Cardiac Intensive Care Unit (CICU)
Virginia’s largest hospital and the Flagship hospital of Inova Health System
In 2021, the CICU faced significant challenges, including a high staff turnover rate of 21.6% and low employee engagement, with scores at just 50.9%. These issues negatively impacted team morale and led to a heavy reliance on travel nurses. Additionally, a lack of professionalism and strained interprofessional relationships contributed to a fractured unit culture and disrupted workflow.
Goals of the initiative aimed to:
The DCCI is a year-long, unit-based program designed to equip leaders and their physician partners to shift department culture from unprofessional and disruptive to professional and supportive. Through a combination of in-person and virtual sessions with the Healthy Workforce team, leaders are guided through a structured four-phase approach. In Phase 1, leaders heighten awareness by engaging staff in open dialogue, collecting baseline data, and identifying behaviors that undermine a respectful work environment.
In Phase 2, they create and communicate a compelling vision for a healthier culture, establish clear behavioral expectations. Phase 3 focuses on addressing disruptive behaviors through close collaboration with HR, implementing a consistent response process, begin targeted skill development, and building confidence in having direct, respectful conversations. Finally, in Phase 4, leaders work to hardwire and sustain their new cultural norms, embedding healthy workforce practices into existing systems, and celebrating progress. This comprehensive approach provides interprofessional teams with the tools and strategies needed to build and maintain a professional, supportive, and high-functioning work environment.
Leaders engaged staff in open dialogue and set clear expectations for respectful, professional behavior across the CICU.
Working closely with HR, leaders built the confidence and skills to address disruptive behavior through direct, respectful conversations and a consistent response process.
Healthy workforce practices were hardwired into daily systems and team routines, with progress celebrated to keep the new culture in place.
The CICU achieved significant and measurable outcomes as a result of their cultural transformation efforts. In 2025, the unit was honored with the Silver-level Beacon Award for Excellence, a national recognition of outstanding patient care and healthy work environment. The team was also recognized in 2024 for excellence in team collaboration and the use of new knowledge to drive improvements. Staff engagement soared as the team rebuilt trust and collaboration, creating a culture where individuals felt valued and supported. With a renewed sense of purpose and unity, the CICU dramatically reduced turnover and no longer relies on travel nurses, reflecting the strength and stability of its transformed workforce. The team also celebrated a growing commitment to nursing excellence, with more nurses obtaining specialty certification and pursuing professional development. These achievements underscore the powerful impact of investing in leadership, professionalism, and a shared visions for excellence.
Decrease in nursing turnover
Cardiac Intensive Care Unit (CICU)
5 Hope is a bone marrow transplant unit, intensive care, and medical oncology
Rise in TMXS score in 2024 — the most improved department at Inova Fair Oaks.
Community Hospital Labor & Delivery Unit (L&D) Obstetrics Maternity Care
Tell us where disruptive behavior is costing you nurses, safety, or trust — and we’ll show you the path other health systems have already walked.