Update on labour adjustment strategies
Focus on nursing, support staff, allied health professionals to support clinical consolidation
Winnipeg Regional Health Authority
Tuesday, October 17, 2017
Today, the Winnipeg Regional Health Authority (WRHA) provided an update on labour adjustment processes for several facilities and job classifications across the region. These changes come as the WRHA updates staffing models to improve patient care in support of the region’s clinical consolidation plan.
“The success of clinical consolidation is anchored in the appropriate resourcing – both of staff and equipment – of every program and facility within the region,” said Réal Cloutier, interim president and chief executive officer of the WRHA. “As we have undergone changes at the first sites impacted by clinical consolidation, an overwhelming majority of staff have opted to select positions. We will continue to work with our employers and their representative unions to ensure that the schedules posted for staff offer them meaningful employment opportunities.”
St. Boniface Hospital
The goal is to improve patient care through the creation of balanced staff rotations that ensure the right staffing is in place 24/7 to meet the needs of the patients.
These changes will affect the work schedule of approximately 1,000 nurses across the site and will require recruitment of an additional 50 nursing positions.
“Balanced rotations that ensure appropriate staffing have positive impacts for patients and staff alike,” said Krista Williams, chief health operations officer for the WRHA. “We want to ensure that the right resources are in place to improve service continuity for patients, while reducing staff turnover and the need for overtime.”
Examples of improvements to patient care associated with these changes include:
- a surgical unit that will now be staffed at a higher rate for full evening shifts to better match the arrival of patients arriving post-surgery, allowing for more frequent monitoring and assessment.
- a move to 12-hour shift model, 7 days per week for clinical resource nurses to ensure these senior leadership resources are available to units daily, not only on weekdays.
“St. Boniface Hospital currently has among the highest overtime and sick time rates in the region, as well as a high vacancy rate (primarily in 8-hour shift positions) and 80 different shift combinations, including many master rotations with either straight-evening or straight-night shifts,” said Karlee Blatz, senior labour relations counsel for the WRHA. “High vacancies result in unfilled shifts or nurses covering vacant shifts through overtime. The future state will standardize the schedule, reducing the current 80 shift combinations down to 22 while increasing the percentage of full-time positions across the facility.”
Health Sciences Centre
Health Sciences Centre employs approximately 2,800 facility support staff and has high overtime use, largely related to schedules that have not been reviewed in a decade. Approximately 250 support staff will be affected by changes at the site as new schedules are implemented. These changes are necessary to address service levels that in the past have varied with the time of day and will allow for consistent levels of patient care, regardless of what time of day they are seen.
The bulk of these changes see the elimination of smaller, harder to staff EFT positions that diminish continuity of care and contribute to increased overtime costs. HSC has also created balanced schedules which will provide the appropriate staffing model for each shift, each day of the week. These new schedules will allow for consistent levels of patient care.
The region also provided an update on changes impacting allied health professionals.
Staffing changes associated with clinical consolidation will affect approximately 50 employees as staff resources are consolidated across the region.
These changes will allow the deployment of allied health resources at various sites to support their patient population and changes with clinical consolidation and the new models of care.
This will increase the availability of diagnostic imaging services at St. Boniface and Grace Hospitals to support emergency and critical care at the two sites.
“Effective distribution of staff resources and specialized diagnostic equipment is essential to quality patient care,” said Williams. “These changes will allow for appropriate staff and specialized equipment like CTs to be optimized ensuring timely access for patients.
Labour adjustment strategies vary for allied health professionals. For nearly half the staff impacted by clinical consolidation, including, pharmacy and the regionalization of the cardiac sciences echocardiography program, as well as occupational therapists specializing in hands and upper extremities, language agreed to by employer and union will result in immediate reassignment or job offers.
For many others, including inpatient occupational therapy, inpatient respiratory therapy, inpatient diagnostic imaging (X-ray, EKG), and inpatient support workers, where budgets are being transferred from one site to another in support of clinical consolidation there will be no
net loss of EFT opportunities and the timing of position deletion notices will correspond with the posting of new opportunities at other sites.
The region also shared information regarding the clinical criteria that will be used to determine eligibility for outpatient OT/PT services, and the intent to ensure patients who meet the clinical criteria are offered services within appropriate benchmark times.
“Our analysis of referrals received over the last two years as well as the number of new patient assessments conducted at HSC within that same timeframe indicates there will be sufficient capacity to absorb the patients eligible for outpatient physiotherapy under the new clinical criteria,” said Williams “We will closely monitor to ensure that patients are receiving the therapeutic services they need in order to achieve the best possible outcomes.”