Background: Patient care connection (PCC) is a virtual de-centralized nursing unit that triages primary care patients. This unit struggled with scheduling issues, work- life balance, and a lack of resources, which resulted in low staff satisfaction and high turnover. Due to the high turnover rates, thirty percent of the nurses had minimal triage experience and little team support due to nurses working from eight physical locations. Inexperienced staff contributed to patient call waiting times and abandonment rates which exceeded intuitional expectations.

Objective: Goals of the project were to optimize quality and service, improve nurse retention, and improve staff satisfaction by providing the opportunity to telework from home.

Methods: The unit benchmarked retention rates of other home teleworking nurses which demonstrated a 99% retention rate.

A telework task force was created to:
• Complete a literature search.
• Develop an objective tool to assess quality and productivity.
• Evaluate SharePoint and Skype to maintain communication.
• Create a PCC specific teleworking contract.

The telework task force presented the findings to leadership and staff for approval utilizing a shared decision-making process.

Results: Patient phone volumes were tracked and monitored by an automatic call distribution (ACD) system. Based on ACD data, a variety of new scheduling options were initiated. This resulted in decreased abandoned calls and improved nurse productivity. Since implementing telework, staff retention has improved to 93% and staff satisfaction scores have increased by 47 %. Leadership has noted decreased complaints and concerns about the triage unit from patients and staff.

Conclusion: Teleworking from home has improved staff satisfaction, retention, productivity, and quality.