Understanding CNO Turnover and Retention Study
Do you have experience with turnover in your role or within your health care system?
We want to hear from Chief Nursing Officers (CNO) and nurses in similar executive positions for the study. Your insights will help us understand the current state of retention and turnover among the top nursing officers in health systems. Data from the CNO turnover and retention study will allow us to develop strategies to track the retention of the CNO workforce.
The survey will ask you to complete a series of questions regarding CNO turnover and retention, your CNO role, and the organization where you work.
Consent Document | Start Survey
This study is made possible by a generous gift to the AONL Foundation from AMN Healthcare.
Study Resources
Chief Nursing Officers (CNOs) provide leadership that is critical to patient welfare, quality nursing practice and organizational performance. Typically leading the largest group of health professionals in a healthcare organization, CNOs "... bear much of the responsibility for ensuring a positive patient experience and for keeping tabs on quality and patient safety issues" (Hendren, 2011, p. 1). In hospitals, the CNO is responsible for developing and maintaining the capacity for care delivery, interpreting and advocating for nurses and patients, and influencing clinical, fiscal and administrative outcomes (American Organization of Nurse Executives [AONE], 2005; Caroselli, 2010; Havens, Thompson, & Jones, 2008; Jones, Havens, & Thompson, 2008; Jones, Havens, & Thompson, 2009; Kippenbrock, 1995; VHA, 2005). CNOs have long been responsible for maintaining and ensuring an adequate nurse workforce to meet patient care needs, maximize “quality of patient care, the professional satisfaction of nurses, and the goals of cost-effectiveness for the institution” (Clifford, 1998, p.5), but contemporary CNOs are responsible for demonstrating care value within and across organizational boundaries, and providing leadership during uncertain environmental changes.
Unfortunately, data on CNO retention, turnover and stability are limited (Bacheller, 2010). The American Organization for Nursing Leadership (AONL) and the AONL Foundation launched an important first step in 2006 by examining CNO turnover and retention on a national level. In collaboration with researchers at the University of North Carolina at Chapel Hill (Havens and Jones), AONL conducted a multi-phased study.
- Phase I gathered data via an online survey of current, interim and past CNOs to describe the CNO role, experiences with voluntary and involuntary turnover, and related CNO retention issues.
- Phase II used confidential telephone interviews with the same CNO population to gain additional insights into CNO turnover that augmented the online survey findings.
- Phase III surveyed staff nurses, nurse managers and directors to examine the impact of CNO turnover on care delivery. The team disseminated findings through multiple presentations and publications to raise awareness of this crucial role, the potential pending crisis and to raise awareness regarding needed strategies to ameliorate the situation.
This is the third study in a series of work to identify and monitor the status of U.S. CNO turnover and retention, taking advantage of the opportunity to compare CNO turnover at three points in time and develop a tested method for tracking CNO turnover into the future.
Dr. Havens is committed to advancing the field of nursing through research and engagement with nurse leaders, practicing nurses and health care organizations. She has served as principal investigator on various federally funded studies focused on improving nursing practice and patient care. Her most recent work includes several initiatives to translate research findings to improve the quality of patient care and nursing practice in hospitals and enhance the quality of patient care in emergency rooms located in rural North Carolina hospitals. A dedicated practitioner, teacher and scholar, she is also a passionate advocate for quality nursing education and practice, as well as quality patient care, and community and global initiatives to improve the health of underserved populations.
Dr. Jones’ research is aimed at uncovering knowledge related to the organization and delivery of care, and the impacts on the costs, quality and safety of care. She is a recognized leader in nursing health services research, having studied micro- and macro-level nurse workforce issues to improve the work environment, executive practice, and the cost and quality of care delivery. One of Cheryl’s most recognized contributions has been the development, testing, and refinement of a method to measure nurse turnover costs. She has studied other important and related nurse workforce issues, including nurse retention, wage differentials, employment patterns and migration.
Chief Nursing Officer Retention and Turnover: A Crisis Brewing? Results of a National Survey
Jones Cheryl B. PhD RN FAAN; Havens, Donna S. PhD, RN, FAAN; Thompson, Pamela A. RN, FAAN
Journal of Healthcare Management: March-April 2008 - Volume 53 - Issue 2 - p 89-105
Chief Nursing Officer Turnover and the Crisis Brewing: Views from the Front Line
Jones, Cheryl B. PhD, RN, FAAN; Havens, Donna S. PhD, RN, FAAN; Thompson, Pamela A. MS, RN, FAAN
JONA: The Journal of Nursing Administration: June 2009 - Volume 39 - Issue 6 - p 285-292 doi: 10.1097/NNA.0b013e3181a72adf
Contact Dani Ward, AONL Foundation Director for questions.
