Investment in a Late Career
Retention Strategy
Policy to Practice – Investing in Your Workforce
September 15, 2014
Prepared by the
Nursing Health Services Research Unit Knowledge Translation
and Exchange Program University of Toronto site
2012/2013 Late Career Nursing Initiative (LCNI)
Evaluation Objectives & Methods
1.
Assess the extent to which special projects align with MOHLTC action
plans (document analysis)
2.
Characterize employer-perceived barriers and facilitators to
implementation of the LCNI across healthcare facilities and benefits
resulting from participating in the initiative (interviews with leaders)
3.
Characterize and quantify specific project characteristics and nurse
experiences with the LCNI and determine the extent to which they vary
at the individual and organizational levels (surveys of LCNs)
4.
Evaluate the effect of LCNI participation, project characteristics, nurse
experiences with the LCNI and nurse demography on self-reported
outcome measures including job satisfaction and career intentions
(surveys of LCNs)
5.
Evaluate the effect of LCNI participation, project characteristics, nurse
experiences with the LCNI and nurse demography on administrativelyrecorded absenteeism and turnover (absentee information and turnover
data)
2012/2013 LCNI Evaluation
Characteristics of Participating Organizations
Sample characteristics:
 Of 184 funded organizations, 47 organizations participated in
the Evaluation (24 Acute Care + 3 Home Care + 20 Long-Term
Care - 25.5%) from 14 LHINs

Surveys: 761 received (404 paper-based + 357 online)
(response rate ~ 35%)

Interviews: 59 completed (33AC, 3HC, 23 LTC) with the leaders
from participating organizations; 17 with the leaders from
non-participating organizations

Absentee & turnover data received from 21 sites
2012/2013 LCNI Evaluation
Participating Organizations by LHIN and Sectors
1. Erie St. Clair
2 (1 LTC, 1 AC) of 9 funded
8. Central
2 (2 AC) of 9 funded
2. South West
5 (4LTC, 1 AC) of 21 funded
9. Central East 3 (2 LTC, 1 AC) of 15 funded
3. Waterloo Wellington 2 (2 AC) of 14 funded
10. South East
2 (2 AC) of 8 funded
4. Hamilton Niagara Haldimand Brant 8 (2 AC, 6 LTC) of 21
11. Champlain
7 (2 LTC, 4 AC, 1 HC) of 27
5. Central West
1 (1 AC) of 2 funded
12. North Simcoe Muskoka 2 (1 LTC, 1 AC) of 12
6. Mississauga Halton
2 ( 1LTC, 1 HC) of 8 funded
13. North East
7. Toronto Central
5 (4 AC, 1 HC) of 22 funded
14. North West 1 (1 LTC+AC) of 4 funded
5 (2 LTC, 3 AC) of 12 funded
Total: 47 sites
(25.5%)
Legend:
AC – Acute Care
LTC – Long-Term Care
HC – Home Care
0
0-19 20-34 35-49
50
Evaluation coverage (%)
2012/2013 LCNI Evaluation
Interviews with Nurse Leaders – Key Themes
Having a Strategic
Approach
Leveraging Staff
Expertise
Securing
Organizational
Support
Achieving
Outcomes
• Aligning the LCNI Goals with Organizational and MOHLTC Priorities
• Setting Clear Goals and Monitoring Progress
• Starting Small, Scoping Projects and Starting Early
• Matching LCNs’ Interests/Skills to Corporate and Local projects
• Getting Nurse Buy-In
• Barriers with Getting Nurse Buy-In
•Barriers with Application, Notification and Funding processes
•Barriers with the Implementation Process
•Barriers with Reporting Requirements and Follow-Up
•Barriers to Applying
• Getting Support from Senior Management
• Collaborating with Union Representatives
• Utilizing the Expertise of Other Interdisciplinary Team Members (e.g.,
computer skills)
• Consulting with Other Organizations
• Benefits to the Organization
• Benefits to Nurses
• Benefits to Patients
Having a Strategic
Approach
Leveraging Staff
Expertise
“I think it’s a great opportunity for us
to look at some of the key strategies as
an organization that we want to
initiate and support and certainly a lot
of them are in alignment with the
healthy Ontario strategy, the senior
strategy, those are actually some of
our corporate goals.” (Hospital 23)
“Don’t have the manager pick what it
needs to be, it needs to be the nurses.
Have the nurses decide because they
need to want to be able to do this. It
needs to be beneficial to them, they
need to feel good about what they’re
doing. We develop that together so
they’ve already got the buy in” (Long
Term Care 08).
Securing
Organizational
Support
“We had everybody endorse this initiative
from our CEO to our middle management, to
our union rep to our HR. The implementation
team presented to the leadership, to the
middle management, to the client services,
HR so they really understand the benefits for
all the organization, the nurses as well as the
clients. We needed to get the leadership on
board, including nursing supervisors and
managers [and]disseminate information
more to the nurses at the point of care. There
was definitely a lot of stakeholder
consultation that happened”. (Home Care 03)
“For the nurses definitely, the feedback
received, the fact that the job satisfaction
went up and the stress level went down, and
all of the nurses that had participated said
that they would be interested in participating
again.” (Home Care 03)
Achieving
Outcomes
“A great opportunity for nurses at the end of
their career to share their knowledge and
expertise and be able to participate in QI
initiatives or little projects on the floor, they
are often able to identify improvements and
contribute and feel part of something and it
takes away from that arduous schedule of
shift work.” (Hospital 18)
“The residents are happier, the families are
happier, the staff are happier based on the
satisfaction level at this point.” (Long Term
Care 02)
2012/2013 LCNI Evaluation Surveys
Healthcare sector
Professional
designation
Age
Reason for not
participating in LCNI
2012/2013 LCNI Evaluation
Project Characteristics
• LCN participants with higher scores were more likely to
report that the LCNI helps to retain late-career nurses.
• LCN participants with higher scores were more inclined to
report that the LCNI influenced their job satisfaction and
cite work environment as an important factor influencing
their decision to remain in their organization.
• Participants who had a less positive view of their project
were less likely to believe that the LCNI aids in the
retention of late-career nurses then those who had higher
scores in the project characteristics inventory.
2012/2013 LCNI Evaluation
Job Satisfaction and Career Intentions
• LCNI participants were more likely to regard coworkers as one of the most important factors
influencing their decision to stay and LCNI aids in
the retention of late-career nurses.
• Older participants were more likely to anticipate
remaining in the organization and profession for a
shorter time.
• Participants who worked FT were more likely to
report that they anticipate remaining in the
profession for at least 5 more years.
2012/2013 LCNI Evaluation
Job Satisfaction and Career Intentions
• Participants who had participated in LCNI frequently were
more likely to report that LCNI influenced their job
satisfaction.
• Participants who volunteered were more likely to report
higher job satisfaction than those asked to join by their
manager.
• Retirement was the most frequently stated reason for leaving
the organization or profession, especially among the
participants not volunteering to participate in the LCNI.
Key Recommendations
To MOHLTC:
• Earlier notification, longer deadlines, a tip sheet with
all the relevant deliverables and timelines; flexibility in
scheduling (LCN time in weeks rather than shifts; parttime and casual nurses; flexible scheduling);
showcasing successful nurse leaders and LCNs.
To Healthcare Organizations:
• Align the LCNI goals with organizational and MOHLTC
priorities; Have clear goals and monitor progress; start
small and scope projects; leverage staff expertise,
interest, and resources; engage stakeholders and get
nurse buy-in.
Key Recommendations
To NHSRU-KTEP:
• Conduct retrospective and prospective designs and mixed
methods to gain further insight into the impact and
experiences at the micro (LCNs and other age cohorts of
Registered Nurses and Registered Practical Nurses); meso
(nurse leaders within health care organizations); and macro
(provincial decision makers and associations); revise the
survey item inventory by eliminating redundant items.
LCNI 2012/2013 Evaluation
Knowledge Translation
Presentations/ Meetings
• Nursing Policy and Innovation Branch – July 17, 2014
• Northern and Rural Profile created for RNAO – Aug. 3, 2014
• Registered Practical Nurses Association of Ontario – Aug. 14,
2014
• JPNC – Sept. 8, 2014
• NHSRU KTEP Policy to Practice Forum – Sept. 15, 2014
• Ontario Nurses Association – Sept. 17, 2014
Publications
• Creating sector specific profiles
• Jeffs L, Nincic V, Hayes L, Jerome D, Malecki V. Insights from
Nurse Leaders to Optimize Retaining Late Career Nurses.
Canadian Journal of Nursing Leadership. Accepted for
publication – September 5, 2014.