Clinical resource team provides support during staff shortages

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Like many other organizations, hospitals are around-the-clock operations. But unlike companies that can continue to do business when employees call in sick or take vacations, hospitals need to be properly staffed at all times in order to ensure patient safety. When more nurses are needed to fill shifts, temporary agencies are called in to support the clinical teams, which can add up to high costs and disruption to the day-to-day flow of the units.

In 2008, William Osler Health Centre was relying heavily on agencies to help meet the health-care needs of a rapidly expanding patient population. In addition to the cost, managers were finding that nurses had to spend a great deal of time assisting agency staff with computer access and equipment use and performing tasks that didn’t fully maximize their nursing skills.

To alleviate these concerns, Lorrie Halliday, Acting Director of Emergency Services, put forth a proposal to form a new support team as part of a broader strategy to address issues of access and flow at the hospital. The goal was to find an in-house solution to the ongoing need for temporary help by creating a new staffing model that included registered nurses, registered practical nurses, personal support workers, orderlies, and clerical staff.

The proposal was approved and Halliday, together with Elaine Harkiss-Laird, Director of Human Resources, developed a Clinical Resource Team (CRT) made up of 23 staff members who were interested in being part of the new service. The team also took on the coordinating of new graduate nurses, providing them with a three-month general medicine rotation and a one-month surgical rotation, with some nurses going into specialty areas such as paediatrics and emergency. Sixty new graduates will be joining Osler this summer.

The idea of the CRT has caught on. Units began using the team to fill short-term vacancies, sick days and holidays. The staff assisted with screening and mask fitting to meet the H1N1 influenza requirements. And when the sinks in the Brampton Civic Hospital intensive care unit (ICU) were temporarily out of commission, the CRT was there to help provide personal care for patients. “This was a challenging time for the ICU. The CRT staff helped our team make patients and families more comfortable as they assisted with some basic care for ICU patients. Their assistance helped staff to feel supported as they provided patient care during this taxing period,” says Liz Cameron, Acting Director.

Liz Buller, Senior Vice-President, Patient Services, agrees. “Lorrie and Elaine have done an amazing job pulling this together, using creative and nimble staffing solutions and working closely with the teams who use the CRT to make sure the CRT staff are treated well and recognized for how important they are to the whole team,” she says.

From January to June 2009, the CRT provided over 28,000 hours of service to clinical teams at both the Brampton Civic and Etobicoke General Hospital sites, and agency use dropped from an average of 15,078 hours per month to 7515 hours. This resulted in significant cost savings for the hospital. Last year, nursing agency costs were as high as $1.2 million per month, but have come down to under 600,000 in recent months.

The program itself has proved to be a popular draw. Staff appreciate the special training, employee benefits and computer access offered at Osler while still having flexible schedules. The staff complement has grown to 95, some of whom are former agency nurses or care providers who previously worked in community settings. Grace Richardson was a personal support worker for five years before joining Osler and enjoys the exposure she now has to various departments. “I love interacting with different people and I like to talk,” she says, laughing. “Sometimes people need that…just know someone is there to talk to them, or just to listen. When they’re in hospital, they need to feel they’re not alone.”