The goal of this Match Day was to match each nurse’s skill level with their desire to work with a certain patient population.
Nursing Directors Deshonna Taylor, M.S.N., RN, and Stephanie Huckaby, M.S.N., RN-BC, NEA-BC, were tasked with creating a process to match nurses to specific patient populations both in the new tower at CUH and at Zale Lipshy Pavilion. They formed a Match Day task force composed of employees who experienced the previous hospital move in 2014, when UT Southwestern’s St. Paul University Hospital closed with the simultaneous opening of CUH. In order to have fresh eyes to review the process, the task force also included new employees who had not experienced a department move. Staff from all job codes participated as task force members, including health unit coordinators (HUCs), registered nurses (RNs), assistant nurse managers, and nurse managers. The first meeting, in March 2020, included a review of past processes. Staff provided input on how to improve the process and determine a rollout plan following the steps below.
Rollout Plan Steps:
1. Review of Current Unit
The initial step was to identify units that would remain intact and serve the same population, which included the ICUs, ED, BMT, and L&D. These units were exempt from discussions regarding staff designations.
2. Projected Staffing Needs
Trending data were used to forecast the potential increase in patient volumes and to project the average daily census (ADC) for the new units. Using the ADC and the assigned nurse-to-patient ratios for the patient population, the number of required full-time employees was determined. While some units would need additional staff, other units would have more than the required staff.
3. Determine Skill Levels
To ensure a safe and balanced staffing mix across all units, RNs were evaluated by their current skills and competencies via a survey, along with input from their nurse managers, and placed in one of four categories (bulleted below). The process took into consideration such criteria as experience, charge capability, certification, critical thinking, and level of independence, using Benner’s Stages of Clinical Competence as a guideline.
- Advanced Beginner – Demonstrates marginally acceptable performance because of prior experience in actual situations. Efficient and skillful in parts of the practice area, requiring occasional supportive cues. May/may not be within a delayed time period. Knowledge is developing.
- Competent – Demonstrated by the nurse with two to three years’ experience in the same or similar setting/situations. Demonstrates efficiency. Is coordinated and confident in her/his actions. Establishes a plan based on conscious, abstract, analytical approach to the problem. Completes care in a suitable time frame without supporting cues.
- Proficient – Understands situations as a whole and perceives meaning in terms of long-term goals. Learns from experience what to expect and how plans need to be altered in response to unplanned events. Decision-making is not labored because the nurse understands which aspects of the situation are important and where to focus.
- Expert – Demonstrates an intuitive grasp of each situation and accurately focuses on solutions without considering a large range of alternatives. Operates from a deep understanding of the whole situation without having to break it into parts/steps. Fluid, flexible performance. Has highly developed analytic skills – and the ability to apply those skills to situations she/he has not experienced before and make sound decisions.
4. Employee Preference
A series of six virtual Q&A sessions reviewed the Match Day process and answered any questions that employees might have. More than 300 employees from the Division of Nursing participated in these Q&A sessions. In addition, 1,440 RNs participated in the survey and were matched to the units with available positions, based first on skill level, followed by stated preference.
With the matches completed, staff were assigned and moved to their new units in either the new tower at CUH or at Zale Lipshy Pavilion.