How Two ‘Sister Hospitals’ Achieved a Zero Vacancy Rate in the Emergency Departments

The Mount Sinai Morningside (MSM) and Mount Sinai West (MSW) hospitals are sister hospitals in a seven hospital enterprise in New York City. As with many hospitals and emergency departments (EDs), staffing levels have been a significant concern since the COVID-19 pandemic. In 2021 the national registered nurse (RN) turnover rate was 27.1%. This rate remains elevated, despite a decrease on a national level to 18.4% in 2023.

A story of progress and stability.

In 2021, the MSM ED had a turnover rate of 27% and MSW ED a turnover rate of 21%. These rates have since trended down, ending 2024 at MSM ED with a 12% turnover rate and MSW ED 7.25%. Today, in 2025, both sites are boasting zero vacancies. This is credited to strategic planning, talent development commitment, and strong partnerships.

A different approach to utilizing travel RNs.

MSM and MSW strategically utilized travel RNs to bridge staffing gaps. However, instead of viewing them as temporary fixes, leadership integrated them into the department culture, ensuring collaboration with permanent staff. A certain percentage of travel nurses ultimately converted to full-time roles, drawn by MSM and MSW ED’s supportive environment and strong team cohesion.

To help strengthen workplace […]

2025-03-17T10:00:25-04:00March 17th, 2025|nurse staffing, Nursing, Quality improvement|1 Comment
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Why Nurses Assist Falling Patients Despite the Risk

A too-common scenario.

Joe opens his eyes and looks through the window of his hospital room. He has always been early to rise. Even at age 82, he can’t shake the habits he learned when he was young.

“I’m woozy again,” Joe thinks as he sits up in bed. His medication sometimes makes him feel that way. Joe presses the call light so a nurse can help him to the bathroom. The nurses have been reminding him to do that so he won’t fall.

Then he reconsiders. “I can make it on my own. I don’t want to bother the nurses. They need to help the patients who really need it.” Joe moves to the edge of his bed. His walker isn’t nearby, but he urgently needs to reach the bathroom. Still dizzy, Joe holds onto the bed for a moment to keep from falling forward. After a moment, he manages to stand up and walk to the bathroom. As he enters the room, his dizziness returns, and his legs suddenly feel weak.  A feeling of dread washes over Joe as he begins to fall…

Nurse Smith starts her rounds and is looking forward to seeing Joe. He is always up early to greet her with a smile and a joke. As she opens the door to his room, she sees him entering his bathroom without his walker. She moves quickly toward him, but he suddenly sways forward. She knows he is going to fall. Reacting immediately, she grabs him by the torso […]

2024-02-20T10:44:39-05:00February 20th, 2024|Nursing, nursing research, patient safety, Quality improvement|1 Comment
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Implementation Science: Systematic, Sustainable, Evidence-Based Change

By Cagkan/Adobe Stock

Reading the article by Russell-Babin and colleagues in the December 2023 issue of AJN made me grateful for all the work that went into developing the nursing implementation science (IS) program at Inova. As a nurse working at this health care system, I’d like to share how I benefited from being in the first cohort of nurses trained and engaged in IS over the last three years.

For the past eight years, I’ve been a clinical coordinator of two different disease-specific programs—first stroke and now sepsis. In these roles, I’ve been engaged in many different quality improvement (QI) projects and have become familiar with the tools and processes used to improve patient care and outcomes.

Towards more comprehensive and systematic evidence-based change.

However, as I was invited to step into the world of IS, I began to realize that a strict QI approach cannot alone bring about all the changes we desire within the complex systems of health care. The fact is that […]

2024-01-11T10:06:42-05:00January 11th, 2024|Nursing, nursing roles, Quality improvement|1 Comment
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A Nurse-Led QI Project to Reduce ED to ICU Transition Time

Countless studies conclude that the longer an admitted patient boards in an emergency department (ED) the greater the risk for negative outcomes such as falls and hospital-acquired conditions. ED patients waiting for admission to the intensive care unit (ICU) may be at the greatest risk, as they are categorized as critical.

Transporting critical patients from the ED to the ICU requires coordination of multiple clinicians from both units, which can lead to delays. Leading and managing these coordination efforts is a challenge. However we are optimistic as small tests of change have led us to advancements in the timeliness of ICU admissions and improvements in quality and safety.

-Jonathan Nover, MBA RN, senior director of nursing, Mount Sinai Queens

The Project

Geneline Barayuga, MSN RN

The ED and ICU teams at Mount Sinai Queens, a 165-bed hospital with 70,000 annual ED visits in Queens, New York, performed a quality improvement (QI) project by developing a collaborative approach between the ICU and ED charge nurses to reduce the median […]

2023-12-11T10:17:23-05:00December 11th, 2023|Nursing, Quality improvement|0 Comments
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QR Codes for Rapid Responses: Improved Clinical Operations and DEI Insight

Improving data collection of RRTs for quality improvement

The method we use to track rapid response team (RRT) data has evolved on our health campus at Mount Sinai Queens. Just a few years ago we were using paper logs; now we use electronic logs accessed by a QR code. The goal initially has been to become paperless and collect data to analyze our rapid responses for clinical insight. The greater data collection with the QR code process has in turn allowed for analysis, including a closer examination of diversity, equity, and inclusion (DEI) variables. 

About our rapid response team

Our RRT consists of the ICU charge nurse, ICU attending, respiratory therapist, and the nurse manager or the evening/night nursing administrator. They are called upon when there is a significant change in a patient’s condition that requires critical care expertise at the bedside. After hearing the overhead call for a rapid response, the responding ICU RN scans the RRT QR code using a smart phone. The QR code is displayed within the ICU nurses station for easy access. Depending on the type of rapid response, the responding RN can enter data into the RRT electronic log as care progresses and/or at the conclusion of the response.

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2023-06-14T17:12:55-04:00June 14th, 2023|equity, Nursing, Quality improvement, Technology|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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