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Success Story

How Mercy Health St. Mary’s Used Relias Assessments to Lower Turnover, Improve Satisfaction and Increase Retention of New Grad Nurses


Mercy Health Saint Mary’s is a 344-bed, acute care teaching hospital in downtown Grand Rapids, Michigan. It is a member of Trinity Health, the fourth largest Catholic health care system in the country. Mercy Health received its initial Magnet® designation for nursing excellence in May 2013. With over 2,500 employees, the hospital employs approximately 1,200 nurses.

The Challenge

For healthcare systems across the U.S., despite best efforts, nurse turnover continues to rise nationally now at 16.5%. If losing one nurse can cost up to $88,000, finding a solution will impact quality, safety, and budget.

The question then becomes how do we identify top talent and predict nurse success to improve retention and impact the bottom line?

The Study

Mercy Health leadership wanted to take significant steps to ensure nurses are hired, onboarded, and developed in a way that puts them on a path for success. Mercy Health wanted to positively influence new grad nurses entering its nurse residency program at the very beginning of their career.

According to Mercy Health’s Theresa McGuire, MSN RN- BC, the system’s Magnet Program Director and Nursing Professional Development Specialist, “We believe that recruiting and onboarding top talent first starts with hiring for our culture.” To accomplish this, Human Resources and

Nursing Departments needed to work in partnership to attract nurses who felt connected to the hospital’s mission, vision, and values. The goal of the new program was to assure all new nurses had a seamless transition to practice and an opportunity to “do what they do best every day.”

Mercy Health looked to Relias Assessments to:

  • Find the best candidates to reduce turnover
  • Match to the best fit role to increase job satisfaction
  • Support nurses in finding their best selves to increase retention

RN Turnover Rate at Mercy Health Chart

Previous Hiring Process

HR used other evidence-based hiring tools to select the best candidates for cultural fit. Then, nurse managers would select new hires from the candidate pool created by HR at a hiring extravaganza. The candidates were asked to list their top three preferences of which units they wanted to work in, and HR offered interviews with nurse managers in at least one of the three.

New Hiring Process

With Relias Assessments in place, a small group of HR and nursing leaders received initial education and training. For 20 months, Mercy Health gathered data and adjusted the hiring extravaganza process to where candidates took Relias Assessments before interviews were scheduled. After initial implementation, the training was expanded to include all leaders involved in RN resident hiring and a few additional structural adjustments were made to the program.

HR focuses on what it does best—finding the best candidates and assessing for cultural fit. A new team, the Clinical Review Team (CRT), was developed to select candidates and compare Relias Assessments scores to the stated nursing specialty preferences. If there is a match, CRT recommends hire. If scores indicate the desired nursing specialty is not a good fit, these RN residents are invited to a second level interview to assure the best alignment for both the nurse and the hospital.

A Nurse’s Story

Nancy is a traditional BSN new graduate nurse who always wanted to be an ICU RN. The nursing leadership saw her passion during the interview and she was offered a position. Relias Assessments indicated she was a 43% fit for ICU.

Soon it became clear that the ICU was not the best place for her. She was overwhelmed and lacked fundamental knowledge that was necessary for clinical decision making.

After educational efforts were made, it was decided that she would transition to Med/ Surg, seeing that her Relias Assessments score predicted 68% success. Now, this nurse is thriving. She is engaged in shared governance. She is acting as a preceptor for student nurses and she is loving nursing again.

The Impact

After full implementation, overall RN turnover continues to be below national average, decreasing to an impressive 5% in FY18. Specifically, for new graduate RNs, Mercy Health has retained 100% of their new nurses at the one year mark in six out of the seven past cohorts.

Retention of New Graduate RNs at One Year Chart

Alongside a desired improvement in nurse retention, Mercy Health also reported improvement in RN resident satisfaction, per Casey Fink Survey Scores. McGuire commented, “Nurses are able to enjoy their job and the literature is very clear that all great patient outcomes are associated with that.”

RN Resident Satisfaction Survey Results

Relias Assessments helps identify the strongest nurse candidates and predict their success prior to independent practice. Data from the behavioral assessments helps hospitals place nurses into units where it’s statistically predicted they will be successful and satisfied, impacting turnover and patient outcomes.

Says McGuire, “Relias Assessments is an evidence-based tool that allows nurse managers, educators, HR to make smart hiring decisions.”

Find the best candidates to reduce turnover.

Match to the best fit to increase job satisfaction.

Support nurses in finding their best selves to increase retention.

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