Using Appreciative Inquiry to facilitate Registered Nurse Advisory Group to improve RN Satisfaction

Purpose:
In response to the 2011 NDNQI RN Satisfaction Survey the shared decision making leadership council at York Hospital (YH) discussed ways to improve performance on 3 key indicators; RN- RN Task, RN-RN Interactions and Nurse Manager as a good leader.

Significance:
Employee engagement with the survey had been strong with exceeding the NDNQI RN survey response rate by over 6 % during the 2011 survey, yet we did not see improvement in the scores we were hoping to achieve when results were returned. Staff was frustrated with the lack of voice they felt they had.

Strategy and Implementation:
Members of the shared decision making leadership council suggested that the sub-team for the survey brainstorm successful strategies that could be implemented to improve scores. A neutral nursing administrator facilitated the session, with all nursing nunits (28 total) repsonding. During this facilitation sessions,themes from the survey were rescripted using using an Appreciative Inquiry (AI) format. Staff appreciated not having a session of complaining, but a proactive discussion of ideas which could be acted upon to improve their top areas of needing fixed: RN-RN Interaction, RN Task and Nurse manager as a good leader. All staff were provided lunch and the session identified actionable items and metrics to track them for success. Follow up and follow through was extremely important to the members of the subteam, and meetings with the staff were held quarterly, to keep them informed and engaged in the process as well as initatives.

Evaluation:
During the 2012 NDNQI RN Survey period we increased our survey participation by over 12% and 10% greater than the national average of hospitals participating in the survey at that time. Results will not be available until July 2012, but it is our hope to show improvements in all action plan areas.

Implications for Practice:
The implication for the staff was positive.Ongoing feedback and quarterly mmeetings, kept the staff engaged. They discussed actions with each other during shared decision council meetings and staff meetings. Having staff feedback is essential for satisfaction improvements and successful outcomes.