Nursing Development at Martin Memorial

An organization recognized for its leadership, culture and best practices can attract and retain top talent and promote a higher level of performance to achieve corporate objectives. Employers of choice enjoy other benefits including high morale, engagement and productivity. Martin Memorial Health Systems (MMHS) recognized the importance of these benefits to retain the best and brightest talent within the organization, particularly its high turnover nursing population. So, when MMHS saw high turnover rates, the solution was to rededicate more than 3,000 volunteers and employees.

Based in Stuart, Fla., Martin Memorial is composed of two hospitals, two MediCenters, a freestanding emergency center and numerous outpatient centers and clinics. The not-for-profit, community-based health care system began a journey in 2007 to earn the Employer of Choice designation from Employer of Choice Inc.

As a result of stronger leadership and education initiatives, some designed specifically for nurses, MMHS was recognized as a national Employer of Choice in 2009, 2010 and 2011. The distinction placed it in a group of 17 health care organizations — and 30 companies — nationwide that have earned the distinction.

“Our journey to become an employer of choice has had tangible benefits for our organization,” said Mark E. Robitaille, president and CEO of MMHS. “Since we began working toward this recognition over eight years ago, we have seen associate satisfaction rise significantly, while reducing workforce turnover.”

MMHS saw turnover fall from a high of 15.85 percent in 2007 to 8.94 percent in 2009. As of January 2011, the results continue to improve with associate turnover at 7.56 percent.

How to Become an Employer of Choice

The journey actually began in 2002 as part of MMHS’ quest to continuously improve engagement and meet its strategic goal to become a nationally recognized Best Place to Work organization. It all started with an anonymous employee questionnaire.

In 2002, MMHS spent most of its time focusing on engagement survey results as a way to tackle key areas that needed improvement such as senior leadership visibility, communication, associate involvement and shared governance. During the past few years, the organization has used those results to initiate proactive planning efforts that promote internal leadership development, succession planning and future growth.

For instance, MMHS partnered with Success Profiles Inc., a measurement survey and talent management company, to produce an engagement survey leader eye chart. The 2010 eye chart indicated that approximately 50 percent of all the organization’s leaders were rated in the top 25 to 50 percentile.

Since December 2010, MMHS leaders have been going through a self-assessment process called Right Path. The senior leadership team starts by rating its own performance, determining individuals’ leadership styles and developing ongoing coaching plans.

In January 2011, MMHS’ senior leadership team used peer assessment to evaluate overall performance of all leaders. The organization found that senior leadership rated approximately 88 percent of leaders in the top 25 to 50 percentile.

Using these assessments, MMHS’ leadership is able to more effectively coach and develop its leadership team to address workforce and senior leadership perception scores and create opportunities to enhance its succession planning process.

During 2010-2011, MMHS held three coaching retreats for more than 20 senior leaders to help secure and maintain senior management buy-in for the process. This support also ensures that leaders own the process and are comfortable with the feedback they receive before they share it with their direct reports.

Filling a Pipeline of Nurses

MMHS’ emerging leader program also has been beneficial for highly talented up-and-comers. This fast-track initiative has enabled the organization to create a talent pool to help meet its needs as it grows.

MMHS conducted a pilot development program for nursing in the spring and summer of 2010. This included a series of workshops, group discussions, reflections and feedback from other participants, leaders and mentors, and gave professional staff and supervisory front-line, management-level leaders the opportunity to learn and grow together.

The nursing pilot has funding for 10 registered nurse associates and is divided into three units covering business management skills, leadership skills and personal development. The course offers 40 hours of continuing nursing education credit from the American Association of Critical-Care Nurses. The learning delivery method is based on the Essentials of Nurse Manager Orientation, developed in partnership with the American Organization of Nurse Executives. This nurse leadership course is one of the first created specifically for nurse managers’ development by experts in the field that covers the skills necessary for successful leadership.

MMHS selected the participants for the emerging leader program based on criteria established by nursing leadership, including performance evaluation and clinical ladders, level of education, current involvement in councils and shared governance, and recommendations from their leaders. After selection, the emerging leader candidates were oriented to the program and paired with their leadership mentor, directors and vice presidents throughout the health system. The 12-week program began in April 2010 with weekly group workshops to address financial management, human resource management, quality, strategic management, leading teams, risk management and legal issues, safety, compliance, performance excellence and lean concepts. Each week, emerging leaders complete their online curriculum and meet separately with their mentors.

The emerging leader program affords participants the opportunity to learn about the business of health care, something they are not always exposed to in roles such as a charge nurse or nursing supervisor. Participants work with mentors to understand principles of leadership, how to hire and manage a staff and how to create and maintain a budget. The program also teaches young nurses how to make things happen, how to go behind the scenes of the day-to-day operations of the MMHS health care system, and exploit the benefits of mentoring to develop an effective staff.

The program was well-received by senior leadership, and plans are now under way for a pilot for ancillary talent as well as additional leadership development programs for nurses.

“Martin Memorial is committed to increasing nursing education and clinical skills through our evidence-based practice and nursing research mentorship program,” said Sherry Guffin, assistant vice president of patient services for Martin Memorial Hospital South.

To further enhance talent in research, MMHS founded a mentorship program to create a core of nurse experts who are familiar with evidence-based practice, are passionate about nursing research and can mentor collegial staff nurses. Each attendee is assigned a nurse mentor.

MMHS also increased emphasis on nursing education, stressing the importance of completing advanced degrees. In an effort to increase the bachelor of science in nursing (BSN) rate amidst staff, the organization started a partnership with Western Governors University, offering online education options that lead to a BSN in a timely and cost-effective manner for nurses who already have an associate degree in nursing.

Further, all nursing directors and supervisors were directed to obtain their BSN. To date 72 percent of nursing directors have completed their BSN, and this number is expected to rise to 75 percent this year. Eighty-four percent of the entire nursing leadership at MMHS has completed a BSN degree or higher.

The Journey Never Ends

Thanks to a focused and disciplined effort to become an employer of choice, MMHS has developed a continuous improvement mind-set that increases staff education and commitment and improves patient care.

MMHS has multiple projects under way including planning for a new hospital; installing Epic, a new clinical electronic medical record system; a new financial, talent management and materials management system; and continuing a three-year effort to improve performance excellence by focusing on enhancing the efficiency and quality of work the organization performs system-wide as new talent joins.

Talent management efforts have produced a pool of skilled, motivated and engaged talent. One of MMHS’ key metrics is its reputation in the medical community among physicians, volunteers and associates. Other metrics gathered from the 2010 employee engagement survey state the following increases in employee and staff satisfaction:

• “I am satisfied with my job” rose from 14.8 percent in 2002 to 88.7 percent in 2010.

• “I have confidence in our organization’s leadership” rose from 8.4 percent in 2002 to 83.7 percent in 2010.

• “I would recommend my organization to friends as a good place to work” rose from 22.9 percent in 2002 to 90.2 percent in 2010.

• “My manager or immediate supervisor seems to care about me as a person” rose from 6.3 percent in 2002 to 84.2 percent in 2010.

• “In the past three months, I have gone home feeling good about my workday more than feeling bad” rose from 40.6 percent in 2002 to 94.2 percent in 2010.

Amy Barry is the vice president and chief human resources officer at Martin Memorial Health Systems. Joyce L. Gioia is CEO of Employer of Choice International Inc. They can be reached at editor@talentmgt.com.