PRC Committees:Structure and Processes

(Mini-Workshop) for UNA Members of PRC Committees

Welcome & Introductions"

•  You are viewing this presentation because you are a UNA member who has been elected to serve as a representative on your PRC Committee

Or

•  Because you are considering running for this position and want to prepare yourself for PRC work

PRC Educational Resources on FirstClass

•  If you are taking this mini-workshop, you should already have viewed the PRC definitions and the presentation titled Introduction to PRC: Principles and Processes.

•  You can find this and other PRC resources by opening the PRC Conference in FirstClass.

•  You can follow the links to learn as much as you want and at your own pace.

•  Please watch for new materials and participate in discussions.

Overview of Presentation"•  Review of terms and definitions •  Resources for PRC committees •  Authority for reporting Professional Responsibility

Concerns •  Structure of PRC Committees •  Requirements for written communication •  Templates to facilitate written communication and

how to use them •  Dealing with dysfunctional committee process •  Questions and discussion

PRC Committee Members Are LeadersWho Demonstrate ... "

•  Advocacy

•  Administrative skills

•  Written and verbal communication

•  Problem solving and decision making

•  Sensitivity to people

•  A focus on results

Do You Know These PRC Definitions? If you need to refresh your memory, go to the presentation Professional Responsibility Definitions

•  Hazard •  Harm •  Close Call •  Patient Safety •  Professional Licensing

Body •  Professional Standards •  Code of Ethics

•  Moral Distress •  Professional Responsibility

Concern •  Collective Agreement •  Professional Responsibility

Article •  Professional Responsibility

Committee •  Professional Responsibility

Process

Authority for the PRC Process "

•  The authority for the PRC Committee and process comes from the legally binding set of principles and procedures contained in the Collective Agreement.

•  The Article about Professional Responsibility acknowledges that it is of mutual interest for employers and United Nurses of Alberta to work together to resolve Nurses’ Professional Responsibility Concerns.

Professional Responsibility Article"

•  The Article and Sub-Articles in the current Collective Agreement describe the requirement for the employer to establish a Professional Responsibility Concern Committee (or an equivalent).

•  This article also explains the process for dealing with unresolved professional responsibility issues by referring them to the CEO and the Governing Board.

Professional Responsibility Committee"

•  As stated in the Collective Agreement, the purpose of the Committee is to:

“examine and make recommendations regarding the concerns of Employees or the employer relative to patient/ resident/client care including staffing issues” (Article 36.01; a & b of the Provincial Collective Agreement).

PRC Reporting: A Constructive & Protected Process"

•  Reporting Professional Responsibility Concerns is a protected and constructive way for registered Nurses to advocate for patients/residents/clients by making their employers aware of their Professional Responsibility Concerns.

•  Reporting PRCs can help Nurses deal with the occupational hazard of moral distress - a form of occupational stress that is related to burnout and attrition of Nurses from the profession.

PRC Process Mutually Benefits Nurses & Employers "

•  Article 36 in the Provincial Collective Agreement provides managers with information and opportunities to address hazards before they become close calls, or before patients/residents/clients experience harm.

•  This Article protects Nurses from disciplinary action when they report their Professional Responsibility Concerns and provides for a formal and open process through which concerns can be discussed and resolved.

Purpose of PRC Reporting & Committee: To Protect Patient/Resident/Client Safety "

•  This article has been mutually agreed upon by the Employer and UNA.

•  It is reasonable to expect the management representatives on the PRC committee will understand and contribute constructively to this common purpose.

How Does The PRC Process Work?"

•  Workplaces differ; PRC Committees differ!

•  This presentation provides basic information and introduces resources available to help your committee.

•  If your questions are not answered in this presentation, consultation and resources are available to assist your PRC Committee with more specific issues.

PRC Committee & Process"

UNA members of PRC Committees:

•  Educate, encourage, support and assist members in reporting Professional Responsibility Concerns.

•  Take members’ concerns through the PRC Committee process, working with management representatives to resolve issues when possible.

•  If necessary present unresolved issues to the CEO or the Governing Board.

Starting Point: Professional Responsibility Concern Report Form "•  The PRC report form has been developed and

made available by the United Nurses of Alberta.

•  The purpose of the form is assist and support UNA members in documenting their Professional Responsibility Concerns in a format and manner that can facilitate the timely review and resolution of issues.

•  The form is designed to enable information about PRC issues to be summarized and reported.

Instructions for Completing PRC Report Form"

PRC Committee Members: Encourage, Assist & Support Members To Document Concerns "

•  Actively educate, encourage, assist and support Nurses in documenting their concerns.

•  Receive the form and discuss the issue with the Nurse.

•  If the Nurse did not feel comfortable discussing the concern directly with the manager, arrange to accompany the member for this discussion, or speak to the manager on the Nurse’s behalf.

Nurses Make their Own Judgement re: Completing PRC Report Form "

•  Nurses do not need the permission of their manager to document a Professional Responsibility Concern form.

•  Managers who intimidate, bully or threaten Nurses in an attempt to prevent them filling out a PRC form are in violation of the Collective Agreement.

Nurses Need To Understand & Comply With Organizational Reporting Requirements "•  In situations of urgency, Nurses must directly and

immediately inform managers or the person in charge of their concerns.

•  When unusual incidents occur, Nurses need to understand their responsibilities to report them through the systems in place in their employing organizations.

•  In AHS the Reporting Learning System has replaced former unusual incident reports and is intended to be a safe reporting system.

Bringing a PRC to Manager's Attention "

•  Ideally, managers are approachable and interested in Nurses’ observations, judgments, and recommendations about what is needed to assure patient safety.

•  When this is the case, a Nurse will immediately discuss a PRC with the manager.

Managers May Resolve Some PRC Issues Immediately "•  When managers are attentive to Nurses' concerns

about hazards and the potential for harm, they may act immediately and a PRC form may not need to be completed.

•  However, an issue resolved in this way might still be discussed at PRC so that people can learn from what has happened.

PRC Committee Process •  The purpose of presenting and discussing issues at the

PRC Committee is to resolve them.

•  After the manager is informed that a PRC concern has been documented, the issue is placed on the agenda of the next PRC Committee meeting.

•  If the manager has taken immediate steps to resolve the issue, this can be reported at the meeting and celebrated as a success story.

•  Information needed to resolve an issue may be requested, and must be provided in writing in a timely manner.

Structure of Professional Responsibility Committee"

•  Equal numbers (up to four) of Employer and Employee-elected representatives.

•  Chair elected from amongst Committee (36.01 c)

•  Must meet at least once a month at a regularly appointed time and within ten days of receiving a written description of the issue regarding patient/resident/client care (36.01 c)

Role of UNA Representatives in PRC Process"•  PRC Committee members are elected by the UNA Local;

may become Chair. •  Receive reports from members. •  Talk with the member to make sure they understand the

situation and member’s view of what the resolution needs to be.

•  Accompany the member to inform the manager of the PRC or inform the manager on the member’s behalf.

•  Enter the PRC summary into DMS Web and open a file. •  Put the PRC report on the agenda of the PRC Committee

and speak to it at the next meeting.

Role of UNA Representatives…cont’d"

•  Identify any information that may be required to resolve the issue and request it be provided.

•  Enter the issues and information requests into the PRC tracking process.

•  Follow up with the member to advise of progress in resolving the issue.

•  Prepare presentations to the CEO and/or Board if it is necessary to advance the issue.

•  Inform the member of the outcome. •  Educate members, managers and others about PRC!

Professional Responsibility Communications"

•  The process for reviewing and resolving Professional Responsibility Concerns is described in Article 36.01 (a-j) of the Provincial Collective Agreement.

•  Requirements for written communication and follow-up are specified.

Written Communication is Required"

•  Agendas must be circulated prior to each meeting.

•  Minutes must be kept and must be approved by both parties prior to circulation (36.01 e)

•  Unresolved items from previous meetings must be highlighted and reviewed.

Templates for Agendas & Minutes "Templates are downloadable from FirstClass/Conferences/PRC Resources

1. Log into FirstClass 2. Open Conferences/PRC Conference/PRC Resources

3. Locate folder with templates

4. Select desired template 5. Save to desktop - customize as needed

PRC Agenda "

PRC Minutes "

Minutes Cont’d…"

Minutes Cont’d…"

Timely Written Responses to Information Requests are Required "

•  To prevent misunderstanding and to assure all issues are dealt with, answers must be communicated in writing to the Committee 36.01(i).

•  Article 36.01 requires parties to provide meaningful information in a timely fashion to allow for meaningful discussion of the issues (and not later than 30 days from the original discussion of the issue).

Template for Tracking Information Requests is Available "

•  Downloadable templates are available on FirstClass/ PRC Conference/PRC Resources

1.  Log into FirstClass

2.  Open Conferences/PRC Conference/PRC Resources

3.  Select desired template

4.  Download & save to desktop

Tracking PRC Committee Information Requests"

Tips for Discussing PRC Issues "•  Keep the tone pleasant, business-like and assertive. •  Take control of the agenda and minutes if possible. •  A knowledge of employer’s mission/values statement,

policies and procedures may help to make the case. •  Make information requests formally; track them and

review them formally; record in the minutes whether the information requested has, or has not been provided.

•  Keep track of issues and their status from one meeting to the next; an Issues Tracking Template is available for your use.

Issues Tracking Template"

What Skills do PRC Committee Members Need to Discuss and Resolve Issues? "

•  Commitment to the goal of patient/resident/client safety

•  Respectful listening

•  Information sharing

•  Constructive problem solving

•  A sense of responsibility for outcomes

•  Willingness to take action

How Should PRC Committees Work?•  The mutually agreed upon purpose of PRC

committees is to protect patient/resident/client safety.

•  This is done through information sharing and problem solving that leads to meaningful action.

•  All members of the committee should be committed to this goal.

Suggestions for Improving PRC Committee Process "•  Consider having a standing agenda item PRC Committee

Process. •  This item should be in the first third of the meeting (after

Business Arising From Minutes and before New Business). •  Under this item, committee members can raise and discuss

issues that have to do with the way the committee is functioning.

•  Suggestions for developing talking points have been prepared to help you develop confidence in presenting and following up on dysfunctional behaviours in the committee.

What if the Management Representatives on PRC Committee are Indifferent or Disrespectful?

•  Address this problem directly under the agenda item Committee Process.

•  An experienced UNA Committee member should speak to the item using prepared notes (talking points) that can be kept on file and, if necessary, appended to the minutes.

•  The discussion should be business-like; focused on observable behaviours and actions needed to assure the committee can achieve its goal of protecting patients from hazards and harm.

Talking Points for Presentations or Giving Feedback "

Decide on the subject or issue for talking points; take time to get this right!

Examples: Management representative in a PRC Committee appears indifferent or uninterested in the issues being presented. Observable behaviour might include

reviewing e-mail during meetings; never offering to do anything to follow up on issues; interrupting while issues are being presented.

Preparing Talking Points: Step 1 "

Start with a positive statement:

Example: “We are all here because we have obligations to assure our patients are safe and protected from hazards and harm.”

Preparing Talking Points: Step 2"

Describe the behaviour that is a problem using examples if possible

Example: “We have noticed in our past few meetings, you have been reviewing messages on your Blackberry as we are presenting PRC issues. We are wondering if you are indifferent or disinterested in the concerns being presented.”

Preparing Talking Points: Step 3"

State what is needed (i.e. The change in behaviour that is needed from the manager to enable the committee to function as intended in Article 36).

Example: “If you are not indifferent, you could demonstrate your interest in the Professional Responsibility Concerns being presented by listening attentively to the speaker and suggesting what you might be able to do to help resolve the issue.”

Preparing Talking Points: Step 4"

Conclude with a positive statement

Example: “Thank you for listening to these concerns. I hope we can all move forward with our common purpose of patient/resident/ client safety in mind.”

Preparing to Present Talking Points "

•  Write out the points you intend to make.

•  Describe behaviour - not personal characteristics.

•  Use direct quotes from the person if available.

•  Before the meeting, practice saying the talking points out loud while referring to your written notes. This will give you an idea of how long it takes to present the points and will help you speak the points in a confident and business-like way when the time comes.

Steps After Presenting Talking Points "•  Ask if there is any further discussion of the item but

do not press the point at this time. •  Allow a few minutes of silence or if the manager

responds, listen respectfully and take notes. •  Thank the manager, then go on to the next agenda item. •  Keep the written notes for your talking points and

record any responses from the manager. •  Use the written talking points to complete the minutes

of the meeting. •  If the manager's behaviour does not become more

constructive, it may be necessary to raise this issue to the CEO or through the grievance procedure.

Objective of PRC Process: Resolve Issues!"

•  Many issues are successfully resolved in PRC Committees.

•  Respectful listening, good will and a shared concern about patient/resident/client safety are needed for PRC Committees to function as intended.

PRC Not Resolved at Committee:Don’t Stop There"

•  An issue not resolved at the committee can be advanced for review by the Chief Executive Officer.

•  If not resolved at the level of the CEO, the issue can be advanced for review by the Governing Board.

•  Watch for the Learning Module on Preparing Communications for the CEO and Board.

Where can I find resources to help our PRC Committee be more effective? "

•  Log on the UNA website http://www.una.ab.ca/

•  Under the Member Resources tab and select Professional Responsibility

•  The PRC page provides a variety of resources

Access PRC Resources on FirstClass"

1.  Log onto FirstClass

2.  Open Conferences/PRC Conference

3.  At the top of the window locate PRC Resources

4.  Click on the icon

5.  Save and work in the templates or worksheets

6.  View the documents within each folder

Resources for PRC Committees"

•  Templates for minutes and agendas

•  Information request tracking sheet

•  PRC issues tracking sheet

•  PRC Committee Planning Tools

•  Available on PRC conference and UNA-Net

Frequently Asked Questions"

•  The next several slides address questions often asked about the PRC process.

•  Resources and consultation are available to assist PRC Committees with additional questions and issues.

Do Nurses need to obtain permission from a Manager before submitting a PRC Report? "•  No

•  It is important that all managers in AHS understand their role in relation to the PRC process.

•  Intimidation, threats and bullying are never appropriate actions by anyone in any workplace.

•  These destructive behaviours are particularly inappropriate when Nurses are attempting to bring PRC concerns to managers’ attention to prevent hazards, close calls, adverse events, harm or omissions in assessment and care.

Are Nurses required to report their issues or concerns to a Manager before submitting a PRC Report?"•  Clause 36.01 (g) provides a clear answer to this

question:

•  When an issue is specific to one unit or program the employee or Local shall discuss the issue with the immediate supervisor in an excluded management position before the matter is discussed at the Committee.

•  This clause does not allow the manager to prevent or stand in the way of a Nurse documenting PRCs for presentation to the PRC Committee.

What if a manager resolves a PRC issue before a PRC Report is submitted?

•  Managers are often made directly and informally aware of PRC concerns.

•  In some instances, managers appreciate Nurses’ reports of PRC concerns and act on them immediately out of concern for the well being of patients/clients/residents.

Why don’t Nurses use the AHS Reporting Learning System (RLS) instead of PRCs to report their concerns?"

•  They do!

•  Nurses understand and comply with the requirement to submit reports on the RLS in accordance with the policies of the employer.

•  The definitions of safety, harm, hazard and close call in this presentation are taken from the AHS Policy on use of the Reporting Learning System (RLS).

•  A PRC report may contain different information than a report submitted through the RLS.

•  The RLS system or equivalent is a policy and procedure of the employing organization and Nurses do not know how, or whether their reports are acted upon.

•  Clause 36 of the Collective Agreement provides a guarantee to Nurses, patient/residents/clients, and the Employer, that Nurses’ PRCs about staffing, equipment or communication will be resolved or if necessary, reviewed at the highest level of the organization.

What the differences between RLS and PRC Reporting?"

What are the differences between Professional Responsibility Concern and a Occupational Health issue?In general, occupational health issues focus on the safety of the nurse and Professional Responsibility Concerns focus on the safety of patients.

In some situations, both nurse and patient safety is at issue.

When a situation has both PRC and OH&S dimensions both dimensions will be pursued through the processes outlined in the Collective Agreement.

In some instances, if a PRC with an OH&S component is not successfully resolved as per the Collective Agreement then a meeting needs to take place with the Executives to pursue other options.

What should I do if my Manager has a pattern of bullying and attempts to prevent me from filling out a PRC Report?"

•  Bullying & intimidation are not acceptable behaviours.

•  Managers are in violation of the collective agreement if they attempt to prevent or stand in the way of a Nurse documenting a Professional Responsibility Concern for review at the committee.

•  Nurses are advised to document violations of this nature, and report them to their Labour Relations Advisor.

Definitions & Location PRC Resources"

•  The slides for this presentation are posted on the PRC Conference with other educational materials, reference materials, templates and planning resources to help you make your PRC Committee as effective as it can be.

•  You can access these materials at any time.

•  The PRC conference provides a forum for questions and answers about PRC. The Professional Responsibility Advisor is the monitor for this conference. Your questions can be answered, or referred for answers.

•  Your suggestions and success stories can inspire and encourage others!

Our Common Goals "•  The purpose of the PRC Article in the Collective

Agreement between registered Nurses and their employers is to protect Nurses when they are fulfilling their professional roles as advocates for the safety of patient/residents/clients.

•  The corporate mission, vision and values statements of AHS commit all of its employees and affiliates to patient safety and proper workplace practices.

•  The PRC Process provides a constructive way to advocate for patients and to protect them from hazards and harm.