Employee Engagement
According to Keyko and colleagues, workplace engagement is essential to ethical nursing practice. Increased workplace engagement contributes to improved job satisfaction, employee retention, and overall organizational outcomes.1 Therefore, it is the ethical responsibility of nurses and nursing organizations to support workplace engagement. Sarah Cannon values the voice of employees and pledges to take action to support employee engagement. The Sarah Cannon Navigation Engagement Committee (SCNEC) was formed in 2018 to identify common areas of opportunity to improve engagement among nurse navigators across the healthcare system/enterprise. The SCNEC comprises 23 oncology nurse navigators representing over 180 navigators and 15 divisions. The SCNEC utilizes the annual employee engagement survey to collaborate, strategize, develop, and implement interventions to increase engagement.
Significance
In the 2018 annual employee engagement survey, nurse navigators across the healthcare system/enterprise identified an opportunity for increased support for professional development as a key issue. Encouraging, promoting, and supporting professional development are successful strategies to increase workplace engagement.1 Organizations with poorly engaged employees are associated with decreased nursing retention.2 Higher turnover rates contribute to higher organizational costs and potentially to insufficient staffing, thus negatively affecting patient care and outcomes.2 The SCNEC began to focus on initiatives and strategies to improve professional development for all nurse navigators as a means to improve engagement.
Planning
The SCNEC established a subcommittee led by the navigation program manager to identify strategies to promote professional development for the navigators. Senior leaders were instrumental in maintaining focus and accountability of the team throughout the development phase. A stoplight methodology was used to provide quick reference on progress and remaining tasks.
The navigators have a wide range of clinical experience—from novice to expert—thus identifying differing needs for professional development at distinct time points along the professional continuum. The team identified several professional development opportunities, such as certifications, educational degrees, professional organization involvement, and speaking and writing opportunities. A roadmap design with frequent stops was selected to highlight opportunities for professional development. A simple single-page visual with hyperlinks to provide detailed information of roles and opportunities would provide resources to promote professional development. A PowerPoint presentation would accompany the roadway visual to provide a more thorough explanation on the various roles, related role development opportunities, and website resources specific for those roles. The clinical operations program coordinator was solely responsible for the graphic designs and Internet connectivity for the Roadmap.
Navigation Roadmap Components
A Roadmap was designed and implemented to promote employee engagement. The navigation Roadmap is not intended to be a clinical ladder, rather it is a tool to guide professional growth and development. The overall purpose is to offer navigators information on career and professional development opportunities. The Roadmap includes career paths, roles, and skills/attributes (Figure 1).
Career Paths
The Roadmap is a self-guided tool to explore career opportunities or enhancements for self-improvement as a professional nurse. Navigators can navigate through the different career paths to gain more information on the specific roles within the organization chart.
Roles
The team identified 11 different roles related to navigation available within the Sarah Cannon Navigation Network (Figure 2). Examples of roles include adult oncology nurse navigator (ONN), virtual ONN, preceptor/mentor, navigation manager, navigation director, and executive level roles such as program director, clinical operations, and service line leadership.
Each role has a link to view the job description, which includes a role overview, knowledge, abilities, and skills. Recommendations are also included for those interested in the role.
Skills and Attributes
Each role comes with a unique set of skills and attributes, which are listed on the Roadmap. Content items under each of the roles include resources for general development, training and education, tumor site–specific education, and professional development/leadership training. These resources are useful website links to help focus those resources, tools, and experiences pertinent to the navigators’ areas of professional interest.
Sources for Implementation
User Guides
The Roadmap and tools are easily accessible to all navigators on a shared site. To assist the navigators with utilizing the Roadmap, a “How to Guide” video was created along with a PowerPoint program. A description of the icons on the Roadmap is provided, and information on how to explore each career path is detailed. In addition, a companion 1-page quick-start user guide was created to provide an overview of the Roadmap and includes key points on existing features to help facilitate the use of the Roadmap.
Personal Roadmap Worksheet
A personal Roadmap worksheet was created to display a snapshot of skills and attributes aligned with the roles for each career path. The navigators can use the worksheet to annotate and individualize their plans, goals, specific courses, and other professional development activities. The navigators identify 1-year, 3-year, and final goals to begin planning for professional growth. Course selection and other professional development activities to strengthen abilities and skills to accomplish the goals are listed on the worksheet. The worksheet is also used as an accountability tool to ensure the navigators stay on track to meet their goals. Each of the content areas contains check boxes and a place to annotate task completion date to document progress. The worksheet can aid the navigators in achieving their professional growth goals and desired career path.
Leadership Engagement
Our navigation program manager played a vital role in this process. The manager worked with the committee members from the development of the initial idea to creating a final concrete tool. The manager also mentored the committee facilitators on tool development, meeting coordination, and creating appropriate action items and ensured goals were feasible from an enterprise standpoint. At times when the group began to fatigue and progress slowed, the manager provided a morale booster or gentle nudge to continue marching forward. In addition, the manager held the members accountable to ensure all were maximizing their efforts. The manager was also instrumental in connecting to senior leadership to relay progress upward and similarly communicate any concerns or general questions senior leaders had.
Barriers
The barriers encountered in the tool development varied. Time commitment and coordination of meeting times across 3 time zones were the 2 most challenging barriers to overcome. Committee members also had other competing priorities in combination with everyday tasks. The time to complete the tool extended across 2 years due to the complexity of the project and committee turnover. Although the committee divided up tasks among its members, a limiting factor was in having a sole member as IT content specialist to produce the final project. Adding more committee members and IT content developers will shorten the time frame for development, which aids the group in maintaining focus and avert committee membership turnover.
Seeds for the Future or Applicability
The Roadmap is the product of a passionate and committed team to develop the tool from conception to final product. The tool is applicable to other navigation programs from large organizations with many different roles to small organizations with a less diverse number of roles. ONNs vary in their level of experience; however, the tool can be used for novice to expert nurses. A similar tool may also be useful for programs outside of navigation. Many organizations desiring to retain and promote professional development within their organization may benefit from a similar tool. Leaders within an organization who engage positively with their employees in aiding professional development may derive benefits, such as positively impacting work performance, employee loyalty, and overall job satisfaction of employees.
Recommendations
Each quarter, the SCNEC will review and update the Roadmap as needed to include relevant and current resources for nurse navigator development, training, and education. Several metrics will be measured to analyze the success of the Roadmap. System navigators will complete an initial survey that will identify the number of navigators viewing and utilizing the program. The initial survey will also assess exploration of resources provided in the tool and navigators’ perception of usefulness for professional development opportunities. The SCNEC will survey navigators again after 1 year to compare and measure outcomes. Finally, the organization’s annual engagement survey will provide data on the Roadmap’s impact on professional engagement, specifically measures on growth.
Conclusion
Sarah Cannon is committed to employee engagement. The primary goal for the navigation Roadmap is to increase nurse navigator engagement by addressing the need for increased support in regard to professional development. The SCNEC will determine the success of the navigation Roadmap by evaluating future employee engagement surveys.
Acknowledgments
Special thanks to Michelle Eck, Sarah Cannon clinical operations program coordinator, who was the SCNEC IT content expert and creative design specialist throughout this body of work. Thanks to Erica Williams, navigation program manager, for providing guidance and support throughout the development process. Erica consistently advocated for SCNEC initiatives with senior leadership when seeking feedback and approval.
Special thanks to Veronica Campos, division director of oncology navigation, for providing guidance, motivation, patience, and editorial expertise in writing this article.
Finally, we would also like to thank our advisory board and Roadmap subcommittee members who dedicated time, energy, and hard work to make our Roadmap a success.
References
- Keyko K, Cummings GG, Yonge O, Wong CA. Work engagement in professional nursing practice: a systematic review. Int J Nurs Stud. 2016; 61:142-164.
- Tullar JM, Amick BC III, Brewer S, et al. Improve employee engagement to retain your workforce. Health Care Manage Rev. 2016;41:316-324.
