Develop a Strategic Plan
Topic Retaining nurses in Hospice
Below is what I had revised as a vision and mission statement however it probably needs work.
Compassus Hospice mission is to preserve each patient’s dignity while removing the fear associated with dying through pain management, emotional and spiritual support (Compassus Hospice), Our vision is leading the transformation of healthcare delivery: continuously and measurably improving the quality of person-centered, physician-driven, team-based care (Compassus Hospice).
Compassus Hospice has established a strong mission statement that implies their goal to be nothing short of medical excellence in death and dying. While this mission statement is a solid foundation for the organization, this mission statement leaves something to be desired for the purpose of this strategic plan. I have chosen to tailor the mission statement to be more inclusive of nursing staff as well as the patient population. My new mission statement is to improve well-being of our patients and families by investing and retaining our nurses by providing excellent end of life experiences. This statement will all a focus on not only the patients but nurses as well.
A vision statement should be valued by those that it sets a goal for. People need to see themselves in the vision (Bonfante 2017). The revised vision statement is the leader in quality end-of-life care delivery, and viewed as the hospice employer of choice in healthcare.
Write a 2- to 3-page summary of the strategic plan issue. Include the following in your summary:
The strategic plan issue and how the issue’s need is evident in the group or organization.
The mission and vision of the group or organization. (Note: Be sure you have reviewed and implemented feedback from your Week 4 Discussion 1: Mission and Vision Statements.)
Data from historical analysis and forecasting to support the need for the plan
Evidence from the literature to support the need for the plan
Previous attempts by various individuals and groups to address this issue
Stakeholders that should be included in the strategic planning process
Summary of the Strategic Plan Issue
Nurse retention is one of the most important quality measures in healthcare. The issue affects not only patients but also other healthcare workers and the healthcare organization. one of the biggest challenges in the selected hospice care facility is retaining nurses. The challenge has been exceptionally high during the COVID 19 pandemic due to the increased burnout and negative experiences. Compared to the pre-pandemic era, more and more nurses have considered leaving the palliative care field during the post-pandemic period due to stress brought on by the pandemic. In addition, organizational data indicates that more than half of the nursing staff do not stay on the job for more than two years. Understanding why hospice nurses leave their workplace or the profession is critical to designing an effective strategic plan to improve nurse retention. This entails analyzing internal and external factors that prompt nurses in the selected hospice facility to leave the facility for other hospice facilities or leave the profession altogether.
One factor contributing to high nurse turnover in the selected hospice organization is increased burnout, related to the increased emotional challenge, stressors, and workload, especially during the COVID 19 pandemic. The issue is escalated by fear of personal safety, primarily due to the limited supply of personal protective equipment. Another significant factor is resource shortage causing nurses to strain in their roles. Another contributing factor is low reimbursement for hospice nurses. Medicare reimburses hospice less than other end-of-life care settings, primarily because patients who enroll in hospice cost Medicare pay less, with the cost further reducing with the increase in admission days. The lower Medicare reimbursement in hospice leads to lower nurse pay. The high rate of hospice nurse turnover in the selected facility has resulted in notable implications.
To start with, the trend is impairing the facility from attaining its vision and mission. Retaining nurses impacts a facility’s ability to provide quality care and maintain a strong culture of safety and engagement. It also impairs nurse morale, teamwork and job satisfaction. Since nurses play a vital role in a patient’s experience, a high staff turnover is associated with lower patient and family satisfaction. Additionally, the need for hiring more nurses to replace those resigning has put a significant financial strain on the hospice agent. this entails the cost of recruitment, screening, and training. The increased mortality rate also indicates the poor quality of care among patients admitted for hospice care.
The Vision of the Organization
The vision of the selected facility is to be a leader in quality end-of-life care delivery and be viewed as the hospice employer of choice in healthcare. The high nurse turnover in the facility impedes this vision’s attainment due to the nurse shortage arising from high nurse turnover. In addition, various internal factors contributing to reduced nurse retention, such as low pay and benefits, exclusion of nurses in decision making, and unfavorable work environment, are destroying the organization’s reputation, thus impairing it from becoming the hospice employer of choice in healthcare.
The Mission of the Organization
The mission of the selected hospice facility is “to improve the well-being of our patients and families by investing and retaining our nurses by providing excellent end of life experiences” The low nurse retention is impairing the facility’s ability to provide excellent end of life experiences to the elated nurse shortage.
High nurse turnover has been established to have significant quality and economic implications on hospice facilities. This indicates the need for hospice facilities to implement strategic plans to help curb the trend. The financial impact of high nurse turnover in hospice facilities is related to the cost of advertising and recruitment, hiring, orientation and training, decreased productivity, termination, potential patient error, and additional turnover (Harris, Narayan & Piskor, 2019). The quality implications mainly arise from the nurse shortage associated with high nurse turnover. Nurse shortage pairs nurses from spending quality time with each patient, thus compromising the quality of care.
Studies indicate that implementing nurse mentoring and psychological support programs for nurses in hospice facilities can help nurses cope with stressors associated with the profession, especially during the pandemic, thus reducing their desire to leave the profession (Efendi et al., 2019). Other studies have established that transforming the palliative care environment by providing robust and top-level nursing leadership and supportive nursing supervision can improve nurses’ desire to remain in the profession (Lysaght Hurley et al., 2020). Nurse retention in hospice care facilities can also be enhanced by involving nurses in decision making related to patient care delivery and practice, creating a culture of safety in the organization, re-designing nurses’ workspaces to be more ergonomic and less physically demanding, ensuring safe staffing levels, offering flexible work schedules for nurses and limiting nurses work hours. Besides, offering employment opportunities such as better wages help nurses feel empowered. Since the issue of nurse retention is multifactorial, integrating multiple interventions in the strategic plan can promote better outcomes (Whiting et al., 2021). Through the successful implementation of a plan entailing such strategies, hospice facilities can enjoy the benefits of nurse retention, such as becoming a nursing employer of choice.
One of the notable strategies that have been implemented in the selected palliative facility to reduce nurse turnover is eliminating mandatory overtime. However, the strategy has not had significant implications. This is due to the increasing number of elderly populations seeking care in the facility and the consequent congestion. Consequently, nurses in the facility find it challenging to end their shifts and leave patients unattended amid nurse shortages.
The strategic planning process to address the issue of nurse turnover in the selected hospice facility will entail Key stakeholders in the facility. Each stakeholder will play a unique role and represent different interests. The selected stakeholders have a vested interest in the issue of nurse retention and its implications and the success of the organization regarding the attainment of set goals, mission, and vision. They include organizational directors, nurse leaders, patients, their families, and nurse unions.
Efendi, F., Kurniati, A., Bushy, A., & Gunawan, J. (2019). Concept analysis of nurse retention. Nursing & health sciences, 21(4), 422-427. https://doi.org/10.1111/nhs.12629
Harris, M. D., Narayan, M. C., & Piskor, B. (2019). Recognition for Home Care and Hospice Nurses. Home Healthcare Now, 37(3), 184. doi: 10.1097/NHH.0000000000000766
Lysaght Hurley, S., Welsh, D. M., Roy, K. M., & Godzik, C. (2020). Bridging the gap: A hospice nurse residency program. The Journal of Continuing Education in Nursing, 51(8), 371-376. https://doi.org/10.3928/00220124-20200716-07
Whiting, L., O’Grady, M., Whiting, M., & Petty, J. (2021). Factors influencing nurse retention within children’s palliative care. Journal of Child Health Care, 25(4), 587-602. https://doi.org/10.1177%2F1367493520971426