Using a proven, evidence-based approach to leadership—in the form of The Leadership Challenge—Presence Health is inspiring its nursing leaders to strengthen partnerships, value contributions, and create innovative solutions that are transforming the culture of the entire organization.
As the largest Catholic health system in Illinois, Presence Health’s 150 locations state-wide include 12 hospitals and 27 long-term care and senior living facilities. What began in 2011 with the merger of two single ministries, Provena Health and Resurrection Health Care, is now a fully integrated health system consisting of five congregations:
- Franciscan Sisters of Sacred Heart
- Servants of the Holy Heart of Mary
- Sisters of the Holy Family Nazareth
- Sisters of Mercy of the Americas
- Sisters of the Resurrection
Collectively, these congregations represent a unified passion, capturing the essence of the Presence Health name: to be present with others. And it was through this desire for unified connection that Presence Saint Joseph Medical Center wanted to ignite change within its nursing staff.
Presence Saint Joseph had a historical baseline turnover of 34.8% among its staff of RNs within their first year. While better than the national average of 49.0% (as of 2013), VP of Patient Care Services and Chief Nursing Executive Officer Jackie Medland, RN, PhD, sought to Challenge the Process to improve the organization’s turnover rate and create a sustainable development program that would help engage each nurse as a leader.
To achieve this, Jackie began working with her team to create a new leadership initiative: Every Nurse a Leader, a program that would establish a new philosophy and mindset for emerging nurse leaders at the point of care and fundamentally transform the culture long-term. They started by looking for the root cause of the high turnover rate among RNs. What they found was a lack of structure—a framework that could provide guidance for new graduate nurses and help them understand more clearly what it would take to be successful in their work. Jackie’s goal was to provide that kind of guidance and also promote an environment of affirmation. To do that, she and her team turned to The Five Practices of Exemplary Leadership® —a living model for exemplary leadership in the nursing staff.
By helping new nursing leaders live each of The Five Practices through their daily work, Jackie and her team sought to create a culture where “everyday leaders” would become the new standard. One important goal also was to reinforce Presence Saint Joseph’s mantra, Today Counts, the organization’s value-based message that seeks to empower everyone to make a difference. To deepen the practice of that value, they designed components into the program that would cultivate interdisciplinary partnerships by nurturing nurse/physician collaboration. They also emphasized developing inter-organizational relationships and holistic teams to focus on the common mission of patient care.
At the heart of the Every Nurse a Leader program is a two-year Transition into Practice residency, set up in stages to allow everyone to grow and become a leader within the organization. Focusing on clinical, technical, interpersonal, and leadership skills, each participant is involved in a series of projects and roles throughout their residency. To build self-awareness, all nurse participants complete The Leadership Practices Inventory 360® (LPI 360), based on The Five Practices model. The first LPI 360 is administered during their orientation period, after their cohort begins. A follow-up assessment is completed at the end of the first year of practice and, again, at the end of the second year—and beyond.
Residents in the program Model the Way with hands-on clinical training in a Simulation Lab where they receive real-time feedback on their clinical and critical thinking skills as well as a full debrief to help analyze and reflect on their performance. Taking the challenge one step further, each cohort spends a full day at an outdoor teamwork facility where they learn how to take risks, to overcome fears, and to trust each other as they work as a unified team.
Jackie and her team at Presence Saint Joseph have found that Enabling Others to Act through these collaborations creates a supportive infrastructure that encourages key stakeholders to make a meaningful investment in the process and strengthens engagement and shared decision-making. More experienced Nurse Managers actively participate in interviewing, onboarding, and providing transitional support during the residency period for new RNs. In addition, interdisciplinary partners, including the nursing leadership team and executives, are involved in the Transition into Practice Program through cohort educational sessions. As a result of this shared investment, quality decisions are aligned more closely with the values of the organization, and decision making is more timely and efficient. Presence Saint Joseph has seen an increased commitment to goals and those involved in the program have also reported an increased capacity to attain goals.
Every Nurse a Leader has already produced stellar results through six program cohorts. Presence Saint Joseph has decreased its turnover rate for RNs in their first year: down to 9.6% (a 70% drop from a historical rate of 34.8%). And although the program currently accounts for only about 12% of the overall Presence Saint Joseph nursing staff, it has reduced the organizational costs associated with overall RN turnover—current annual cost savings are estimated between $435,000 and $775,000.
The Every Nurse a Leader program at Presence Saint Joseph Medical Center continues to grow and reach more and more aspiring leaders within the organization. We, at Integris Performance Advisors, are proud to have played a part in their success. We congratulate Jackie Medland and her team for leading the charge and showing so clearly what it truly means to liberate the leader within.
KJ Jenison is Leadership Advisor with Integris Performance Advisors—Platinum Sponsor of The Leadership Challenge Forum 2014—and a Certified Master-In-Training of The Leadership Challenge. Helping Integris clients succeed using innovative thinking, delivering meaningful results, and fostering personal growth, he can be reached at KJ.Jenison@IntegrisPA.com.