The COVID-19 pandemic amplified the need to improve clinician well-being and create robust, healthy work environments.1 Clinical nurses, the majority direct care stakeholders in healthcare systems, are accountable for professional practice, including meaningful recognition. A sustainable recognition program can be established through structural empowerment and shared decision-making within a healthy, strong, and clinical nurse-led governance structure. Infusing recognition into a 10,000-person organization's culture can result in a 9% increase in productivity, 22% decrease in safety events and absenteeism, and a cost savings of up to $16.1 million dollars.2 This narrative presents the journey of rejuvenating meaningful recognition across 27 hospitals and more than 500 sites of care, with the aim of positively impacting nurses' well-being and connection to purpose.
The DAISY Rejuvenation Project
The health system's Midwest Nursing Professional Development Council (MNPDC) adopted the DAISY Award as a form of meaningful recognition because of its global success in fostering a culture of gratitude and appreciation within healthcare organizations.3 The MNPDC commissioned the DAISY Rejuvenation Project to create a sustainable system of recognition to be adopted by the 27-Site Nursing Professional Development Councils (SNPDC) and align with the health system's strategic nursing plan. The goal was to engage, empower, and enhance clinical nurses' well-being.
The team's 1st 3 priorities were establishing a robust system for obtaining patient and family expressions of gratitude, systematizing award processes, and standardizing DAISY Award celebrations. The vice president of Nursing Quality and Practice, the shared governance executive sponsor, assigned a program manager to assist with planning and implementation. After consultation with The DAISY Foundation and sign-off from health system leadership, the project was launched in January 2023. With the endorsement of the shared governance councils, the MNPDC chair led the project team and served as the communicator to system leaders.
Each of the 27-site SNPDCs established a DAISY Honoree Selection Team and collaborated with site chief nursing officers (CNOs) to appoint a DAISY coordinator at every location. The DAISY coordinators, primarily administrative assistants to the CNO, were given administrative release time each month and were instrumental in managing the collection and processing of nominations, preparing reports for the DAISY Honoree Selection Team, and coordinating monthly honoree celebrations. DAISY coordinators ensured site-level consistency and attended monthly DAISY coordinator committee meetings to share data and best practices. Sites were strongly encouraged to score nominations using a rubric based on the nursing professional practice model. The MNPDC developed guidelines for monthly honoree celebrations and recognizing nominees. A DAISY Coordinator Resource Guide was created to standardize the onboarding of new coordinators and aid in succession planning. The new structure supported a consistent and transparent process in selecting and recognizing deserving nurses across the organization.
Simultaneously, an online system-wide nomination portal was established as a central access point and means for patients, families, and colleagues to express gratitude and nominate nurses for a DAISY Award in all clinical locations. Feedback from the Patient Advisory Council led to the creation of a streamlined DAISY nomination form(s). The redesign made the nomination process more accessible and inclusive, encouraging patients, families, and fellow healthcare professionals to recognize exceptional clinical nurses. In turn, the Health Literacy and Interpreter Services teams translated the new nomination forms into 6 languages, ensuring accessibility to all populations.
Results
In a period of 5 months, more than 2000 DAISY nominations were received, and each nominee received a copy of the submission and a nomination pin. This demonstrated a 100% increase in expressions of gratitude year-over-year. Nurses from previously unrecognized specialties, such as the regional float department, ambulatory surgery centers, and clinics, received patient feedback. The new portal and redesigned forms made it easy for patients to give thanks everywhere nurses practiced. A noteworthy outcome was the system-wide improvement in patient engagement and overall patient experience. Formal celebrations honoring the extraordinary contribution of clinical nurses have positively impacted morale, job satisfaction, and clinician well-being. A growing culture of gratitude has created a more positive environment and a renewed commitment to exceptional patient care.
Conclusion
The rejuvenation of meaningful recognition through shared governance positively impacted nurses, patients, and the healthcare system. Success was possible because clinical nurses were at the helm and given the appropriate dedicated time, support, autonomy, and tools to be successful. It was crucial to secure leadership support, engage key stakeholders, establish clear goals and objectives, and allocate resources and time to develop, implement, and evaluate the success of meaningful recognition. Rejuvenation was possible because of strong nursing leadership, effective communication, and, most importantly, the dedication of direct care clinical nurse shared governance leaders.
Acknowledgment
The author thanks the MNPDC members, the DAISY Coordinator Committee, the Project Manager, Talent Management, and Human Resources for making nursing recognition a priority and the DAISY Rejuvenation Project a success.
References