The problem

Turnover is a symptom, and it is priced in dollars

$60,090

average cost of a single RN departure. The average hospital loses $5.19M a year to RN turnover

Industry figure, not an Adelo Consulting result. Source: 2026 NSI National Health Care Retention & RN Staffing Report (527 hospitals, 262,405 RNs).

The published cost of a single RN departure now runs above $60,000, and the average hospital carries a seven-figure annual turnover bill. Yet most retention programs are still built around engagement surveys and referral bonuses.

Nurses leave managers, schedules and workload. Our work targets those three directly — and pairs them with a staffing model that does not depend on premium labor to survive a Tuesday.

Keep the nurses you have.

What we do

Capabilities in nursing & workforce.

Retention strategy and turnover analytics

Turnover segmented by unit, tenure, shift and manager — so the intervention matches the actual driver rather than the average.

Staffing and scheduling model design

Acuity-based staffing, core schedule design, self-scheduling governance, float pool and internal resource pool architecture.

Contingent labor reduction

Structured agency exit planning, internal agency design, premium pay governance and the transition sequence that avoids a coverage cliff.

Nurse manager development

Span of control, manager selection, onboarding and the operating skills first-time managers are usually never taught.

New graduate and first-year experience

Residency program design, preceptor development and the first-year support that determines two-year retention.

Professional practice and Magnet readiness

Shared governance, professional practice model, clinical ladder, and Magnet or Pathway journey support.

What we target

Outcomes we scope engagements against.

These are the results we design toward and measure. We commit to targets in writing at the start of an engagement, and we report against them honestly — including when we miss.

We do not publish client results we cannot substantiate or attribute. Targets on this page describe engagement design, not guaranteed outcomes.

  • First-year and total RN turnover reduced
  • Agency and premium labor dependence structurally lowered
  • Manager span of control brought into a workable range
  • Vacancy and time-to-fill improved without lowering the bar
  • A staffing model that holds through census swings
Engagement models

Three ways to start.

1

Diagnostic2–4 weeks

A focused assessment with a written finding and a ranked set of actions. Fixed fee, defined scope. Most relationships start here because it is a low-risk way to find out whether we are useful.

2

Sprint8–16 weeks

A defined improvement engagement against a named target — throughput, denials, turnover, survey readiness. We work alongside your team rather than around them, and we transfer the method as we go.

3

Embedded6–18 months

Interim leadership or sustained transformation support. Our leader carries real accountability in your operating structure, with a written mandate and measurable commitments.

Frequently engaged by