Last week, nurses in California staged a one-day strike which actually led to a 5-day lockout as the hospitals hired temporary workers on a 5 day contract. During the lockout, a patient died as a result of a mistake by one of the temporarily hired workers. It’s a tragedy that has led to a contentious debate between nurses and hospital administrators.
The point here isn’t to enter that debate, but to have an informed discussion about staffing practices surrounding temporary workers in the wake of the strike. Some have taken an opportunity surrounding the tragedy to question the quality of staffing agency nurses. That debate does a disservice to the hard-working nurses that come from agencies. There are thousands of high quality nurses temporarily filling important roles at hospitals throughout the country every day and they do a great job. But it’s up to the healthcare facilities that hire these workers to employ high quality staffing practices to best utilize temporary workers. In a recent post by Mariah Scott, a healthcare industry veteran and COO at ShiftWise, she touched on this very topic.
In order to provide safe nurse staffing levels, most hospitals need to rely on contingent staff. High quality hospitals take responsibility for the training and onboarding of contingent staff, to ensure that they are ready and able to deliver quality care
She goes on to say:
However, the real issue is the process the hospital follows for ensuring that they are hiring qualified temporary staff, and that staff are appropriately trained for their shift.
Hospitals are going to need some form of temporary workers whether its internal or external. That’s a fact of an industry that runs 24/7 even when the lives of employees do not. However, that is not an excuse for a drop in the quality of care provided. There are many best practices that a hospital can put in place to ensure it maintains quality across all shifts filled. Below are some best practices that healthcare systems can utilize for contingent staffing and we’ve included information about how ShiftWise enhances the utilization of each.
Credential and document management. It’s important to have a system in place that effectively manages credentials and other required documents for nurses. As we’ve written before, it’s absolutely critical that a nurse not be hired with expired requirements. That’s a HUGE JCAHO no-no and threatens the quality of care provided.
- How ShiftWise helps: Nurses can’t be submitted to an order if they don’t have proper credentials, licenses and other required documentation on file. This blocks anyone from working in your facility that may be unfit for the job. Furthermore, ShiftWise offers its credential management tool, VeriStaff, as a free, stand-alone tool available to agencies and healthcare systems of any size. The system handles expirations automatically and notifies key people when something is out of date.
Nurse grading and filtering. Keep a record of nurses that work for you and how they perform. If you’re not comfortable with a nurse, don’t hire that person back for another shift.
- How ShiftWise helps: Every nurse can be graded on their performance. When a staffing office has multiple nurses to choose from for a shift, they can use the grades of each nurse to help make an informed hire. And there’s also a “Do Not Use” function that allows facilities to restrict a nurse from working in a specific unit or even an entire hospital.
Preferred vendors. Do you have certain agencies or internal resources that you know you trust and prefer to use? Of course you do, so use them first. Building relationships is important in any business and healthcare is no different.
- How ShiftWise helps: You can set up tiering within the system in such a way that your first choices submitted for a shift are always the ones you most desire. If no one is availabe in the first tier, it’ll move down to the 2nd and so on until someone is confirmed to the shift.
Use internal resources. Many hospitals prefer to use internal resources to fill open shifts. It makes sense because after all, these are the people most familiar with your facility practices and regulations and will require minimal training when filling an opening.
- How ShiftWise helps: There are two ways to go about using internal resources within ShiftWise. (1) Set up your internal resource pool in the same way others do with agencies and draw from only that pool to fill openings. You get the benefit of automating this practice and all the efficiency improvements that come with that. (2) Set up a hybrid system that utilizes both internal and external resources, but within the tiering system previously mentioned in this post. In doing so, internal employees are always up first for any openings followed by agencies if the shift can’t be filled internally.
This list is a guide and there are certainly other practices that can and should be implemented. A good onsite training program is especially important. Whatever your practices may be, ensure they are strictly adhered to and you’ll find the quality of care your hospital provides never wavers regardless of how shifts are filled.