysis before and after implantation phase of the proposed plan to evaluate effectiveness and progress of the plan. Name/Title ………………………………………………………. Location…………………………………………………… 4 No. of years worked…………………… Location…………………………………………………… Are you comfortable with your work and do you feel motivated…..yes………..no….. Do you feel overworked………………………………………………………..? 5 How can your status be improved……………………………………… 1. 2. 3. Do: On 06/26/2020, I sent email reminders to nurses encouraging them to return the completed questionnaires above. I also received and reviewed the data collecting questionnaire which provided base data on how nurse surveyors felt as well as their idea on how to address staffing situation. I held a conference call with licensed nursing staff in the region on 06/29/2020 and discussed licensed nursing retention issues. They were vocal and shared insights which centered on non- competitive pay when compared with other healthcare organizations round us as well as heavy workload they inherit when other nurses quit. Appreciation emails were sent to Nurses, emails were acknowledged and appreciated. On 07/01/2020, I met with regional leadership/management and discussed licensed nurse’s retention issues which all were aware of . We discussed my plan to implement a process that will increase the morale of our current employees and suggested staff meeting where our nurses are recognized for their hard work especially during the COVID19 pandemic. I recommend that our regional director speaks to nurses to provide support, appreciation and encouragement during our weekly conference calls. I also suggested location stipend for our nurses in the Houston metro area which can help keep our nurses and reduce turn over. I also suggested using regional private funds to obtain gift cards for nurses as a token of our appreciation for carrying our workload this period. I also suggested asking other regions across the state for assistance while we try to recruit more nurses. I was reminded the obvious that state workers’ salaries are approved or rather mandated by the state legislators, but the stipends can be offered as merit awards to nurses in our area. The team were in agreement to at least give plan a try .Our regional director admired my concerns and agreed to escalate my approach to state office in Austin for deliberation . I sent reminder email to regional director for follow up. Check/Study: Data analysis confirmed that nurses were overwhelmed. Data indicated nurses loved their jobs but believed overwhelmingly that pay could be better. All agreed employee motivation was lacking, they feel overworked and believed time off work could help them recharge and improve morale. Unfortunately, the information gathered was a true representation of my prior perceptions. Gift cards presented to nurses were appreciated and most expressed that mere conversation and discussion of issues affecting them was satisfying as it made them feel that their struggles were seen, and their efforts were recognized. The outcome of the meeting and discussion with the regional managements was shared with nurses and they welcomed it. Assistance from other regions are pending at this time due to the covid19 pandemic and travel restrictions. Approval of location stipend for nurses in region 6 is also pending state office review. Nurses were approved one day additional day of their choice off as long as workload permits. From the study conducted and little action implemented , it was found that there was a significant improvement in licensed nurses morale which will lead to longer stay at job and also improve productivity, hence is retention achieved while recruitment is work in progress. ACT: This project’s expectation was met, although not fully as expected due to time constraint. Date collected helped to better understand perception of nurses in question and also proved interventions implemented so far were well received and appreciated. The project achieved about a 60% of the expectation, and more need to be put in place to ensure that all requirements are met. Follow up with state office survey operation will be continued to seek approved of assistance from other regions in state while approval for stipend and possible salary increase will be presented to state operations. Survey operations and other state office policy makers will then present this to the state legislators for hearing during their next session and repeat the cycle. According to research, more than one million nurses will retire by 2030, with over 50% of registered nurses being over 50 years old, there is need to act now in other to avoid challenges in the future (Gottlieb, 2016). For sustainability of our program, more nurses need to be recruited and trained in the near future. References Gottlieb, L. N. (2016). Shortage of nurses, shortage of nursing. Canadian Journal of Nursing Research Archive, 32(3). Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2020). Nursing shortage. In StatPearls [Internet]. StatPearls Publishing. Lippincott Nursing Education. (2016). The Importance of the Optimal Nurse-to-Patient Ratio .