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Jan CurrieVice President and Chief Nursing Officer
Winnipeg Regional Health Authority
The Big Picture inWinnipeg Regional Health
Authority
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Background-the 90’s
• Healthcare “Re-structuring” - loss of nursing positions throughout system
• Nursing graduates unable to find employment in Manitoba
• Closure of hospital based nursing education programs- decrease in total number of nursing education seats
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Background-the 90’s
1999Winnipeg Regional Health Authority(WRHA)created by amalgamating Winnipeg Hospital Authority and Winnipeg Community Authority.
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Winnipeg Regional Health
Authority (WRHA)
• WRHA “Unique” configuration• 9 facilities - operating agreements
- 2 devolved; 7 non-devolved- Faith based agreement
• Community Services - Public Health, Community Mental Health, Home Care
devolved- 37 Personal Care Homes - Service Purchase
Agreements- Community Agencies - Service Purchase Agreements
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Winnipeg Regional Health Authority (WRHA)
Provides services to approximately
1 million people in catchment area
Also provides services to manyManitobans who live outside the Regional boundaries but receive healthcare services from WRHA.
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Background
In February 2001 there were 1021 vacant RN positions in WRHA
Graduating nurses had fallen to 200 in 1999 from 700 in 1992
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Background
Government of Manitoba and educational facilities responded to increase the number of nursing education seats in Manitoba
• In 2001 there were 198 RN graduates in Manitoba
• In 2005 there were approximately 400 RN graduates in Manitoba
• Total of 690 nursing graduates in 2005
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Retention Strategies- Provincial
Provincial Recruitment and Retention Fund
- Created in 1999- Provides funds to support Recruitment and
Retention activities including funding for Regional Continuing Education Funds
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Provincial Recruitment and Retention Fund
Needed to facilitate processes for nurses wanting to re-enter the
workplace- Refresher programs subsidized through the
Provincial Recruitment and Retention Fund- 342 nurses have applied for funding to date
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Provincial Recruitment and Retention Fund
Provincial Recruitment and Retention Fund provides relocation incentives for nurses relocating to Manitoba
- Applications have been accepted for:• 719 RNs• 23 RPNs• 108 LPN
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Retention Strategies - Regional
• Advertising for nursing positions is coordinated regionally with an emphasis on high vacancy areas
• Facilities in WRHA provide opportunities for RN nursing students to be employed as HCAs
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Retention Strategies- Regional
• RN Nursing graduates are surveyed annually to determine employment preferences.
• Vacancy data is posted on University of Manitoba website.
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Retention Strategies- Regional
Aboriginal Initiatives• Representative workforce• Self-declaration process
Francophone Initiatives
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Retention Strategies-Regional
Improving Full-time/Part-time Nursing Ratios:
- Improved Continuity of Patient Care- Jobs for nurses in the future- Predictability in schedules for nurses- Enhanced staffing during periods of peak
demands• less reliance on nurses “picking up” shifts
- Improved fairness in scheduling- Reduced overtime
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Retention Strategies- Regional
Full-time Part-time• Over 200 more Full-time positions in WRHA since
2002• At the same time, the number of positions less
than 0.6 EFT has decreased• While reliance on Part-time staff has decreased
where Relief Teams have been implemented, there are still opportunities to further decrease this reliance and to reduce overtime costs and agency use.
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WRHA Nursing Overtime Premium Dollars Paid
$-
$1,000,000
$2,000,000
$3,000,000
$4,000,000
$5,000,000
$6,000,000
$7,000,000
$8,000,00019
97/9
8
1998
/99
1999
/200
0
2000
/01
2001
/02
2002
/03*
2003
/04*
2004
/05*
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Agency Hours
• Use of agency nursing staff is decreasing
• More sites are reporting that they are not using Agency nursing staff • SBGH, HSC, MHC and RHC
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Retention Issues-Regional
Variation in roles and span of control for
nursing managers throughout Region
• ABC project on Nursing Roles developed Regional role descriptions for CRN and Unit Managers
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Retention Strategies - Regional
Perceived lack of mentorship and continuing
education opportunities for managers- Annual Firstline Managers workshop
established• organized by and provided free to managers
- An applied model for sustainable nursing leadership development being developed
- Ongoing continuing education programs addressing management issues established throughout the Region
- Leadership Mentoring opportunities
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Retention Strategies - Regional
Quantify staff satisfaction with workplace• Staff satisfaction surveys developed
- Regional- Facility
• Information from staff surveys used to identify and address workplace issues
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Retention Strategies - Regional
Provision of equipment needed to provide patient care
- 2000 - $1.2 million “Hallway Medicine”- 2003 - $ 700,000 Safety and Security
• Cell phones for community nurses• Safety training program developed and offered to all nursing staff
- 2004 – Safety Engineered Devices - Bed replacement project- 2005 – Smart Pump project
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Retention Strategies-Regional
Preceptoring/Mentoring• Need for formal preceptor education
programs- Workshops available through facilities or
University of Manitoba Faculty of Nursing
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Transition Facilitator
Transition Facilitator- assumes mentoring role for new
graduates- 2003 Nursing Sector Study – 72% of RN
graduates are retained in MB
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Retention Strategies -Regional
Continuing Education Fund• Funding to promote continuing education
for direct care staff- Funds allocated to Regional Continuing
Education Committees by Provincial Government• Nurses may receive up to $500/year in
addition to $200/year allotted in Collective agreement
• Also provides subsidies for unpaid leave days taken for Continuing Education Activities
• Funding available to subsidize group activities e.g. Conferences, Seminars
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Retention Strategies-Regional
Support for certificate and post-basic programs. e.g. ICU course, Manitoba Nephrology Nursing Course
- Funding received through Provincial Recruitment and Retention fund to subsidize costs of these programs.
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Retention Strategies- Regional
Enhancing public image of nursing as a profession• Utilize a number of communication
strategies to promote the image of nursing
• Open Letter to Nurses provides opportunity for communication to nurses in Region.
• All nursing education facilities have waiting lists
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Retention Strategies - Regional
Transition Facilitator role- created to enhance retention of new
graduates in the workplace- experienced nurses who assist nursing
graduates make the transition from student to practicing nurse
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Challenges for the future…………
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In September 2005 there were 518 vacant RN positions
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Continue to identify need for nurses based on vacancy reports, retirement projections and the projected numbers of new graduates
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Considerable concern about the number of nurses eligible to retire in the near future
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Projected Nursing Retirements in WRHA
Winnipeg Magic 80 by Year
0
50
100
150
200
250
300
350
400
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
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Projected Nursing Retirements in WRHA
• Data is for MNU and MNU related staff
• Depicts number of nurses who will reach magic 80 under the current provisions of HEPP
• Shows that we are entering a period where the number of nurses eligible to retire is increasing
• Trend is expected to continue to rise until 2007 and then remain at a high level until 2020
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Supply of RNs
For the next 2-3 years, we will be in a situation where we will have increasing numbers of nurses eligible for retirement
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Supply of RNs
It is essential that we continue to recruit nursing graduates to the workforce
The number of nursing seats in Manitoba needs to remain at its present level
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Need to identify new strategies to:• Retain new graduates in the
workforce• Retain experienced nurses in the
workforce
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Continue to develop HHR forecasting tools such as RN Projection Model
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“Even if you are on the right track you will get run over if you just sit there”
Mark Twain