Henry Ford Wyandotte Hospital has undergone a seemingly miraculous turnaround.

The Wyandotte, Michigan hospital experienced a 40 percent turnover rate among ICU nurses during the COVID-19 pandemic and shortly afterward. Today, turnover in the ICU has dropped all the way to zero, said Kim Meeker, vice president and chief nursing officer (CNO) at the 360-bed acute care hospital.

Meeker and members of her nursing leadership team attribute the dramatic change to a series of initiatives developed by the hospital’s Nursing Excellence Steering Council (NESC), a group that later morphed into the CNO Advisory Council (CNAC).

The First Assignment: ANCC Magnet Recognition

The transformation began shortly after Meeker joined the hospital as CNO in January 2021. One of her first assignments was “to get Henry Ford Wyandotte to Magnet certification,” she said, referring to the American Nurses Credentialing Center’s (ANCC) Magnet Recognition Program. Magnet recognition designates hospitals that promote nursing excellence and align nursing values with improving patient outcomes.

“I came in aware that this was the system’s goal,” Meeker said during a Tipton Health nursing leadership webinar. “I had to assess if it was really our [nursing’s] goal and were we ready to do that? How could we decide if we were ready as an organization to really take this on?”

One of the first things Meeker did was survey her nurse leaders to get a better idea of their enthusiasm for pursing Magnet.

A poll of nursing leaders showed that 97 percent agreed that pursuing Magnet recognition was important. However, Meeker said, only 52 percent of the nurse leaders said they thought their nursing teams would also agree.

“I interpreted that as saying they understood it was the right thing to do but were so compassionate about their team members that they were worried about their fatigue and that the plans would not resonate well with them,” Meeker said.

To better understand the hospital’s current state, Meeker and her team decided to use Tipton Health’s Nursing Excellence Assessment Tool (NEAT). Through survey, assessment and analysis, 31 nursing excellence structures at Wyandotte were evaluated.

“We received our results, and they were not great,” Meeker said. “I was not shocked because we had just gone through a very trying time in our organization. The survey was not only an assessment of where we were, but it was a learning tool for our nurses,” Meeker explained.

A Lot of Work to Do

As part of this work, Wyandotte formed a Nursing Excellence Steering Council to help guide next steps. “We shared the results with the council and asked for advice on how to tackle the problem,” Meeker said.

The council’s recommendation was to focus on two things:

  • Leadership, communication, visibility and accessibility
  • Shared decision making

“If we could put all of our eggs in those two baskets, the committee felt we could make some pretty big improvements,” Meeker said.

Meeker and her team got to work. For example, to help improve nurse participation in shared decision making, the hospital implemented a system of dedicating one day every month for nurses to participate. Nurses would no longer be expected to participate during their time off but could instead participate during a scheduled work shift or during time off. Or, if they preferred, they could also participate from home via a virtual meeting. In addition, if they participated in a meeting during their time off, they would be paid for their time.

Other wins included:

  • New lift equipment on all floors
  • Virtual monitoring equipment to help alleviate staffing shortages
  • Quarterly nursing town halls with remote attendance for flexibility
  • A group to review and improve nurse residency programs

Changing From Steering Committee to Advisory Council

At the start, the NESC was intended to be a temporary solution.

“The committee was so engaged, and I felt such a connection to them that I didn’t want to lose them,” Meeker said. “So, we had some discussions and determined we wanted to develop a CNO advisory committee.”

Meeker sent formal invitations to each of the NESC participants and invited them to participate in the CNO Advisory Board. Every one of them agreed to do it.”

“They were all very excited to continue on this path,” Meeker said. “Like me, I don’t think any of them really fully appreciated the power of the CNO Advisory Committee or what this work was going to lead us to.”

One of the most successful activities developed by the advisory board is the CNO Shadow Program. One day each month, Meeker spends three to four hours following a staff nurse as they go about their daily workday.

“As a CNO, you’re not at the bedside as often as you could be,” Meeker said. “Most CNOs have their personal beside experience but if it’s anything like mine, it’s a little bit dated.”

The shadow program gives Meeker the opportunity to experience a nurse’s day. “I am absolutely doing direct patient care and then I accompany the nurse through all of their activities. I can talk to him or her about what gets in the way of being able to do the excellent work that they want to do. Through that program we’ve been able to really make a lot of changes at the bedside.”

The shadow program has had other benefits too. Jodie Cole, Magnet program manager at the hospital, said the shadow program has helped increase the comfort level staff nurses feel when they are interacting with Meeker or other nurse leaders.

“This really helps make sure that bedside nurses are feeling comfortable talking to all nurse leaders,” Cole said. “They feel like they’re being heard. Kim goes to where the work is and she’s seeing it firsthand and it’s really opening that door for the clinical nurses so that they can develop a relationship with Kim and give her their thoughts, their positive thoughts. It’s improved our relationships and trust building among the nurses.”

Out-Culture the Competition

One of the values of increased transparency, said Cole, is that nurses understand why some of the requests they make cannot be granted. At the same time, Meeker says she works hard to make the work environment and culture as good as she can.

“You’ll hear all of the things that people typically say, like we need to pay more money, or we need better benefits or we need this or that to be able to keep people,” said Meeker. “What I had said early on and what I will continue to say is I personally don’t get to make those decisions. I don’t decide how much money we’re going to spend on wages for nurses.”

But, said Meeker, she can help improve the work environment and work culture at Henry Ford Wyandotte Hospital.

“I know what I can control, and that is the culture that we work in, how we treat each other, how we manage our patient care experiences, how we manage our nursing experiences,” she said. “What I have control over is the ability to out-culture the competition, the hospital down the road.”

That, she said, helps improve both retention and recruitment. “I want you to be a nurse here, not because you’re paid more, but because you want to be a nurse here,” she concluded.

Additional Resources: