Nursing retention and recruitment strategies are recognized as an essential activity to ensure the viability of the nursing workforce and health care delivery in Canada. To meet its current nursing shortage, Alberta’s 2001 and 2007 collective agreements included seven nurse retention and recruitment initiatives. Alberta Health Services (AHS), the amalgamated health authority covering the entire province, and United Nurses of Alberta (UNA) recognized the need to evaluate the effectiveness of these different initiatives. The two organizations have been working together since 2001 when the Multi-Employer/UNA Joint Committee in Alberta was established to resolve issues of mutual concern between rounds of collective bargaining.

These initiatives included a Retirement Preparation Program, a Pre-Retirement FTE (full-time equivalent) Reduction Retention Program, a Weekend Worker Program, a Flexible Part-Time Project, a Seasonal Part-Time Positions Project, a Benefit Eligible Casual Employee Positions Project (BECE) and a Transitional Graduate Nurse Recruitment Program (TGNRP) providing supernumerary positions for a maximum of 900 new nurses per year.

Project Objectives:

  • Identify sites where the seven retention and recruitment initiatives have been adopted
  • Evaluate the impact of the seven initiatives
  • Determine, in particular, if the retention and recruitment initiatives have had a positive impact on quality of worklife indicators
  • Contribute to the national body of evidence-based research on retention and recruitment

Project Implementation:

The project took place over a 27-month period and required the support of two project coordinators, a contracted evaluation team, and a Social Return on Investment consultant. Key activities included:

  • Development and implementation of a comprehensive retrospective evaluation framework
  • Eight consultations with the Alberta Project Steering Committee concerning the intent and design of the retention and recruitment initiatives
  • Data mapping in order to identify and confirm where the retention and recruitment initiatives had been implemented
  • Sixteen key stakeholder consultations
  • Three on-line surveys with a total of 577 responses: one survey of nurses graduating in Alberta between 2001 and 2009, covering those who both did and did not participate in the Transitional Graduate Nursing Recruitment Program, and an initial and follow-up surveys of participants in the remaining six retention and recruitment initiatives
  • Five site visits that included discussion groups with 51 project implementers (e.g. nurse managers) and 36 nurse participants
  • Production of a video reflecting highlights from the evaluation
  • Presentation of the findings to the Joint Committee (AHS and UNA) and Alberta Health and Wellness

Project Outcomes:

  • Initiatives achieved their expected outcomes by improving the retention and recruitment of nurses
  • Nurses reported improved and healthier workplaces, and that they were better prepared for work and more able to respond to patient needs
  • Participating nurses and employers noted substantial benefits such as decreased absenteeism, reduced stress and fatigue, and increased energy
  • Participating nurses noted improved work-life balance and described having greater control over their workload and work environment
  • Findings specific to each initiative were identified and recommendations were made relative to the future implementation of these initiatives
  • The Transitional Graduate Nurse Recruitment Program had a positive impact on participating nurses in terms of their ability to assume the nursing role (confidence), work collaboratively with other team members, improve overall nursing skills (competence) and provide high-quality patient care. Nurses also reported increased overall satisfaction with their jobs and the nursing profession
  • The Benefit Eligible Casual Employee Positions Project increased job satisfaction as participants had greater job security, access to benefits and improved control over their work-life balance
  • The Weekend Worker Program benefited nurses and the quality of care provided. It also allowed managers to focus more on patient care and less on scheduling issues
  • The Pre-Retirement FTE Reduction Retention Program participants experienced more energy and a reduced sense of being overwhelmed
  • The project provided clear direction and set of recommendations to the Joint Committee for current and future initiatives
  • The evaluation contributed to the national body of evidence-based research on retention and recruitment initiatives because of the depth and breadth of the seven initiatives and their appeal to nurses in various career stages

Project Partners

Project Contacts

Carol Graham
AB Pilot Project Coordinator