Turning the Tables on Action Planning

Collaborative relationships are essential for quality patient care, including care coordination between nurses and therapists in inpatient rehabilitation facilities. In our inpatient rehabilitation unit, strained relationships between nurses and therapists were refractory to repeated efforts for improvement. The leaders for nurses and therapists worked together to address this issue using the evidence-based, theory-based Cone Health Conceptual Framework for Nurse Retention(c) ("Framework"). The Framework identifies 18 concepts derived from 80 peer-reviewed nursing studies with empirical outcomes for intent to stay, intent to leave, retention, and turnover. The concepts are grouped according to two established theories. The Framework formed the basis for a unit-based continuous improvement project. The project leaders collected pre-implementation data using anonymous surveys and independent observations, planned and implemented actions, and then collected post-implementation data through anonymous surveys and independent observations. The data reflected culture change on the unit within 3 months. The process used was simple, executable, and nimble, offering busy frontline leaders a way to address work environment issues in real time. Previously used with nursing units, our outcomes demonstrate that the Framework and planning process are effective for clinical disciplines beyond nursing.