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Case Study

How Valley Children's addressed leaders' perceptions of unsafe staffing

15 Minute Read


The challenge

Units and care sites strive to have safe, appropriate, and cost-effective staffing levels at all times. But even when staffing levels meet that bar, a variety of other factors can cause frontline leaders and staff to feel like staffing levels are not safe. These perceptions cause short-term stress. Over time, they can also lead to larger challenges, like moral distress, because staff feel they have to make compromises in care delivery due to staffing.

The organization

Valley Children’s Healthcare, a 358-bed pediatric hospital in the Central Valley of California.

The approach

Valley Children’s director of workforce engagement and development facilitated a working session to discuss perceptions of unsafe staffing with frontline leaders. During the session, leaders identified the root causes contributing to these perceptions and developed action plans to address the root causes within their control.

The result

Leaders better understood the root causes that contribute to staff distress over staffing and how they can address them. All leaders developed action plans to address staffing challenges. Within a year, Valley Children’s saw a 12.4% increase in positive responses to an engagement survey question:
“My unit or department has enough staff.”



How Valley Children’s addressed leaders’perceptions of unsafe staffing 

At Valley Children’s Healthcare, the director of workforce engagement and development facilitated a working session for frontline leaders, including charge nurses, managers, and directors. The goal was to help leaders better understand the many factors influencing staffing and develop actions plans to solve for those that cause staff to feel short-staffed.


The three steps

Here are the three steps Valley Children’s took to address leaders’ perceptions of unsafe staffing:

  • Step

    Provide a forum for leaders to discuss staffing concerns

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  • Step

    Identify the root causes of feeling short-staffed

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  • Step

    Equip leaders with action plan templates for common root causes

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Addressing perceptions of unsafe staffing can be a difficult. But it’s worthwhile because it can alleviate moral distress. Valley Children’s achieved this by targeting leadership, using an exercise to reframe their own thinking, and helping them understand the many factors that contribute to feeling short-staffed.

The actions plans then helped address the factors exacerbating staffing challenges. As a result, Valley Children’s staff engagement scores improved. Specifically the engagement driver “My unit/department has enough staff” improved by 12.4% in the 2017 staff engagement survey, one year after implementing the action plans.


One-year increase in staff
engagement driver, “My unit or
department has enough staff”

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