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Biofeedback program delivers surprising results
Everyone knows that health care is a high-stress industry. But stress is a known factor in many illnesses and causes numerous lost workdays per year. Finding a way to get staff to relax — both on and off the job — could be a way to combat burnout and, as two hospitals are finding, improve employee retention.
Stress was something that employee satisfaction surveys at Methodist Hospitals of Dallas noted was a problem for staff, says Kim Hollon, executive vice president of Methodist Hospitals of Dallas and Methodist Medical Center. "I’ve been here for 16 years, and it always comes up, " she explains. "It is a stressful industry, and hospitals are a stressful place to work. Nurses in particular are involved in high-risk work with constant pressure to make the right decision."
Hollon was always interested in finding something that could help reduce that stress. "We tried brown-bag lunches, but that didn’t work well. I wanted something that really, really worked."
Imagine Hollon’s glee when a staff member saw something on the web about a program that had led to reduced self-reported stress among RNs, reduced turnover, and even reduced length of stay among patients. The program is HeartMath, and now Methodist is one of a few hospitals using the program. HeartMath trainers teach participants to use biofeedback software that can help them monitor their heart rhythms and bring them into a calmer state.
"I’ve taught many classes on stress management where they tell you to think happy thoughts, and that doesn’t always work," says Dawn Sorenson, vice president of organizational effectiveness and the person responsible for bringing HeartMath to Methodist Hospitals of Dallas. "HeartMath is different because you not only draw on a positive feeling experience, but you also train your body to react the same way it did when you initially had that experience."
Every nurse on the two pilot units — the Level III neonatal intensive care unit (NICU) and a telemetry transitional care unit — went to an eight-hour training class that taught the participants about the science of stress, stress management, how the brain reacts to stress, and emotional intelligence.
Hollon says they then learned ways to increase DHEA (an adrenal hormone) and decrease cortisol through biofeedback. "The neat thing is that the effects can last four to six hours," she says. The program relies on a computer-based biofeedback tool, and there are units available for employees to check out for home use. There are also two computers on each of the units for them to use. A month after the initial training, employees could take a second training course if they felt they needed it.
Shiella DelaCruz, RN, a nurse in the NICU, says that she noticed an immediate improvement at work once she started using HeartMath. "I feel much more relaxed and I have more energy," says DelaCruz. "I feel that I can give even better care to my patients."
"We want to help our employees learn how to better manage their stress," says Hollon. "In return, our employees’ success in this program will help us reach our goals of reduced sick-time, increased employee morale, more coherent communication, optimal mental clarity and creativity, and, ultimately, greater patient satisfaction."
It has only been six months that Methodist has been using the program, but she has high hopes for its success, particularly if it mimics that of Delnor Community Hospital in Geneva, IL — the facility that Hollon’s colleague had read about on the Internet.
A great program doing great things
In 2000, Delnor Community Hospital was going through a lot of changes, says Diane Ball, RN, MSEd, a professional associate at the facility. "We felt that giving employees a tool to help them hold it together while we underwent a great deal of change was a gift we could give them in a time of flux."
Sixty leadership staff went through HeartMath training initially. Eventually, two in-house trainers — Ball is one of them — were hired. In late summer, the program was rolled out to the staff. In four months, they trained 45% of the work force in the program. "What we started to see was turnover dropping — from 28% to 21% in the first year. The next year, it was down to 14%. The third year, it fell to 7%. Now it bounces between 7% and 11%."
But Ball wanted to know how the HeartMath group was doing in terms of turnover. "I looked at the 400 users and found their turnover rates were between 1% and 1.5% during the three years. In nursing, our eyes were really opened up: 33 nurses left in year one, when no nurse had the training. In year two, 17 left, only three of whom had the training."
Every nurse coming into the hospital as a new employee now gets the training as part of orientation. Nurse leaders also are getting training in HeartMath. If a single nurse costs a year’s salary to replace, says Ball, it’s worth it to spend about $100,000 on a program like this. "All you have to do is save two RNs and you’ve paid for the program."
Hollon says since they’ve only been using it a short time at Methodist, there’s only anecdotal information to gauge HeartMath’s effectiveness. "But I hear a lot of positive comments coming from staff. I know of one nurse who had been out of nursing for a while. She was going through some testing and didn’t do too well on the first exam. On her way from Oklahoma to Dallas for the second test, she listened to the HeartMath material again and scored 100 on the exam."
The nurses comment that there is less grumbling on the floor or that they are sleeping better, says Hollon. "We already have a low turnover rate, but I hope it will decrease it further. If this can be successful, and we can show employees we are truly concerned about them as individuals, that we are interested in helping them manage stress, they won’t burn out as quickly as they have before."
For more information, contact:
Kim Hollon, Executive Vice President; Dawn Sorenson, Vice President of Organizational Effective-ness; Shiella DelaCruz, RN, Methodist Hospitals of Dallas and Methodist Medical Center, 1441 N. Beckley Ave., Dallas, TX 75203-1201. Telephone: (214) 947-2501.
Diane Ball, RN, MSEd, Professional Associate, Delnor Community Hospital, 300 Randall Road, Geneva, IL 60134.