‘Business as usual’ won’t to retain nurses: Massachusetts hospital CNO says

In May, Holyoke (Mass.) Medical Center became one of 10 hospitals selected in Massachusetts to participate in an initiative, dubbed the Healthy Work Environment Academy, that aims to empower frontline nurses to lead workplace culture and retention efforts.

“Nurses are sort of leaving the profession, and the ones at the highest risk to leave hospitals are first-year nurses,” Margaret-Ann Azzaro, DNP, RN, senior vice president of patient care services and CNO at Holyoke Medical Center, told Becker’s. “Providing staff with a healthy work environment, making sure we have mentoring and coaching available, and authentic leadership — those things help decrease turnover.”

The academy is part of an 18-month program, the Clinical Scene Investigator Academy’s Nursing Workforce Solutions, coordinated through the American Association of Critical-Care Nurses and the Massachusetts Health and Hospital Association. The program is designed to provide frontline nursing teams with tools to tackle unit-specific challenges at no cost, according to an MHA news release shared with Becker’s. 

Participating hospitals identify a nursing team from one unit to address a specific, on-the-job challenge. Using in-person and virtual workshops, the teams create and implement challenge-specific initiatives. Educational sessions and expert mentoring are also made available. Once the team has addressed its challenge, they then replicate the initiative with other units in their organizations through “train-the-trainer” resources, according to the release.

Specifically, the tools help nurses strengthen leadership skills, develop healthy work environments, experience mentorship, contribute to ongoing success and improve job satisfaction while reducing turnover, according to its website. 

At HMC, three staff nurses are leading the project.

“They were charged with doing a few things. One is doing a baseline,” Ms. Azzaro said.
They call it the HWEAT — it’s the healthy work environment assessment tool — so that we had baseline data on how healthy our environment is on medical telemetry at Holyoke. They were able to get good participation … our baseline was a moderately healthy work environment, [which is] a very good place to start from.”

With that foundation, the nurses were able to also identify areas that the organization was the least healthy.

“They decided that they were going to design and implement an acuity tool,” Ms. Azzaro said. “It’s an objective tool that assigns a score and a number to each patient. … It helps to balance the workload. That means [nursing] assignments are going to be more equitable, more fair, more balanced. In turn, what is that going to give you? That’s going to give patients better outcomes … it’s going to improve the patient experience, and it’s going to improve the nurses’ satisfaction and the culture.”

For Ms. Azzaro, the program represents a needed shift in how hospitals approach workforce challenges, while also ensuring that employees feel heard. At HMC, the facility has also created a new council where its leadership team meets with frontline employees quarterly.

“Business as usual is not going to retain nurses,” she said. “If we can deliver these healthy work environments, we’re going to sustain our workforce, decrease nurse turnover and have happier nurses. That translates to the patients. It’s going to be an improved culture in which people want to go to work.”

Along with HMC, the other participating Massachusetts hospitals include Palmer-based Baystate Wing Hospital, Boston-based Beth Israel Deaconess Medical Center, Pittsfield-based Berkshire Medical Center, Boston Medical Center, Cape Cod Healthcare, Newton-Wellesley Hospital, Boston-based Tufts Medical Center, Spaulding Rehabilitation Hospital Boston and Attleboro-based Sturdy Health. 

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