FE004 Costs and Savings

FE004 Costs and Savings

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Western Governors University

D030 Leadership & Management in Complex Healthcare Systems

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Date

SWOT Analysis: Chief Nursing Retention Officer

The Chief Nursing Retention Officer (CNRO) role is a strategic initiative designed to strengthen workforce stability within the Clinical Center (CC). By evaluating internal and external factors influencing its implementation, a SWOT analysis offers a comprehensive view of the program’s viability. The following sections expand on each component—strengths, weaknesses, opportunities, and threats—while incorporating additional insights that support organizational decision-making.

Overall SWOT Summary Table

Strengths

Strength 1: All training for the program is conducted in-house.

A major advantage of the proposed CNRO program is its ability to utilize internal training resources. Conducting all training sessions within the CC ensures consistency, allows customization to the organization’s unique culture, and minimizes the financial burden associated with outsourcing. In-house education also promotes strong alignment with institutional processes and fosters relationship building between new hires, clinical leaders, and retention specialists.

Strength 2: The Clinical Center (CC) is implementing the clinical ladder in 2021, and serving as a new-hire champion could facilitate promotion from GS-11 to GS-12.

The planned rollout of the clinical ladder structure provides an opportunity for professional growth within the nursing workforce. Acting as a new-hire champion positions nurses to progress from GS-11 to GS-12, thereby supporting career advancement and strengthening long-term retention. This interconnection between the CNRO program and the clinical ladder reinforces a culture of professional investment.

Strength 3: The CC, with 200 beds, is small enough to effectively implement the program and achieve the objective of reducing nursing turnover.

A 200-bed environment allows for manageable oversight and consistent application of retention strategies. The CNRO program can be closely monitored, evaluated, and adjusted more efficiently in a smaller care setting. This increases the likelihood of successful adoption and measurable outcomes related to turnover reduction.

Strength 4: As the largest government-funded research facility in the country, implementing the program could potentially save the CC millions.

Because the Clinical Center operates as the nation’s most extensive government-supported research hospital, turnover reduction could result in substantial cost savings. Lower vacancy rates decrease reliance on overtime, temporary staffing, and recruitment expenditures—yielding long-term financial benefits.

Weaknesses

Weakness 1: Hiring federal employees involves a lengthy process and obtaining federal clearances.

Federal hiring processes are inherently time-consuming due to mandatory background checks, security clearances, and regulatory requirements. These delays can slow down the onboarding of CNRO personnel, new-hire champions, and other essential team members—potentially jeopardizing timely project launch.

Weakness 2: Training managers and new-hire champions will require a significant amount of time.

Developing a fully prepared team involves extensive training commitments. Managers and champions must be educated on best practices in retention, coaching, orientation, and performance support. This time investment may strain existing workloads and limit productivity during the transition period.

Weakness 3: The CC, being a doctor-driven research facility, cannot afford delays in initiating the CNRO program.

The research-focused culture of the CC places a premium on operational efficiency. Because the facility’s priorities center on clinical studies and scientific outcomes, delays in retention-focused initiatives could conflict with the organization’s time-sensitive research demands.

Weakness 4: The current retention department at the CC is weak and ineffective.

A lack of strong infrastructure within the existing retention team represents a significant barrier. The new CNRO program will need to rebuild foundational processes, improve communication, and create evidence-based retention protocols to ensure long-term sustainability.

Weakness 5: Hiring a GS-13 is expensive, adding to the financial burden.

Recruiting a GS-13-level professional increases labor costs, potentially complicating budget approvals. While necessary for program leadership, this cost may pose a challenge during periods of fiscal constraint.

Weakness 6: Data to support the program may not be readily available due to the unique nature of the National Institutes of Health.

Because the NIH operates differently from traditional hospitals, standard workforce metrics may be limited or unavailable. This could hinder baseline analysis and delay program justification, evaluation, and continuous improvement.

Opportunities

Opportunity 1: Attaining magnet status is a current goal for the CC, and the CNRO program could contribute to achieving this status.

Improved workforce stability strengthens the CC’s journey toward Magnet designation. Retention initiatives support nursing excellence, professional development, and organizational culture—key components of Magnet accreditation.

Opportunity 2: Improving retention can enhance morale, ultimately benefiting patient safety during JACHO inspections.

A stable nursing workforce fosters higher morale, improved teamwork, and consistent care delivery. These outcomes can positively influence Joint Commission (JACHO) survey readiness and strengthen patient safety indicators.

Opportunity 3: Promotion of an employee to GS-13 within the CC to fill the CNRO position could save time compared to hiring externally.

Internal promotion expedites the hiring process and leverages institutional knowledge. Staff members familiar with the CC’s culture, workflows, and patient population can transition seamlessly into leadership roles.

Opportunity 4: Rebuilding the current retention program using in-house training could lead to significant cost savings, which could then be reinvested in patient care.

Internal program development reduces reliance on external consultants or trainers. Savings generated through improved retention can be redirected toward patient-centered initiatives, technology enhancements, and professional development.

Opportunity 5: The implementation of an evidence-based research council (EBR) by shared governance can support nurses with projects within the CC, potentially bolstering the CNRO program.

Shared governance and EBR councils empower nurses to engage in practice innovation and scholarly projects. Collaboration with the CNRO program enhances evidence-based retention strategies and fosters a culture of continuous improvement.

Threats

Threat 1: Hiring federal employees is challenging and time-consuming, with potential candidates often opting for other positions, posing a threat to the program’s initiation without securing a GS-13.

Competitive job markets and lengthy hiring processes can discourage qualified candidates. Failure to secure a GS-13 promptly may jeopardize program initiation and reduce organizational momentum.

Threat 2: Convincing the Chief Executive Officer, who is a doctor, to replace the current retention program may prove difficult.

Leadership resistance is a potential barrier. The CEO may prioritize research outcomes and perceive retention initiatives as secondary, requiring strategic communication and evidence-based justification to gain organizational approval.

Threat 3: Recruiting an adequate number of new-hire champions is essential for the success of the program.

The CNRO program relies heavily on engaged champions. Without sufficient participation, the initiative may struggle to support new staff effectively and achieve desired retention outcomes.

Threat 4: Gaining management buy-in and understanding of the program’s significance in reducing nursing turnover could be a challenge.

Managers play a pivotal role in program success. Resistance or lack of awareness may impede implementation, necessitating education, communication campaigns, and clear alignment with organizational goals.

Threat 5: Finding EBR support within a research facility setting might be challenging.

While the CC focuses on scientific research, this may limit availability of clinically oriented EBR resources. Competing research priorities could reduce support for nursing-driven EBR projects related to retention.

References

American Nurses Credentialing Center. (2023). Magnet recognition program application manual. ANCC.

Joint Commission. (2022). Hospital accreditation standards. Joint Commission Resources.

FE004 Costs and Savings

National Institutes of Health. (2023). Clinical Center overview. U.S. Department of Health and Human Services.