N 5430 University of Texas Six Sigma Proposed Steps In DMAIC Discussion As an exemplar from your work place discuss how Six Sigma can be employed to improve outcomes and apply to a process problem in your current work environment. Using your identified problem, define proposed steps in DMAIC.
problem- shortage of licensed nurses – strategy to retain nurses in state regulatory agency
Analyze and Improve:
Initial post: Reflection, application with exemplar and minimum of 2 resources, one in addition to texts.
Also, as you write your DB’s if you have successfully used it as a process – please give a line or two in your introduction of how it was applied in a place where you have worked.
attached previous work i did on the same problem
I am not a clinical nurse , use examples relating to administration Application Exercise: Plan-Do-Check-Act (PCDA)
Ugonma Darling Anyanwu RN. BSN.
University of Texas at Arlington College of Nursing and Health Innovation
N5430 Management Seminar
Cynthia Plonien, DNP, RN, CENP
July 4th , 2020.
Name of Organization: HHSC Regulatory Services; Region 6 Date: 07/04/2020 City: Houston
TOOL: Questionnaires and emails
STEP: Improve recruitment of Nurses and increase morale of current nurses to enhance retention
CYCLE: 1st Attempt
My region being in a Houston metro area is surrounded by many hospitals and is home for a
renowned medical center- Houston Medical center. It is hard to recruit nurses as most of the
nurses prefer to work for the private sector where they are paid better. This competition
results in high licensed nurses turnover for my agency. We are frequently losing licensed
nurses while unable to recruit new ones . With the increase in the number of skilled nursing
facilities and assisted living facility in region 6 , it is extremely tasking and impossible to
accomplish organizational goals timely as nurses continue to see better work opportunities
and benefits to meet individual needs .
In most of the states, the demand for nurses is higher than the supply as shown below from
random centers (Haddad, et.at., 2020).
Estimated no. of patients daily
No. of nurses
I plan to meet with our nurses to discuss their thoughts on how to improve our staffing
problems especially with retention of current nurses . Nurses were also asked to complete a
current work situation questionnaire and return to me. I also plan to meet with regional
management which included regional program managers the assistant regional director and
the regional director to discuss the problem and possible solutions. I also plan to disclose my
intention to meet with nursing staff and to gather their perception of the problem as well as
approaches that can mitigate the problem. I plan to suggest location stipend for our nurses in
the Houston metro area which can help keep our nurses and reduce turn over. This can also
be in the form of merit award for nurses.
The following data collection tool will be sent to all nurses in region 6 regulatory division .
They will be asked to complete questions and return to me via email within 48 hours . This
will help to determine employee morale in relation of current work situation . Their
responses will be complied for analysis before and after implantation phase of the proposed
plan to evaluate effectiveness and progress of the plan.
No. of years worked
Are you comfortable with your work and do you feel motivated ..yes ..no ..
Do you feel overworked………………………………………………………..?
How can your status be improved
On 06/26/2020, I sent email reminders to nurses encouraging them to return the completed
questionnaires above. I also received and reviewed the data collecting questionnaire which provided
base data on how nurse surveyors felt as well as their idea on how to address staffing situation.
I held a conference call with licensed nursing staff in the region on 06/29/2020 and discussed licensed
nursing retention issues. They were vocal and shared insights which centered on non- competitive
pay when compared with other healthcare organizations round us as well as heavy workload they
inherit when other nurses quit. Appreciation emails were sent to Nurses, emails were acknowledged
On 07/01/2020, I met with regional leadership/management and discussed licensed nurses retention
issues which all were aware of . We discussed my plan to implement a process that will increase the
morale of our current employees and suggested staff meeting where our nurses are recognized for
their hard work especially during the COVID19 pandemic. I recommend that our regional director
speaks to nurses to provide support, appreciation and encouragement during our weekly conference
calls. I also suggested location stipend for our nurses in the Houston metro area which can help keep
our nurses and reduce turn over. I also suggested using regional private funds to obtain gift cards for
nurses as a token of our appreciation for carrying our workload this period. I also suggested asking
other regions across the state for assistance while we try to recruit more nurses. I was reminded the
obvious that state workers salaries are approved or rather mandated by the state legislators, but the
stipends can be offered as merit awards to nurses in our area.
The team were in agreement to at least give plan a try .Our regional director admired my concerns
and agreed to escalate my approach to state office in Austin for deliberation . I sent reminder email to
regional director for follow up.
Data analysis confirmed that nurses were overwhelmed. Data indicated nurses loved their jobs but
believed overwhelmingly that pay could be better. All agreed employee motivation was lacking, they
feel overworked and believed time off work could help them recharge and improve morale.
Unfortunately, the information gathered was a true representation of my prior perceptions. Gift cards
presented to nurses were appreciated and most expressed that mere conversation and discussion of
issues affecting them was satisfying as it made them feel that their struggles were seen, and their
efforts were recognized.
The outcome of the meeting and discussion with the regional managements was shared with nurses
and they welcomed it. Assistance from other regions are pending at this time due to the covid19
pandemic and travel restrictions. Approval of location stipend for nurses in region 6 is also pending
state office review. Nurses were approved one day additional day of their choice off as long as
From the study conducted and little action implemented , it was found that there was a significant
improvement in licensed nurses morale which will lead to longer stay at job and also improve
productivity, hence is retention achieved while recruitment is work in progress.
This projects expectation was met, although not fully as expected due to time constraint. Date
collected helped to better understand perception of nurses in question and also proved interventions
implemented so far were well received and appreciated. The project achieved about a 60% of the
expectation, and more need to be put in place to ensure that all requirements are met. Follow up with state
office survey operation will be continued to seek approved of assistance from other regions in state
while approval for stipend and possible salary increase will be presented to state operations. Survey
operations and other state office policy makers will then present this to the state legislators for hearing
during their next session and repeat the cycle. According to research, more than one million nurses will
retire by 2030, with over 50% of registered nurses being over 50 years old, there is need to act now in
other to avoid challenges in the future (Gottlieb, 2016). For sustainability of our program, more nurses
need to be recruited and trained in the near future.
Gottlieb, L. N. (2016). Shortage of nurses, shortage of nursing. Canadian Journal of Nursing Research Archive,
Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2020). Nursing shortage. In StatPearls [Internet].
Lippincott Nursing Education. (2016). The Importance of the Optimal Nurse-to-Patient Ratio
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