Cross-Trained Nurses Boost Retention and Save Money  

April 6, 2023
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* This blog is part of the Flexible Nursing and Allied Health Workforce series.

It’s no secret the workforce has changed. People prioritize their time and worth differently now. Companies have redefined their work from home policies and younger generations are challenging traditional views on workforce flexibility. Leaders across America are taking a hard look at the “acceptable norm” and how their policies are impacting retention.

In the world of healthcare that means reassessing the standard shift mentality to retain nurses and get the largest returns within tight operating budgets. Let’s not forget, recent Advisory Board studies indicate it takes an average of 89 days to fill a bedside RN role and the average turnover cost can be $40K.

As a staffing manager and leader in healthcare, you need to start shifting your current and future strategy. Hospitals nationwide have found success in cross training nurses to fill the gaps.  

Cross Training and Cross Specialization in Healthcare

Cross training, or cross specialization as it is also known, is an ideal solution for hospitals struggling to fill specialty vacancies. In the simplest terms, cross specialization is a strategic redeployment of your nurses with similar technical skills to multiple units or specializations. Ideal for both experienced and newer graduates, targeted roles will have 50% or more of aligned technical skills (like ventilator care support).  

This provides your nursing team with more variety in their work, which can limit feelings of frustration or burnout. They have an opportunity to explore other career paths and areas in your healthcare system. Typically, implementing a cross-specialization program will increase employee engagement and improve the patient experience thanks to more engaged nurses. In addition, the nurse should see this as an opportunity to learn and grow on the job. While many employers will say they offer career advancement, you will be creating clear progression paths through the cross-specialization program – a huge value add for retention.

As a manager in a healthcare system, your organization will also see benefits of redeploying existing staff. You’ll have a better trained, more experienced staff who offer greater flexibility in fulfilling roles. Your team will have more confidence in managing an absence, because rather than scrambling or stressing, more of your nurses will have the skills to cover these shortage areas.

Overall, this is a win-win for your organization and can also provide long-term benefits. Simply put:

Organizational benefits: Cross specialization helps you address immediate and future coverage gaps while maintaining excellent patient care and continuity. Which in turn benefits value-based payments with improved patient outcomes, decreased (unnecessary) readmissions, and reduction in overall costs. Overlapping skill roles also helps to decrease the demand on physicians, nurses, and support staff.

Staff benefits: Nurses develop new skills which can create additional career paths. Flexibility of the cross-specialization program can be a great way to engage and attract new employees to your organization. It can create a buzz of excitement as your staff refers other nurses to your hospital’s opportunities.

How to Identify Cross-Specialization Opportunities

Before launching an integrated cross-training plan, take a step back to identify your current and future shortages. Also consider the national trends when it comes to nursing. In today’s market, nursing talent is at a premium. You’re not only competing to attract the best talent in your community, but nurses are now considering positions beyond their backyard. Even with a top-notch program and dedicated recruiters, you may not be able to fill every role. This is where cross training can provide a strategic benefit.

Assessing your staff’s technical skills helps you identify difficult-to-fill roles and plan a targeted workforce retention strategy. Accurately understanding your shortages helps you determine the total cost of those vacancies – cancelled procedures, loss of reputation, and possibly further alienating an already taxed staff. Once you’ve identified gaps, you can see the related experience and expertise of your existing staff, which will provide a boost in cross training.

That’s just a starting point in the process. As you investigate and plan, take time and work with key internal stakeholders and SMEs (Subject Matter Experts). This will give you buy-in for the project, help develop internal advocates for cross specialization, and ensure you are working with the best possible information. Here are a few additional steps to make sure you have a successful cross-specialization program.

  • Define the Need – Look at all care areas, including beyond the traditional or obvious roles. Ask veteran and newer graduates for their feedback. Not only will this increase engagement, but it will help you to temperature check their understanding of your system and culture.
  • Ask Other Experts – Cross specialization is on the mind of many experts across the industry. Seek out insight from your networking contacts about their successes, failures, and plans. Contact subject matter specialists like the Advisory Board about their latest research or case studies. And lean on your partners like Health Carousel whose clinically led and board-certified team has approximately 200 combined years of acute hospital and nurse leadership experience. Their firsthand experience will help you maximize staff retention and performance.
  • Cross Unit – RNs can be cross trained to alternate between different units or specializations like critical care, med-surg, PACU, and telemetry. Overlapping skill sets and patient needs make it easier to implement float pools or scheduled rotations. The change of pace may be a welcome relief for those nurses looking for variety or a break from the challenges of high-acuity patients.
  • Cross Specialization – Nurses rotate between in and outpatient settings within the same service line for high-volume/high-value specialties like cardiology, orthopedic surgery, GI, and select areas like inpatient oncology and outpatient infusion centers. This will promote a better understanding of the full spectrum of patient care and let nurses follow patients across settings.  

Launching Your Cross Specialization/Cross Training Program

Once you have the data and plan for launching cross specialization, role the program out in phases. Set clearly defined goals with benchmarks for activity and learning (for example, identify the key skills and experience to be covered, and the expected results for everyone involved).  

With the goals in place, start with a smaller, more focused first phase that includes a few nurses and limited departments. Roll it out over a few months and then collect data and feedback. Adjust the program as needed, maybe by starting the cross training with a team of mentors rather than a single cross trainer. Launch a secondary phase with more nurses and expand into more specialties or units. Once the program has fully launched, set regular feedback opportunities to assess the programs.

Simple in concept, this tactic can pay dividends in nursing retention.

Getting Started with Cross Specialization and Cross Training in Healthcare

While it may seem daunting, even frightening at first, there are clear and measurable benefits to cross specialization. In the current nursing workforce shortage, healthcare staffing managers can’t ignore these benefits, and should at least explore how cross training might work.

If you have questions or want to explore turnkey solutions and other clinical consultative services for healthcare staffing, then contact Health Carousel today to discuss your needs.

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About Health Carousel

Health Carousel is committed to partnering with world-class healthcare facilities across the country, providing rewarding assignments for Registered Nurses and Allied Health Professionals, and attracting the best internal talent at all career levels.