Becker's Clinical Quality & Infection Control

21 CLINICAL LEADERSHIP Why (and how) Jefferson Health is expanding its nurse 'SEAL team' By Erica Cerutti P hiladelphia-based Jefferson Health is working to expand an innovative nursing program into the system's newly integrated Lehigh Valley Health Network region in Pennsylvania. In 2022, the system formed its "Nursing SEAL Team" program, aiming to fill vacant shifts while reducing reliance on agency nurses. The program stands for service, excellence, advocacy and leadership and applies the Navy unit's "anywhere and anything" approach to nursing. Over its three-year tenure, the program has achieved both of its goals and is now expanding into the Lehigh Valley. Jefferson and Allentown, Pa.-based LVHN completed their merger in 2024, combining into a 32-hospital system. Since the SEAL program's launch, Jefferson has cut its use of agency nurses by more than 75% and is currently working to grow the team from 152 to 236 full-time nurses as it brings the model to LVHN hospitals. "When we initially launched the SEAL team, the goal was to improve filled vacant shifts, decrease agency nurse use and decrease internal premium pay, and we were able to do all those things," Andrew Thum, DNP, director of nursing workforce operations at Jefferson Health, told Becker's. SEAL nurses can be deployed wherever they're needed — medical-surgical units, critical care units or emergency departments. On average, nurses on the SEAL team have nine years of experience and can choose to work assignments across multiple divisions, states or the system's entire 32-hospital footprint. They are deployed on assignments ranging from two weeks to six weeks. "This team is unique in that it is speaking to nurses who value that type of flexible role where every day is a little bit new and different and isn't necessarily committed to the same type of work day in and day out with the same team on the same unit," Dr. Thum said. "We think that that provides some value and flexibility." That value is showing up in retention data. Over the past three fiscal years, turnover among the SEAL team workforce has averaged 6%, compared to 16% for acute care nursing overall across the legacy Jefferson Health system, according to Dr. Thum. Jefferson has also seen engagement and satisfaction levels improve among bedside staff on units where SEAL nurses are deployed. The experienced SEAL nurses provide critical support and mentorship in areas of greatest need — a particularly valuable resource given that in some of Jefferson's units, 50% to 75% of staff have two years or less of nursing experience, Dr. Thum said. "When we have this experienced team floating and working in some of these units, they act as a really valuable resource to those frontline team members who are not as experienced and are more novice," Dr. Thum said. The plan to scale the SEAL team to 236 nurses may seem like an oddly specific number, but it's intentional. Jefferson aims to maintain between 5% and 7% of its overall nursing workforce in flexible resource roles — whether that's the SEAL team, which can deploy across the entire system, or hospital-based resource positions. This structure enables the system to align resources where they're needed and respond to fluctuating patient care demands, Dr. Thum said. Sarah Rinker-Puentes, RN, a patient care manager overseeing the program's introduction in the LVHN region, said leaders have been working with nursing staff at all hospitals to secure buy-in before SEAL team nurses arrive on their units. Discussions are being held to educate nurses on the model, with new hires learning about it during orientation. The goal is for unit staff to understand the value and support SEAL nurses bring. A key advantage in this expansion, leaders said, is that LVHN already operates with standardized nursing policies and procedures across its hospitals, which simplifies the SEAL team's deployment. When Jefferson initially launched the program, the system was still newly integrated from multiple mergers, requiring SEAL nurses to navigate variations in practice across different campuses — down to nuances like different pieces of equipment. LVHN's existing standardization eliminates much of that complexity, though leaders are still working to align nursing policies across all of Jefferson's regions over the next year, Dr. Thum said. Dr. Thum said he's spoken with numerous hospital and health system leaders across the country who've expressed interest in launching similar programs over the past few years. His advice? The model's underlying structure can work for organizations of any size. "While the example of the SEAL team we have today is for a large, multi-regional health system with 32-plus hospitals, the strategy and the high-level structure that we've developed as part of this program can really be applied to hospitals and health systems of any size," he said. The key is building flexibility into the nursing workforce model, Dr Thum said. Having a dedicated percentage of nurses who can flex to meet real-time demands allows hospitals to respond proactively to changes in patient volumes and vacant rates while reducing reliance on costly agency labor. n

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