As a part of a nurse retention strategy focused on data insights, Mission Health began using Relias Assessments, powered by Prophecy®, in 2013 to reduce turnover. Finding an effective and sustainable solution to screen and retain top nurses was the driving factor in Mission Health’s decision to initiate Relias' holistic assessment tools as the cornerstone in their hiring process.

By identifying top performers and placing nurses in best-suited roles, the result was an 81 percent reduction in nurse turnover rate.

During the study period, Mission Health reduced the overall 90-day attrition rate for graduate nurses from 6% to 2.44% with a continued turnover rate of only 4% at one year. In addition, the turnover rate for non-new graduate nurses was reduced from 23% to 4.5% at 2 years. Additional data is evidence of sustained impact. For example, the average RN involuntary terminations at seven hospitals is only 1.8%. Since Mission Health expanded the use of Relias Assessments as a pre-hire screening tool for Allied health and non-clinical candidates, YTD 2016 data demonstrates a system-wide retention rate of 90.04% with four hospitals exceeding 92%.

 

The Challenge

Quality care and patient safety are top priorities in healthcare, especially as HCAHPS scores and quality outcomes drive reimbursements. Unfortunately, rising nurse turnover rates are disruptive to delivering safe, consistent, quality care. And, the correlation between unhappy staff and dissatisfied patients now impacts the bottom line. The question then becomes how do we identify, support, and retain our top nurses to maximize patient care?

 

The Study

As a part of a nurse retention strategy focused on data insights, Mission Health began using Relias Assessments in 2013 to reduce turnover. Finding an effective and sustainable solution to screen and retain top nurses was the driving factor in Mission Health’s decision to initiate Relias Assessments' holistic assessment tools as the cornerstone in their hiring process.

By identifying top performers and placing nurses in best-suited roles, the result was an 81 percent reduction in nurse turnover rate.

During the study period, Mission Health reduced the overall 90-day attrition rate for graduate nurses from 6% to 2.44% with a continued turnover rate of only 4% at one year. In addition, the turnover rate for non-new graduate nurses was reduced from 23% to 4.5% at 2 years. Additional data is evidence of sustained impact. For example, the average RN involuntary terminations at seven hospitals is only 1.8%. Since Mission Health expanded the use of Relias Assessments as a pre-hire screening tool for Allied health and non-clinical candidates, YTD 2016 data demonstrates a system-wide retention rate of 90.04% with four hospitals exceeding 92%.

 

The Results

Nurse Turnover Rates 2013 - 2014

 

The Goal: Standardization

Mission Health uses Relias Assessments to standardize its pre-hire screening process. The data from the assessments are used to evaluate and benchmark clinical knowledge. Validated clinical competency exams provide an approved checks and balance system for determining if the applicant’s specialty experience notated on the resume matches up with the job requirements. Putting all applicants through the same hiring process provides a fair and equal opportunity for employment and also sets the standards across the board so that new employees take pride in knowing they were selected from an elite pool of candidates. In addition to implementing a tool to build standardization, Mission Health also used the Relias Assessments data insights in the hiring process to:

  • identify high-performers with strong clinical proficiency
  • place nurses in best-suited roles to foster satisfaction and success
  • eliminate subjective decisions that result in the wrong hire and also insert bias that leave the hospital unprotected against discrimination claims.

"A formally validated, legally approved assessment process evaluating the “whole” candidate – clinical skills, personality/attitude and interpersonal skills – has demonstrated impressive results in improving retention rates of both graduate and experienced nurses and has been expanded to include Allied health and non-clinicians."

 

The Criteria: Why Mission Selected Relias Assessments

When choosing Relias Assessments, these are the key criteria Mission Health examined when evaluating assessment solutions:

  1. Do assessments adhere to the Uniform Guidelines on Employee Selection Procedures? Does the vendor provide proof to back up their claims of validation?
  2. Are questions and answers unavailable on a public forum in order to maintain the reliability of the assessments?
  3. Are there clinicians on staff who respond to questions related to assessment content?
  4. Does each assessment have a statistically valid pass/fail cutoff score?
  5. Do assessments include the latest evidence, and are they regularly monitored for updates as well as bias against any protected groups?

 

The Impact: Sustaining Results, RN Turnover

RN Turnover ChartData from 2016 to date indicates that pre-hire assessments are maintaining low involuntary terminations, a strong indicator of continuous program impact