Feedback tool helps Ascension hit 82% retention

Ascension has reached its highest nurse retention rate in five years — 81.96% — aided by its employee feedback tool Always On Listening, or AOL. 

The tool helps address the “pebbles” in people’s shoes, according to Rob Rose, DNP, RN, chief nursing officer and senior vice president of nursing at the St. Louis-based system. 

Whether it’s squeaking doors, hallway trash or a service issue, nurses can access the AOL platform by scanning a QR code. After inputting the feedback, the tool routes the issue to the appropriate group leader. For example, a submission about a squeaky door will be sent to Ascension’s internal maintenance and repair group. 

The goal is to acknowledge an AOL submission within three days. Ascension averages 2.73 days in response time, and the average time to resolve an issue is 3.84 days. 

The system piloted the tool in three states in February 2025. After the pilot’s quick success, Ascension rolled out the feedback platform throughout its network, which spans more than 100 hospitals across 16 states and the District of Columbia.

Dr. Rose told Becker’s the tool helps resolve pain points rather than allowing the problem to grow. 

“I think that’s [an] issue we have in healthcare. We identify these issues. Again, I go back to the pebbles in your shoe. The reason why they become more than pebbles is because we don’t fix it. And it’s not any one person’s fault. It’s just, people get busy, right? Or they forget about it,” he said. 

The AOL platform also serves as a recognition tool for nurses to praise other team members or departments. 

Dr. Rose attributed Ascension’s five-year record-high in nurse retention not only to the AOL platform but several other initiatives, including competitive wages, retention calls with local leaders, tuition assistance programs, and a standardized education platform for onboarding and competency trainings. 

For other hospitals looking to retain more of their nurses, his recommendation is simple: Listen to front-line staff, and design efforts based on their feedback. 

“Don’t make it hard to do the right thing,” Dr. Rose said. “[Ask,] ‘What barriers can we take out of your day?’ We know nursing is a complex cognitive, heavy burden profession. We want to be able to do things that reduces that.”

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