Becker's Hospital Review

20 CMO / CARE DELIVERY Cleveland Clinic ups retention efforts for an 'indispensable' nurse position By Mariah Taylor Cleveland Clinic has created a workforce retention program for patient care nursing assistants. "Nursing assistants add so much to the patient and caregiver experience, and their work contributes significantly to patient outcomes," Barb Zinner, DNP, RN, vice president and chief nursing officer at Garfield Heights, Ohio-based Cleveland Clinic Marymount Hospital, said in a July 9 system news release. "Retaining this indispensable group of caregivers is a top priority of Cleveland Clinic's executive nurses." Nursing assistant roles face the highest turnover rates among healthcare positions; they are as high as 30% annually, according to a report released in May. For some, nursing assistant is a steppingstone to other positions, but there are many who have no desire to change careers. Cleveland Clinic designed a retention program for these nursing assistants who want to remain in the role. e MAGNUS empowerment program, an education and training initiative for participants selected by their nurse manager or clinical director based on job performances, is designed by a systemwide nursing assistant task force. Here are four ways the program is improving nursing assistant retention, according to the release: 1. Improving job clarity and creating support resources for potential, new and current nursing assistants. 2. Creating a shadowing experience for potential workers to learn about the job. 3. Refining nursing assistant clinical orientation practices for new employees and adding a precepting experience. e program also created a detailed orientation guideline with specific skill expectations for each day of the four-week orientation period. 4. Outlining role-related care standards, including a checklist for tasks such as changing/bathing, oral care, environment, and mobility. "ey provide the highest standard of compassionate care — oen with more frequent patient interactions than any other caregiver," Mary Beth Modic, DNP, APRN-CNS, a clinical nurse specialist of diabetes at the system, said in the release. "PCNAs establish trusting relationships with patients and their families and provide comfort and support. ey also gain valuable insight about patients that the entire team can use to inform future care decisions." n AHA backs bill to expand physician residencies By Mariah Taylor T he American Hospital Association has expressed its support for a federal bill that would increase the number of Medicare- supported medical residency positions for the first time in 28 years. The bipartisan Resident Physician Shortage Reduction Act, introduced by Reps. Terri Sewell, D-Ala., and Brian Fitzpatrick, R-Pa., would add 14,000 residency positions over seven years, with an annual increase of 2,00 slots per year between 2026 and 2032. The bill would also give $63.5 million in grants to rural hospitals seeking to launch residency programs. The number of residency slots has been frozen since 1997, except for 1,200 slots created in 2021 and 2023. "The AHA is firmly committed to ensuring hospitals' staff and governance reflect the communities that they serve, and your bill would support our efforts," Lisa Hrobsky, senior vice president of advocacy and political affairs at the AHA, said in a July 7 letter. "We are grateful for your strong leadership in introducing this crucial legislation. The AHA stands ready to work with you to ensure its enactment." n AI spots physician fatigue in clinical notes By Mariah Taylor A recent study found clinical notes could be used to identify fatigued physicians. The study, published July 1 in Nature, used data from 129,228 ED visits to a single academic medical center over 2010 to 2012 to train a language learning model. This dataset included patient demographics, the patients' chief complaint and key outcomes related to an important physician decision: whether or not the patient is tested for heart attack (via stress testing or catheterization), and the outcome of testing. The model was then asked to identify physicians who were showing signs of fatigue. The model was able to flag high-workload physicians both in the ED and in other settings with overnight shifts and high patient volumes. In cases where fatigue was flagged in notes, physician decision- making for that patient appeared to be worse. For example, the yield of testing for heart attack was 19% lower with each standard deviation increase in model-predicted fatigue. A key identifying factor of notes written by fatigued physicians was the predictability of the next word. "We demonstrated the potential of detecting physician fatigue using the notes that they wrote," the study authors wrote. "Our predicted fatigue allowed us to reveal connections with decision quality. Our finding highlights the role of clinical notes not only as a medium of storing medical information but also as a window into physician decision-making." n

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