1 It's More than just Unsafe Staffing -- Workload and Practice Issues you may Not have Thought of. September 20, 2010 Professional Practice Teleconnect.

Slides:



Advertisements
Similar presentations
Common/shared responsibilities between jobs.
Advertisements

Care Coordinator Roles and Responsibilities
Service Employees International Union (SEIU) California State University Employees Union (CSUEU) Association of California State Supervisors (ACSS) California.
Develop and Validate Minimum Core Criteria and Competencies for AgrAbility Program Staff Bill Field, Ed.D., Professor National AgrAbility Project Director.
Accident Incident Policy Changes to Policy September 2007.
Complaints An Overview for Staff Prepared by MSM Compliance Services Pty Ltd.
FRANK ESPOSITO DIRECTOR OF SPECIAL EDUCATION SOUTH PLAINFIELD SCHOOL DISTRICT Effective Communication Pathways in Special Education.
National Health Information Privacy and Security Week Understanding the HIPAA Privacy and Security Rule.
2 Agenda Goals of documentation training Iowa Administrative Code SURS Reviews Questions & answers.
Quality Improvement/ Quality Assurance Amelia Broussard, PhD, RN, MPH Christopher Gibbs, JD, MPH.
SESSION 2 Key points Module 4 covers consultation requirements under the WHS Act and relies on participants having completed Modules 1 – 3 of this course.
Independent Educational Evaluations Developed by Contra Costa SELPA As Recommended for LEA Board Policy
Leading Teams.
Nursing Workload/Staffing Report Guidelines For Use.
Children’s Social Care Workload Management System (WMS) A Two-fold approach DSLT 16 th November 2010 Updated with new SWRB standards.
The Process of Scope and Standards Development
Palliative Care in the Nursing Home. Objectives Develop an awareness of how a palliative care environment can be created. Recognize the need for changes.
RENI PRIMA GUSTY, SK.p,M.Kes
Healthy Work Environment Elizabeth Degelbeck, Justin Hacker, Kristine Lantz, and Courtney Wilson.
Ottawa Police Service Chief’s Complaint Investigations Insp. T. Youngson-Larochelle and S/Sgt. M. Marin.
 Increasing concerns about the nursing profession in the U.K.  Concern from NMC over the number of new registrants reported for fitness for practice.
Nurse Staffing in New Hampshire Implementing a Nurse Staffing Committee NH Staffing Toolkit July 2010.
DEEMING REQUIREMENTS AND APPLICATION PROCESS FOR FTCA MEDICAL MALPRACTICE COVERAGE For Calendar Year 2013 Department of Health and Human Services Health.
Claims Management. Initiatives Bureau of Workers’ Compensation (BWC) Industrial Commission (IC)
1 The Dentist’s Legal Responsibilities to the Patient Dental Law and Ethics.
Occupational health nursing
Department of Education 2011 Campus Policy Memo Dr. MAK Mitchell Executive Director of School Governance DAPS 1.
Clinical Resource Management Inpatient Care Coordination 2002.
The Policy Company Limited © Control of Infection.
Introduction to Operational Teams “Rounding out” the major aspects of operational teams Mike Davies, MD FACP Mark Murray and Associates.
Steps for Success in EHR Planning Bill French, VP eHealth Strategies Wisconsin Office of Rural Health HIT Implementation Workshop Stevens Point, WI August.
Local Assessment of Code of Conduct Complaints. 2 Background  On 08 May 2008 – the local assessment of Code of Conduct complaints was implemented due.
Continuing Education Presentation 2008
SETMA Provider Training October 19, One of the catch phrases to medical home is that care is coordinated. At SETMA it means more than just coordinating.
Local Assessment of Code of Conduct Complaints. Background  On 08 May 2008 – the local assessment of Code of Conduct complaints was implemented due to.
New Hanover Health Network Wilmington, North Carolina An Innovative Approach to Establishing Shared Governance Gabriele Pike, RN New Hanover Health Network.
Enabling Professional Networking: Building Leadership and Excellence in Professional Practice through Communities of Practice CHNC June 2010 Janet Purvis.
On the CUSP: STOP BSI Improving Situational Awareness by Conducting a Morning Briefing.
Guidance Training (F520) §483.75(o) Quality Assessment and Assurance.
 Canada Occupational Health and Safety Regulation 20 (Part XX) was proclaimed dealing with Violence Prevention in the Work Place.  Work Place Violence.
On the CUSP: STOP BSI Improving Situational Awareness by Conducting a Morning Briefing.
10/11/00AR REWRITE INTENT OF n Ensure that quality anesthesia care is provided at home and when deployed n Implement a uniform CRNA Scope.
Care Delivery Systems. Nursing Care Delivery Models A method of organizing and delivering nursing care The manner in which nursing care is organized and.
Supporting The Works of Public Accounts Committees – Strategies for Success Deji Olaore World Bank Institute (WBI)
UNIVERSITY OF DAR ES SALAAM t Selection and Employment of Consultants Negotiations with Consultants; Monitoring Performance of Consultants; Resolving Disputes.
Safeguarding the public: Through ensuring Fitness to Practise.
Friday 1 st December 2006 Careers & Employment Workshop Group B: Policy.
Dianne Martin RPN, RN, BScN Brenda Mundy RPN, RN, PNC(C)
Exceptional Children Program “Serving Today’s Students” Student Assistance Team.
Continuous Quality Improvement Basics Created by Michigan’s Campaign to End Homelessness Statewide Training Workgroup 2010.
SPECIAL EDUCATION PROCEDURES TO ADDRESS NON-COMPLIANT FINDINGS RELATED TO CHILD FIND Presenter Jim Kubaiko, Director Special Education.
Performance Management – Part 3 BCUHB Capability Procedure (WP3A) 69.
For OFFICE-BASED CARE Team Structure ®. TeamSTEPPS | Office-Based Care Team Structure Slide 1 INTRODUCTION SAY: This presentation will cover the Team.
Northern Health Specialist Clinics Access Policy Implementation Forum Cherie Hunter Ambulatory Care Access.
Josha Harvey, Katie Morell, Brittany Pharo, & Christy Rapoza
NCAHRMM Spring conference
Designing Effective Accommodation Plans in Clinical Placement & Internship Settings
Medication Reconciliation ROP Compliance
A Guide for Managers for Professional Staff
Example process for managing incoming calls
ALLEGATIONS OF ABUSE Internal Occurrence Reporting and Investigation.
HREC Operating Procedures for the Review of Low and Moderate to High Risk Projects
A Guide for Professional Staff
A Guide for Professional Staff
Example process for managing incoming calls
Finance & Planning Committee of the San Francisco Health Commission
Workload Staffing Reports
MAKING QAPI PAINLESS It doesn’t have to hurt!! Joan Balducci, RN, BS
Ethics Committee Guidelines
The role of the CSP Safety Rep
Presentation transcript:

1 It's More than just Unsafe Staffing -- Workload and Practice Issues you may Not have Thought of. September 20, 2010 Professional Practice Teleconnect

2 OBJECTIVES Identify various workload issues and practice concerns Demonstrate how to use the Professional Responsibility Complaint process to deal with a number of practice concerns, beyond unsafe staffing levels. Provide information to assist ONA leaders in dealing with various other types of workload and practice issues such as Disruptive Physician Behaviour, Hallway Nursing, etc.

3 Professional Responsibility ONA’s Professional Responsibility Clause provides a documented process to address workload issues that deal with professional practice concerns and patient safety. The PR clause provides member (RN) input into resolutions to support practice according to their standards and accountabilities.

4 The Professional Responsibility Clause (PRC): Provides RNs a say in the quality of care they provide Provides a problem-solving approach that helps RNs meet professional standards Provides documented evidence Provides union representation for practice concerns Provides for resolution of disputes

5 The Professional Responsibility process has: increased staffing levels developed safer work places improved communication with employers improved quality of care provided necessary equipment and supplies

6 Complaints/Concerns Indicators There are a number of indicators identified that impact on the workload and the ability of RNs to provide quality, safe, client care.

7 Professional Responsibility Process Think of examples of issues that affect your practice in each of the above categories. We will be discussing examples during the teleconnect. (for members - write in your thoughts and our discussions)

8 COMMUNICATION Lack of Leadership & Support Policies & Procedures Patient Factors/Complexity Charting/Documentation System Other

9 EDUCATION / ORIENTATION Access to Reference Material Education for New Processes, Equipment etc. Prior to Implementation Policies & Procedures Float Pool/Agency Nurses

10 ENVIRONMENT –Cleanliness of Unit –Construction/Renovation –Noise Level –Physical Layout –Safety for Clients/Staff –Fragmentation of Care –Over-Capacity

11 EQUIPMENT & SUPPLIES Faulty Insufficient/Lack of Not Maintained Not Appropriate Slow or Infrequent delivery of Supplies

12 JOB DESCRIPTIONS/DUTIES Charge Nurse RPNS Clerical Porters Unregulated Care Providers

13 MEDICATION / POLICY Access to Administration of Pharmacy Related Processing Orders Supply Inadequate/Outdates System Issues Other

14 NON-NURSING FUNCTIONS Answering Telephone Portering Visitor Inquiries Ward/Unit Clerk Other

15 PHYSICIAN RELATED Spontaneous Clinics Off Hour Rounds Disruptive/Inappropriate Behaviour –When nurses encounter disruptive physician behaviour, it has a negative effect on their practice and patient outcomes.

16 POLICIES AND PROCEDURES Some policies do not allow you to work in accordance with CNO standards ie: restraint policy, gridlock/ overcapacity policies Flow processes through a unit or from one department to another Policies and Procedures Related to: –Computers –Equipment –Patient Classification Systems –Clinical Pathways/Medical Directives

17 STAFFING LEVELS 24 Hour RN Coverage RPN Coverage Baseline Staffing Bed Utilization (Over Capacity) Patient Factors/Complexity Staff Experience - Sr/Jr/Mix Float Pool Nurses Patient Mix/Acuity Scheduling Staff not Replaced Weekend Coverage Break Relief Model of Care (Pod Nursing) Other

18 Professional Responsibility Process

19 Professional Responsibility Registered Nurses are professionals and as part of their leadership role in the health care team, are obligated to bring their concerns forward on how the “system” is not working in the most effective manner to meet patient care needs. ALL RNs are obligated to make the employer aware of concerns of quality and safe patient care. Recommendations should be provided to the employer to address these concerns.

20 Summary Take a fresh look at your practice environment and you may notice practice concerns, other than just staffing or workload issues. Report practice concerns to your employer and give them the opportunity to fix the problem. Build a quality practice setting and nurses will want to work on your unit. Follow ONA’s Professional Responsibility decision tree for all practice and workload concerns.

21 Decision Tree a. Discuss PRWRF and your recommendations with manager on next day that both RN and manager are working, or within five calendar days. b. Manager provides written response. If there is no response within five days, contact manager to follow up when a response can be expected. Fill out the PRWRF as soon as possible after the incident. PRW Rep and nurse who completed form to meet to develop potential resolutions. PRW Rep also preps members re: process, reviews how to accurately complete forms and seeks to recruit members to sit on Union Unit Committee. Submit PRWRF to HAC within 20 days of incident. HAC meets within 15 days of receipt of the PRWRF to PRW rep. HAC to hear and attempt to resolve complaint. Consult servicing LRO if required Workload Issue Arises Continued on Page 2 Seek help from nursing leaders responsible for timely resolution. Follow lines of communication: e.g. Charge Nurse  Manager  Unit Director  Chief Nursing Officer or management on call. Discuss workload concerns with co-workers on unit.

22 At HAC, attempts are made to resolve issue. Upon request of BUP/PRW Rep, LRO attends HAC If resolved – Minutes of Settlement signed If not resolved: Option #1: LRO submits pre-complaint letter. Option #2: LRO gets extension in timelines to further explore issues. 1. Union proposes a Unit Committee to engage in further discussion:  Modified PRC Workshop for Union Unit Committee on trending reports.  Propose that Union provide PRC lecturette to Agency/Unit/HAC Committee. 2. Failing resolution, LRO submits pre-complaint letter. If not resolved within 15 calendar days of HAC meeting, or within agreed extended timelines, Specialist Considers Referral to Independent Assessment Committee. ONA PP Specialist may forward written report outlining complaint and recommendations to Chief Nursing Officer/hospital Board/LHIN. PP Specialist invited to attend next HAC. PP asks management at HAC to further extend deadlines to attempt resolution. Continued from Page 1