Improving Engagement in an Emergency Department: A Quality Improvement Project


Improving Engagement in an Emergency Department: A Quality Improvement Project


Publication Date



Medicine and Health Sciences | Nursing


Purpose: This quality improvement, doctorate of nursing practice (DNP) project assesses the need for and evaluates the impact of an engagement intervention focused on improving nurse, physician, and emergency department technician (EDT) engagement within an emergency department.

Background: Engagement is defined as an energetic state of involvement with personally fulfilling activities that enhance one’s sense of professional efficacy and is characterized by vigor, dedication, and absorption. While a significant amount of research exists that correlates the relationship between low nurse engagement levels with high turnover rates, there is little known about the effectiveness of interventions aimed at improving nurse engagement. Therefore, a project evaluating the impact of an engagement intervention on increasing engagement levels for all staff was piloted in an emergency department.

Methods: In September 2017 staff (physicians, nurses and EDTs) who work in the emergency department (N=69) completed a pre-intervention survey to assess baseline engagement levels, using the Utrecht Work Engagement Scale (UWES). The preintervention survey included open-ended questions developed by the project team to solicit qualitative information regarding engagement, as well as demographic questions. The preintervention data revealed overall low engagement levels of participants (m = 2.10, sd = 1.63, n=40). The dedication subscale had the lowest mean (m = 1.30, sd = 1.49), while the absorption subscale had the highest mean (m = 2.53, sd = 1.78); the vigor subscale fell between these two means (m = 2.33, sd = 1.59). The open-ended pre-intervention survey results, along with recommendations from the literature and guided by the six areas of worklife framework, were used to guide the design of the unit-based engagement intervention. Some of the interventions will include enhanced staff recognition, activities to improve the sense of community within the department, increased accountability of staff members, augmented shared governance structures, and improved follow-through by the leadership team when staff suggestions are presented. The post-intervention survey will be administered in March 2018 following the intervention phase of the project. Pre- and postintervention survey results and the intervention will be presented.

Outcomes: The level of staff engagement is the primary outcome of this quality improvement project. Pre- and post-intervention survey data will be compared to understand the effectiveness of the intervention designed to increase engagement in the emergency department. The outcomes of this project will help to inform future interventions focused on supporting and maintaining high levels of staff engagement.

Conclusion: Staff engagement is integral to the vitality of the healthcare workforce. A onesize- fits-all approach is not enough to keep staff engaged, excited to come to work, and able to provide the best care for their patients. Listening to staff suggestions and creating an individualized approach for each unit is essential to keep the workforce engaged.






Emergency Medicine

Conference / Event Name

51st Annual Communicating Nursing Research Conference


Spokane, WA, United States

Improving Engagement in an Emergency Department: A Quality Improvement Project