Competency-based talent management in nursing: Framework development and validation study
TL;DR
The NURSE-TALENT framework is a validated, evidence-based model for systematic nursing talent management that demonstrates practical feasibility, strong expert endorsement, and positive early outcomes, supporting its use as a strategic tool in addressing workforce sustainability in healthcare.
Abstract
Background: Healthcare organizations worldwide face critical nursing workforce challenges, including high turnover, skill mismatches, and fragmented talent strategies. Competency-Based Talent Management (CBTM) offers a strategic solution, yet nursing-specific frameworks remain underdeveloped and empirically unvalidated. Objective: To develop and validate a comprehensive CBTM framework tailored to nursing, ensuring both conceptual soundness and practical relevance across diverse healthcare contexts. Methods: A multiphase sequential exploratory mixed-methods design was used across three phases. Phase 1 involved a systematic literature review and meta-synthesis. Phase 2 included focus group discussions with 42 nurse managers and interviews with 15 nurse executives to refine the framework. In Phase 3, a three-round Delphi study with 28 international experts was conducted to validate the framework. Consensus was set at ≥80% agreement, and validation metrics included Content Validity Index (CVI) and modified kappa statistics. Preliminary implementation was tested in three hospitals using a pre-post design. Results: The final NURSE-TALENT framework comprises seven interconnected domains: Need assessment, Understanding competencies, Recruitment strategies, Strategic development, Engagement practices, Transparent advancement, and Leadership succession planning. Delphi consensus exceeded 80% for all components by Round 3, with an overall CVI of 0.87, indicating strong content validity. Preliminary implementation showed improvements in nurse retention (+17.4%, p<0.01), job satisfaction (+28%, p<0.01), medication error reduction (−32%, p<0.01), and patient satisfaction (+14.2%, p<0.01). Conclusion: The NURSE-TALENT framework is a validated, evidence-based model for systematic nursing talent management. It demonstrates practical feasibility, strong expert endorsement, and positive early outcomes, supporting its use as a strategic tool in addressing workforce sustainability in healthcare.