Learning Objective #1: describe the use of hospital wide and unit based innovative organizational approaches to developing evidence to inform the creation of healthy workplaces

Learning Objective #2: delineate the evidence from the nursing staffs' perspective of the top priorities for developing their units and the nursing organization

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PROBLEM/SIGNIFICANCE: The development of nursing organizations needs to be informed by evidence. The nursing shortage is recognized as an international problem and comprehensive hospital wide and unit based strategies are needed to promote recruitment and retention.

PURPOSE: The purpose is to describe innovative organizational technologies to develop evidence to inform the development of healthy workplaces in acute care hospitals. The organizational assessment strategy promotes collaboration and communication to enhance patient care and the work environment through staff organizational and clinical decision making.

RATIONALE: An overarching framework for Healthy Workplaces (Parsons, 2004) guides the intervention. The key concepts are shared leadership, participatory change management, and empowerment.

METHODOLOGY: Participatory action research was used through future search conference (FSC) methodology to facilitate the nursing management teams and all patient care units' staffs in two hospitals to develop their vision and priorities to create a Healthy Workplace (N = 20 units; N = 965 staff). Through a systematic participatory planning process teams determined priorities, made decisions, and developed action plans to create their own healthy workplace. Assessment data included qualitative data analysis of all units FSC records and a comprehensive staff self report survey.

RESULTS: Qualitative analysis revealed the 5 top opportunities for developing the nursing units and organization were: Staffing Systems, Patient Care Standards for Practice, Team Behavioral norms, Sufficient Equipment and Supplies, and Need for Change of Shift Transition Processes. 56.2 % of the staff responded to the staff survey. Staff ethnicity was statistically significant different between hospitals. Mean scores for control over practice, work satisfaction, empowerment, organizational commitment, relational health, and trust in peers and management instruments were also measured as components of the organizational assessment.

POTENTIAL IMPLICATIONS: Nurse Executives need to role model evidenced based practice through the use of evidence to inform the development of their organizations.