Standardized Communication Across Interprofessional Teams: A Quality-Improvement Initiative to Support Nursing Staff Retention

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Background/Objectives: The purpose of this nursing-led quality-improvement initiative was to strengthen organizational culture, support staff well-being, and improve patient safety by implementing an evidence-based collaboration model that redefined registered nurse (RN) and unlicensed assistive personnel (UAP) teamwork in acute care settings. Methods: Guided by transformational leadership principles, Nursing Professional Development (NPD) practitioners, nurse directors and managers, and frontline staff collaboratively redesigned communication and workflows. After piloting the process change, expansion occurred across acute care and step-down units through leader-supported team training alongside ongoing rounding, observations, and feedback cycles. The four phases of the EPIS framework of implementation science were used to implement the initiative, and data were collected via direct observation, anonymous staff surveys, and organizational retention and quality reports. Results: Across the seven units in Cluster 1 of the expansion, 335 RNs and 180 UAPs participated. Standardized communication using a structured handover tool increased from 18% to 95% with corresponding improvements in discussions of quality-related measures such as fall risk, turn schedules, and toileting. Patient safety measures exceeded threshold goals for fiscal year (FY) 2026 across falls with harm, pressure injuries, and catheter-associated urinary tract infections (CAUTI). RN and UAP retention demonstrated overall improvement, with RNs exceeding their retention goal and UAPs exceeding their goal by removing a single outlier unit. Perceptions of overall team communication throughout the shift increased for both RNs and UAPs. Conclusions: This initiative exemplifies how uniting transformational leadership with frontline staff empowerment supports inclusion, improved quality measures, and strengthened workforce resilience. This scalable framework for nurse-led transformation fosters belonging, safety, and shared outcomes across organizations.

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