Improvements in staff and patient satisfaction after deploying a structured work environment improvement plan in...

Emergency departments (EDs) are often high-stress and fast-paced. ED nurses face multiple challenges which impact attrition. ED nurses report unsupportive practice environments lead to burnout. Improving work environments is essential to promote staff satisfaction and quality of care. Nurse managers have significant influence over the practice environment; they need an effective, simple, direct process for designing targeted interventions that improve staff satisfaction and ensure patient care quality. An established work environment improvement process, based on an evidence-based, theory-based conceptual framework for nurse retention, was deployed in seven EDs, cyclically. Pre- and post-data comparisons revealed increases in nurse satisfaction, patient satisfaction, and new graduate nurse retention. Staff experienced improved resources, increased trust, feeling heard, and a new sense of collaboration with their leaders. Managers reported increased satisfaction with their roles, appreciation for the simplicity and relevance of the approach, and the ability to plan strategically and efficiently, resulting in successful workplace enhancement. Repeated deployment built a 'solutions-oriented' culture. The work environment is a key variable in the complex equation of nurse satisfaction, engagement and retention, which are all linked to patient care quality. Deployed consistently, this evidence-based approach can ensure that improvements in satisfaction and quality of care are realizable.