Nursing Demonstration Project in Nursing Human Resources Planning Building Capacity in Nursing Human Resource Planning A Best Practice Resource for Nursing Managers

2 The Challenge…. Retirements Over half of the nursing workforce is over the age of 45, and will be eligible for retirement within 10 years – 55, 000 of Ontario’s nurses will be retiring Instability Unstable employment patterns, heavy workloads and fewer supports for entry to practice negatively impact retention in the profession Gaps in Capacity Employers lack the capacity to identify their own HR needs Need for Change in Practices Employment practices and labour agreements impact rates of full- time employment among new graduates. 14% of RPNS and 40% of RNS secured fulltime employment in Without interventions to attract and retain nurses in Ontario, will will face a critical shortage that will impact our ability to care for the population

3 Goals of Demonstration Projects Contribute to the development of a ‘blueprint’ for Health Human Resources Planning that balances: 1.Nursing Human Resources 2.Organization Outcomes 3.System Outcomes 4.Patient Outcomes Support informed decision-making at the organizational level as it relates to HHR planning Pool Resources across the province and share best/promising practices in nursing HR planning and Management Ensure active implementation across a range of sectors and organizations

4 Nursing Human Resources Best Practice Resource Tool Kit A partnership network consisting of seven acute care hospitals and one academic partner: Mount Sinai Hospital North York General Hospital SickKids St. Joseph’s Health Centre St. Michael’s Hospital Sunnybrook Health Sciences Centre; Toronto East General Hospital and, The Bloomberg Faculty of Nursing, University of Toronto

5 Project Objectives Develop a best practice toolkit (BPT) that represents an inventory of systems, tools, processes and evaluation methods currently in place for human resource planning in nursing; and effective orientation and integration of new graduates Create a network to facilitate the sharing of knowledge among partner organizations Develop a coaching model, delivered through a series of workshops to disseminate information about the BPT to nursing managers Develop an evaluation framework that can be adapted for HR planning initiatives.

6 Toolkit Project Framework

7 Who Is the Toolkit For? 1. Organizations: » To develop a coordinated planning approach to nursing HR planning » To review and better use data currently available in their organization » To inform nursing leaders about relevant workforce trends, facilitate planning, increase forecasting accuracy, strengthen recruitment and retention strategies and provide for workforce continuity 2.Nurse Managers: » To bring a disciplined approach to workforce planning that the nursing manager can implement » To use data currently available in their organization To address planning at the nursing unit level because it is written from the perspective of nurse manager ’ s day to day reality 7

8 Development of Toolkit Review of best practices from literature, research and published practices from other jurisdictions Surveys and interview data collected from organizations and nursing managers Tools/templates collected from partnering organizations

9 Nursing Manager Survey 107 respondents from the 7 hospitals; 69% response rate Purpose was to understand nurse managers reflections about how they engage in nursing HR planning, supports available, information they perceive as valuable, skill development needs

10 Nursing Manager Survey Challenges in accessing timely, useful human resource planning information. Lack of analysis and trend information Utilization of various reports is variable Minimal use of forecasting tools Education for nursing managers is combination of formal and informal learning – differences in how this was perceived by CNEs versus managers

11 Nursing Manager Survey Managers do not receive consistent assistance in HR planning Planning is more likely to be done when a vacancy occurs or prior to each schedule 50% do annual HR planning; most plan for one year or less 27% reported having no forecast plan Majority utilize master schedules Extensive use of New Graduate Guarantee program – variation in models of integration, some restrictions in clinical areas but these were not consistent across organizations 60% hired new grads in

12 Nurse Manager Workshop There were 52 participants present at the workshop The majority were first line nursing managers 83% submitted an evaluation

13 Workshop Day Overall

14 Toolkit Contents  Chapter 1: Framework for Toolkit  Chapter 2: Planning for Nursing Human Resource Needs  Examples of current nurse managers’ planning activities, data sources and tools  Recommendations from the literature (what to do and what not to do)  Suggested steps for nurse managers to implement and plan for HHR needs  Examples of tools to guide nurse managers’ planning activities  Chapter 3: Maximizing Nursing Human Resource Utilization – A focus on scheduling  Discussion of different scheduling and staffing types  Tools and templates for nurse managers to use for staffing and scheduling purposes 14

15 Toolkit Contents  Chapter 4: Recruitment  long- and short-term recruitment strategies  Chapter 5: Retention  retention strategies that cater to new graduate, mid-career, and late-career nurses  Chapter 6: Professional Practice  Information on four key areas of professional practice: 1) nursing leadership and the context of practice; 2) collaborative practice efforts 3) work environment and organizational culture; and 4) educational opportunities and professional development.  Chapter 7: Customizing the Toolkit to your Setting

16 Key Recommendations Funding for future initiatives should be aimed at supporting the uptake and implementation of initiatives identified in the evidence and toolkit to advance the capacity of nursing human resource planning at the organization and unit level. Role expectations, educational preparation and opportunities for professional development for first-line managers vary among organizations. Evidence suggests that there are specific leadership and management competencies for first-line nursing managers that are tied to outcomes for nurses, patients and organizations. Future initiatives should be aimed at defining core competencies and providing formal mechanisms to assist nursing managers to achieve them.

17 Key Recommendations Organizations should ensure that adequate training is provided to first-line nursing managers to ensure they are developing skills in effective human resource management including planning and forecasting, recruitment including interviewing, bias free hiring, and use of different types of recruitment and retention strategies. Organizations should provide structures for internal and external networking for first-line managers. First-line managers identify peer mentoring and access to, and support from their direct supervisor as the most common mechanisms for attaining competency in nursing HR planning and other leadership and management skills. Organizations should consider developing formal mentorship and support programs for first-line managers.

18 Key Recommendations Organizations should provide nursing managers with consolidated and consistent reports of human resource information in order to assist nursing managers to effectively manage and plan for nursing human resources. Currently information tends to come from disparate sources and information systems and source at different time intervals. Strategies that seek to consolidate information in regular reports would improve the planning and evaluation cycle of nursing human resource management.

19 Key Recommendations Nursing managers should be provided with guidance in the understanding, analysis and utilization of reports on human resource planning and encouraged to review their planning on a regular basis. Regular reviews of staffing and scheduling procedures are recommended (minimum yearly) in order to be responsive to the recruitment and retention issues. In addition, triggers such as staff complaints, increased sick time or overtime may warrant a review and further action.

20 Key Recommendations In our interviews with experts, all nursing managers stated that in learning about staffing and scheduling, most had relied on their colleagues for support or taught themselves - formal mechanisms for learning staffing and scheduling techniques would have been very helpful to them as new nursing managers. Creating healthy workplace environments, providing adequate training opportunities for new nurses, as well as supporting professional development are important steps in both the recruitment and retention process.

21 Toolkit Project Expert Panel