Reducing turnover and labor costs by providing support to new nurses

Like many health systems, NYC Health + Hospitals has faced increases in labor costs compounded by high resignation rates among their first-year nurses. For their health system, that universal challenge is compounded by their status as a safety net provider employing nearly 10,000 nurses throughout its vast care system.

To help stem the staff losses, NYC Health + Hospitals partnered with Vizient to implement a large-scale residency program developed by Vizient and the American Association of Colleges of Nursing (AACN).

A partnership that brings together resources, expertise and education

In 2018, Vizient and New York Alliance for Careers in Healthcare (NYACH) partnered together to implement a large-scale nurse residency program. NYACH covers the fees for the program and convenes 28 participating hospitals to collaborate and share best practices. NYC Health + Hospitals coordinates and manages the program and Vizient provides the curriculum, tools and advisory support.

Nurse leaders at NYC Health + Hospitals play an important role in supporting the program. Depending on the position, specific NRP leadership roles range from giving guest lectures at seminars to releasing nurses from their shifts to attend the monthly seminars, and chief nursing officers are an integral part of kickoff and graduation sessions. Everyone in a nurse leadership or management post throughout NYC Health + Hospitals has a stake in the program’s success.

Together, the consortium works together to improve transition to practice for first-year nurses in New York City by providing education and support. Visit NYACH’s website to learn more.

“What we try to do in all of our programs—including the nurse residency program—is bring pride back to public health, and with the NRP curriculum from Vizient, that has been possible.”

Natalia Cineas DNP, RN, NEA-BC, FAAN
Senior Vice President, Chief Nursing Executive
Co-chair, Equity and Access Council,
New York City Health + Hospitals Corp.

Better engagement improves retention

Expanding the nurse leadership program increased its impact

Initially, only about 30 of the 1,000 nurses hired each year participated in the health system’s residency program. Working with Vizient, NYC Health + Hospitals has scaled up the program by involving more nurse leaders and managers in the program.

NYC Health + Hospitals leaders determined that the NRP needed a more organized approach, a bigger team and more engagement from nurse leadership.

Improving retention and labor costs while navigating the COVID-19 pandemic

As the pandemic has led to burnout among clinicians, NYC Health + Hospitals experienced dramatic improvements in turnover rates—directly attributable to the NRP.

As nurse retention rates have risen, recruitment and retention costs have dropped. Most importantly, the system’s patients benefit from the continuity of care provided by a well-trained, well-supported and stable nursing staff.


Nurses have completed the
NRP program


Cohorts have gone through the
NRP program


Average cost to replace a nurse

Source: Jones CB. Revisiting nurse turnover costs: adjusting for inflation. J Nurs Adm. 2008;38(1):11-18. doi:10.1097/01.NNA.0000295636.03216.6f

Nurses have become a focal point due to their essential role on the frontline of care delivery

Registered nurses make up 31% of the acute care workforce and many are burned out and leaving the profession. Understanding the extent and context of this reality is critical for hospital leaders to reimagine traditional approaches for recruitment, retention and care delivery.

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