Community Behavioral Health Hospital: Change Strategy and Implementation
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The Healthcare sector faces many challenges today. The most problematic issue in
healthcare is the high and ever-increasing turnover rates of the registered nurses in our healthcare
facilities across the country. According to Wells (2018), the report given by National Healthcare
Retention and Registered Nurse Staffing shows that in 2017, the nurse retention rate was at
18.2%. This rate is the highest rate ever recorded; according to the report, hospitals have lost
approximately 85.2% of their registered nurse staff. Healthcare facilities in the country need to
improve their processes towards nurse retention in various organization departments.
Community Behavioral Health Hospital (CBHH) is not an exception to the organization
that needs to improve on their registered nurse staff retention efforts and process to curb the
problem of nurse high and increasing turnover rates in all its departments. In this paper, I will
come up with a table that clearly shows the current turnover rates and the desired turnover rates
among registered nurses in CBHH. The paper further recommends a change strategy that can be
used to have the desired nurse turnover rates in healthcare and the justification of this strategy.
Lastly, the article looks at how the organization can use inter-professional considerations and
communicate the change plan for proposed changes using data and rationale.
Registered Nurse (RN) Turnover Rates
Registered nurse turnover refers to the number of nurses quitting their job and leaving the
organization either voluntarily or involuntarily (De Arruda et al., 2017). The CBHH has more
than 12 departments; however, in this paper, we shall look at the ten departments that are
adversely affected by the high registered nurse turnover rate. The table below shows the turnover
rates of each of the ten selected departments in the organization during 2017. In the table, the
rates for the four quarters of the year and the total rate for the whole year are represented in their
own column. The desired/goal nurse turnover rate for each department is also presented at the
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table in the last column. Some of the departments in the organization met while others exceeded
their desired turnover rates in either one quarter or more than one quarter. The fact that no
department was able to meet the desired turnover rates in all four quarters of the year shows a
greater need to reduce turnover rates among registered nurse staff. In order to reduce turnover
rates among nurses in the organization and improve patient outcomes in the future, the
Community Behavioral Health Hospital should make changes and implement strategies for the
same.
Table 1 Nurse Turnover 2017 – Community Behavioral Health Hospital
Q1 Q2 Q3 Q4 Year
Total
Desired/goal rate
Behavioral health 34% 27% 25% 29% 29% 20%
Critical care 12% 16% 15% 20% 16% 10%
Emergency 23% 19% 19% 13% 19% 10%
Med/surgery 13% 19% 22% 23% 19% 15%
OBGYN 75% 7% 12% 14% 10% 5%
Oncology 21% 24% 15% 22% 21% 20%
Pediatrics 11% 7% 6% 10% 9% 5%
Step Down 15% 13% 22% 19% 17% 15%
Surgical Services 17% 9% 24% 16% 17% 15%
Telemetry 18% 17% 22% 20% 19% 15%
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There are various ways that can be used to lower turnover rates among registered nurses,
improve patient safety and at the same time satisfy all the stakeholders in the organization. Neely
(2017) states that a reduction in registered nurse turnover will lead to the affordability of care by
the community. This is because low RN turnover will mean reduced costs and increased profits
for the organization’s stakeholders. CBHH could be experiencing high turnover rates among
registered nurses due to various reasons. Among the common reasons for these high turnover
ratios are; working conditions, salary problems, other job offers, and personal reasons (Dewanto
& Wardhani 2018). It’s also essential for us to note that high turnover rates have consequences
such as high training and recruitment of new nurse costs, increased overtime payments, and other
staffing concerns.
Strategy for change
From the above data, CBHH needs to reduce the registered nurse turnover rates in the
organization. They can only achieve a lower turnover rate by making the necessary changes in
their process and system. In previous research, high turnover rates have been linked to patient
dissatisfactio