CHI Health Mercy Council Bluffs

Workforce Planning to right size “the people” with a focus on contingency layers

Leigh Bagshaw, BSN, RN

Workforce Evolution

Introduction

House Team

Relief: Molly Sorrell, RN Beth Guerreiro, BSN, RN Cassie Olson, BSN, RN

House Supervisors:Theresa Savino, BSN, RNChristina Knotek, BSN, RNChris Springer, BSN, RNAllen Sunde, RN

CHI Health Mercy Council BluffsCHI Health Mercy

CHI Health Mercy Council BluffsCHI Mission and Core Values

AWARDS

• Comparion Ranked Mercy Orthopedic Care #1 in Iowa Mortality Overall Complications Overall Inpatient Quality Patient Safety

• Source: Comparion Medical Analytics, Inc

Blue Distinction+Top Centers of Specialty Care--Hip and Knee

For the 4th Year!Orthopedic:

OB Care:

Wellmark Blue Cross Blue Shield of Iowa

CHI Health Mercy Council Bluffs2016 Rankings

Joint Commission Hospital Accreditation

Nursing Honor Guard

• Integrated with other hospitals, CUMC Bergan Medical Center, Immanuel, Midlands, Lakeside, Lasting Hope

• St. Elizabeth, Nebraska Heart, Good Samaritan, Richard Young and St Francis

1998 Teamworks developed.

2001 RMC Developed

2008 i-choice

2009 low number of employees

2011 changed policy

2012 spent 1.4 million on travelers.

2013 Developed the Nursing Services PAC $10 Tier 1 24 hour commitment$15 Tier 2 48 hour commitment

2015 Variable Incentive Program

Resource Pool History

House Expectations (Supervisors):Report to the Director of Patient Care ServicesAccountabilitiesFunctional AccountabilitiesManaging the Day to Day

operations and throughputResource Pool

RP Expectations:multiple departmentsWeekend commitment

Expectations

House Supervisor Accountabilities

Has the authority to interview, hire, orient, terminate, promote, train and conduct performance evaluations.

Assigns day-to-day work activities; directs the functional and technical job performance of team members.

Allocates and directs staffing needs to meet patient, unit/department and organizational needs and collaborates with others to ensure overall staffing needs are met.

Manages performance including: setting goals, clarifying job expectations, monitoring performance progress, providing feedback, recognizing performance, developing skills and addressing performance issues related to work and our Commitments using corrective action.

House Supervisor Functional Accountabilities

Provides support, interacts, and serves as a clinical resource to patient care staff. Functions as a resource for policy and procedure interpretation. Utilizes age appropriate patient care interventions.

Identifies and responds to high risk/emergency situations to decrease risk exposure to patient, family members, staff, and organization. Follows approved procedure for notification of appropriate departments and individuals involving risk management issues. Assumes administrative responsibilities as defined by policy Events for Notification or Consultation of Nursing Management (#000.004) in the absence of Administration.

Provides support in determining staffing needs. Allocates float pool resources to meet shift staffing needs. Collaborates with Operations Directors and patient care area staff in making assignments.

Assures appropriate level of understanding, awareness and compliance with all applicable JCAHO, federal, state and local agency laws, internal/external regulations, guidelines, policies, procedures and professional standards.

Assumes responsibility for personal and professional growth through participation in meetings, in-service programs, continuing education programs, and fulfills yearly requirements as stated by policy. Participates in achieving nursing division goals and supports shared governance structure.

Vacation/Personal time • Time off will be granted per manager discretion on a unit-basis to maintain safe core

staffing levels. • Requests for time off need to be submitted through approved unit based practice/tools. • If request encompasses committed weekend shift, then coverage is required to unit

practice.

Unscheduled Absence • Please see Attendance Policy. The attendance policy will be followed and corrective

actions enforced. • If an unscheduled absence occurs on committed weekend shift, you will automatically be

scheduled the next weekend. You unit director or designee can move this shift to another high need weekend if needed. It is YOUR responsibility to re-arrange this if needed.

• Per policy, you are considered “tardy” one minute after the start of your shift even though you are paid 7 minutes before or after your shift.

Clocking Transactions • Staff may clock in 7 minutes before the start of the shift. • Staff is responsible for clocking in and out appropriately and also changing departmental

cost centers when floating. • Per policy, staff will be held accountable for missed punches.

Weekends

• Per policy, all staff are obligated to work a minimum of 50% of the weekend hours annually.

• Weekend shifts are defined as: o Day shift: 50% Saturday and Sunday o Night shift 50% Sunday and Monday

• If an unscheduled absence occurs on a committed weekend shift, you will automatically be scheduled the following weekend. You unit director or designee can move this shift to another high need weekend if needed. It is YOUR responsibility to re-arrange this if needed.

Staffing for “Every Patient is my Patient” • All staff has the obligation to float to meet patient care needs throughout the hospital. • You may be asked to assist in patient care needs at other campuses. • Floating will occur based off unit practice and skill needs throughout the campus(es).

Professionalism

• All staff is expected to act in a professional manner.

Expectations

Resource Pool Team

Resource Pool RNScheduled 9 New Hires every other weekend Day / Night Currently have 1 day and 2 night

Premium Plus 31 24 hour requirement every 2 pay periods

High Needs Currently have 1 person in this position

CNA Scheduled 4Premium Plus 15

CNA/Phleb 8 Total of 59 employees Averaging 2500 hours per pay period

Successes:

StructureSetting clear ExpectationsDirector by inFlexibilityOrientation checklistPolicy to not cancelSharing Resources across multiple Campus’Creating needed job positionsHuddle held by all the House SupervisorsNursing Services PAC

Developing New Positions

IR / Cath lab / Cardiac Rehab outpatient position

CNA Phlebotomy

Developing System Enterprise PoolRN’s include OR, ED, Acute CareWomen’s Resource Team (OB)Behavioral HealthFuture plans with OT/PT

Ken, Michelle, Kiley, Cynthia will be at the back table for any questions