Original Message from Deborah Gordon (Oct 25, 2013)

Detailed Information to UNA re: Scheduling and Rotation Changes

 October 25, 2013

 Issue: UNA plans to release information to their members related to the future impact of staff scheduling transformation (rotation optimization, regular relief staffing and staff scheduling processes).  AHS leaders are asked to communicate the facts to their staff prior to UNA releasing this information to their members on October 30, 2013.

Information on the first two phases of the staff scheduling transformation is attached and was provided to UNA in early August to allow UNA to prepare bargaining proposals.

It is likely that UNA will tell their members and the media that staff scheduling optimization will mean “eliminating 400 nursing jobs.”   (The total first two phase headcount change is a total change of 323 if the optimized regular and relief rotations developed to date were to be implemented as planned effective immediately.)

It is misleading to say there will be 400 lay-offs or jobs lost as we have jointly agreed with UNA on a process to implement the optimized rotations through position change (as nurses change positions and positions are vacant we will make the necessary adjustments).   This will largely mean the elimination of vacant positions and will not impact current staff.  Any staff member who might receive a lay-off notice as required on under the collective agreement will be able to exercise their rights to another position.

We know that Albertans care about nurses and that they want to know that AHS is ensuring that nurses are being respected and treated fairly. The fact is, we have both full time and part time vacancies that nurses facing changes to positions can be placed in and that nurses outside the organization can apply for. If we could make the necessary changes without triggering a lay-off, we would.

Key Messages

Why change?

  • There are three key reasons to change: we need to make sure we are providing the best possible care for Albertans; we need to make sure we have a health care workforce now and in the future; and we need to build a financially sustainable system that will be there for all of us.
  • If we don’t begin to make change today, starting now and every year thereafter we will need to hire about 9,000 more staff per year to simply make up for retirements, turnover and growth. (Supply is not confirmed but has been projected at between 4,000 and 6,000 per year.)
  • Every year, about 1,100 AHS clinical staff are expected to retire, including 500 nurses.
  • Recruitment alone will not help us keep pace with the demands of a growing and aging population.

Why this is good for patients

  • We are building a health system to care for patients now and in the future.
  • Any change is made with patient need, safety and quality at the forefront.
  • We are taking action and creating new care teams at many hospitals and health care settings to ensure that all Albertans will have access to safe, quality care now and in the future.
  • Recruitment alone will not help us keep pace with the demands of a growing and aging population.
  • We are bringing together patients and families, care teams and all parts of the health system to change how we work together, across the system, to ensure that no matter where you access care, your experience is at the centre of everything we do.
  • We are building team-based work environments, made up of a range of health care providers using all of their valued knowledge, training and ability to care for patients.
    • More full-time positions mean patients and families see the same health providers more regularly. Patients and families have the opportunity get to know their care team and express their care needs and preferences.
    • Improving how we schedule health care providers means patients and their families can be assured of reliable staffing levels and a consistent level of care. We can do this by developing a pool of regular relief workers and expanding scheduling technology.
    • This work will also allow us to operate more efficiently. Every dollar saved is a dollar we can use to increase patient care.

 Workforce Growth

  • Our clinical workforce has been continuously growing.
  • In 2012/13, we increased the number of full-time clinical staff by 4.6 per cent, or approximately 2,900 staff working in full-time positions.
  • Overall, our overall nursing workforce (including LPNs and HCAs) has increased by 13 per cent, or more than 3,650, since 2010.
  • We have increased the overall number of RNs working full time to 31 per cent, from 28 per cent last year. Nationally, the rate of RNs working full time is about 59 per cent.
  • Front-line staff will have opportunities to apply for and secure regular, full-time positions; something that they have asked for.

Optimization, Scheduling and Rotations

  • Staff deserve predictable schedules and well-earned time away from work.
  • These schedules are a work in progress as many schedules are still under development including many new regular relief schedules.
  • Every year, about 1,100 AHS clinical staff are expected to retire, including 500 nurses. (AHS- Clinical Workforce Planning, July 2012)
  • The number of regulated nurses working in Alberta is continuing to increase at a faster pace than the population growth rate. (CIHI 2011)
    • Recruitment alone will not enable us to provide the level of care and service Albertans expect and deserve in the future.
    • Compared to the national average, Alberta has more RNs and fewer LPNs per 100,000 population. (Alberta has 800 RNs and 204 LPNs per 100,000 compared to the national average of 785 RNs and 246 LPNs.)  (CIHI 2011)
      • Only 31 per cent of AHS nurses hold full time positions. Nationally, the rate sits at 58.6 per cent. Albertans – our patients – expect us to compare positively with other organizations across the country and we have work to do to increase the number of full-time positions at AHS.
      • If current full-time/part-time ratios are continued, growing demand for health services will translate to a need for 35,000 additional clinical workers in five years.  Increasing the percentage of full-time positions could contribute to decreasing the number of additional workers needed in the future and to closing the gap between supply and demand.
      • New provincial scheduling processes will support reliable, fair, equitable staff schedules, with consistent, province-wide interpretation of collective agreements.
      • AHS has developed a five-year clinical workforce strategic plan and has included workforce transformation as one of its top priorities.  Each year, more than 1.2M clinical shifts are filled by relief staff. These shifts can be difficult to fill and are often paid at over-time rates.
  • AHS is increasing the number of full-time nurses through changes to rotations and scheduling.  Most RNs will see no changes in the number of hours they work. Some units will reduce their overall nursing hours.

Contact for Follow Up:

Deb Gordon, Leader, Collaborative Practice, Nursing and Health Professions

Phone: 780-342-2026

Staff Scheduling Transformation                                                                            July 24, 2013

Phase I FTE and Registered Nurse Head Count Information by Site and Unit – as of July 24, 2013

This information captures 44 Phase I units.  If the optimized rotations were implemented as developed, the total FTE would decrease by 6 and the total head count would decrease by 205.

Site

Unit Total FTE Before Total FTE After Head Count Before Head Count After Avg FTE Before Avg FTE After

Brooks

Site Summary

28.83

38.47

39

44

0.74

0.87

Acute

18.59

15.55

24

17

0.77

0.91

ER

10.24

22.92

15

27

0.68

0.85

Chinook

Site Summary

72.20

70.16

97

79

0.74

0.89

4B

22.07

20.80

31

22

0.71

0.95

4C

20.69

19.96

29

24

0.71

0.83

ICU

29.44

29.40

37

33

0.80

0.89

Drumheller Site Summary

18.21

15.77

24

19

0.76

0.83

Acute

18.21

15.77

24

19

0.76

0.83

Edmonton

SW

Site Summary

39.30

48.42

47

51

0.84

0.95

ED SW Home Care

39.30

48.42

47

51

0.84

0.95

FMC

Site Summary

211.15

209.47

265

231

0.80

0.91

L&D

84.22

84.06

104

92

0.81

0.91

ED

21.88

8.84

37

12

0.59

0.74

ED

105.05

116.57

124

127

0.85

0.92

NLRHC

Site Summary

31.67

30.25

35

32

0.90

0.95

ER

31.67

30.25

35

32

0.90

0.95

QEII

Site Summary

35.72

44.1

38

47

0.93

0.95

Psychiatry

14.77

12.60

17

13

0.87

0.97

ED

20.95

31.5

21

34

1.00

0.93

    Olds Site Summary

27.42

25.88

42

31

0.65

0.83

Med Surg ER

18.12

18.30

30

22

0.60

0.83

OR Day Surg

9.30

7.58

12

9

0.78

0.84

RAH

Site Summary

89.36

101.21

122

111

0.73

0.91

ED

89.36

101.21

122

111

0.73

0.91

    Redwater Site Summary

6.35

6.30

6

7

1.06

0.90

Acute /ER

6.35

6.30

6

7

1.06

0.90

RDRH Site Summary

195.68

164.04

246

186

0.80

0.88

Unit 32

30.69

17.69

41

24

0.75

0.74

Unit 34 & 36

27.26

17.68

34

24

0.80

0.74

ER

64.07

55.16

79

62

0.81

0.89

ICU

71.06

71.41

89

73

0.80

0.98

ICU

2.60

2.10

3

3

0.87

0.70

RMH

Site Summary

25.53

30.42

35

41

0.73

0.74

Med Surgery & ER

15.87

20.21

21

27

0.76

0.75

OR

2.32

2.87

5

5

0.46

0.57

ER

7.34

7.34

9

9

0.82

0.82

St Paul

Site Summary

10.65

10.86

16

14

0.67

0.78

Acute

10.65

10.86

16

14

0.67

0.78

Sturgeon

Site Summary

42.84

41.60

59

44

0.73

0.95

ER

42.84

41.60

59

44

0.73

0.95

UAH

Site Summary

360.75

365.63

448

402

0.81

0.91

5C4 Gastroenterology

11.80

12.60

14

15

0.84

0.84

3G3

14.20

14.85

18

16

0.79

0.93

3D4

17.40

14.85

21

16

0.83

0.93

3F2

27.00

24.60

35

27

0.77

0.91

3F3

14.30

14.85

19

16

0.75

0.93

3D3

14.65

14.85

19

16

0.77

0.93

3E2

13.40

12.00

18

14

0.74

0.86

3E3

13.40

12.00

18

14

0.74

0.86

3E4

15.80

12.00

18

14

0.88

0.86

3F4

14.40

12.00

19

14

0.76

0.86

Stollery ED

108.1

114.83

141

122

0.77

0.94

Stollery PICU

96.3

106.2

108

118

0.89

0.90

Westlock

Site Summary

18.90

20.63

24

28

0.79

0.74

Acute

18.90

20.63

24

28

0.79

0.74

Edson

Site Summary

12.40

12.43

16

17

0.78

0.73

Acute /ER

12.40

12.43

16

17

0.78

0.73

Coaldale

Site Summary

61.85

62.32

70

64

0.82

0.87

Home Care

57.43

57.89

64

58

0.90

1.00

LTC

4.42

4.43

6

6

0.74

0.74

Cross Cancer

Site Summary

63.35

48.2

82

50

0.77

0.96

Inpatient

63.35

48.2

82

50

0.77

0.96

Totals

 

1352.16

1346.16

1711

1506

0.78

0.86

This report does not include South Health Campus as there is no before information.

This report includes all available data as of July 24, 2013 and is subject to change as additional information is available. 

Please note that it has not been possible to implement the optimized RN rotations as planned to date. 


Staff Scheduling Transformation                                                                            July 24, 2013

Phase II Registered Nurse FTE and Head Count Information by Site and Unit –as of July 24, 2013

This information captures 48 Phase II units.  If the optimized rotations were implemented as developed, the total FTE would decrease by 74.71 and the total head count would decrease by 186.

Site

Unit Total FTE Before Total FTE After Head Count Before Head Count After Avg FTE Before Avg FTE After

Drumheller HC

Site Summary

14.87

6.11

16

7

0.93

0.87

Continuing Care Drum

14.87

6.11

16

7

0.93

0.87

FMC Hosp

Site Summary

107.92

109.63

137

112

0.79

0.98

ICU

103.67

105.43

132

107

0.79

0.99

Outreach

4.25

4.20

5

5

0.85

0.84

Innisfail CHC

Site Summary

17.99

15.79

23

20

0.78

0.79

Innisfail – Acute Care CHC Medical Nursing 18

17.99

15.79

23

20

0.78

0.79

Northern Lights Hospital

Site Summary

113.89

101.25

122

105

0.93

0.96

Medical Nursing Unit18

22.23

18.90

23

20

0.97

0.95

Surgical Nursing Unit 05

22.05

21.08

24

21

0.92

1.00

Intensive Care Nursing Unit 04

17.00

12.65

17

13

1.00

0.97

Obsetrics Nursing Unit 01

22.50

21.08

25

21

0.90

1.00

Operating Room

14.80

12.80

15

13

0.99

0.98

Pediatric Nursing Unit 17

5.05

4.22

6

5

0.84

0.84

Home Care Combined 27

10.26

10.52

12

12

0.86

0.88

QEII

Site Summary

13.50

14.50

16

16

0.84

0.91

3N

13.50

14.50

16

16

0.84

0.91

RAH

Site Summary

88.26

64.80

112

70

0.79

0.93

PCU 29

4.42

4.20

6

5

0.74

0.84

PCU 27

4.20

4.20

5

5

0.84

0.84

5 East

12.98

9.40

15

10

0.87

0.94

6 East

15.99

9.40

20

10

0.80

0.94

PCU 41

13.21

9.40

17

10

0.78

0.94

PCU 43

12.94

9.40

17

10

0.76

0.94

PCU 44

11.77

9.40

16

10

0.74

0.94

PCU 52

12.75

9.40

16

10

0.80

0.94

RDRH

Site Summary 86.75

80.36

121

100

0.72

0.80

Stroke/General Medicine Unit 33

29.69

26.53

41

37

0.72

0.72

Orthopedic/Urology Surgery Unit 21

23.76

24.76

31

29

0.77

0.85

Day of Admission Surgery/Inpatient Short Stay Unit 24

12.39

12.21

20

14

0.62

0.87

Pre – Admission Clinic

3.97

3.79

6

4

0.66

0.95

Day Surgery

3.19

4.21

5

5

0.64

0.84

Out Patient Surgery Clinics

2.61

3.55

4

5

0.65

0.71

Outpatient Medical Specialty Clinics

11.14

5.31

14

6

0.80

0.89

RGH

Site Summary

204.52

173.71

289

232

0.71

0.75

71 Cardio Medical

20.94

17.69

29

24

0.72

0.74

73 Medical PCU

22.99

17.69

30

24

0.77

0.74

74 Medical PCU

22.61

17.69

33

24

0.69

0.74

81 Orthopedics PCU

25.35

22.11

39

30

0.65

0.74

82 URO & GEN SURG

25.56

21.26

34

26

0.75

0.82

83 Colon & Rec Surge

23.94

20.63

34

28

0.70

0.74

84 General Surgery

20.64

18.32

31

22

0.67

0.83

93/94 Medical [Pulmonary]

42.49

38.32

59

54

0.72

0.71

UAH

Site Summary

124.80

130.90

150

140

0.83

0.94

5C3

13.20

11.20

15

13

0.88

0.86

5C4

11.80

12.60

14

14

0.84

0.90

5D2

4.20

10.50

5

11

0.84

0.95

5D3

12.90

12.60

14

13

0.92

0.97

5D4

10.15

9.80

12

10

0.85

0.98

5E2

10.20

9.80

12

10

0.85

0.98

5E3

21.95

22.40

27

25

0.81

0.90

5E4

12.00

9.80

16

10

0.75

0.98

5F2

10.50

9.80

13

10

0.81

0.98

5F4

13.70

12.60

17

14

0.81

0.90

5G2

4.20

9.80

5

10

0.84

0.98

Wetaskiwin

Site Summary

17.14

17.87

23

21

0.75

0.85

Unit 35

11.24

11.97

15

13

0.75

0.92

LTC

5.90

5.90

8

8

0.74

0.74

Totals

 

789.63

714.92

1009

823

0.78

0.87

This report includes all available data as of July 23, 2013 and is subject to change as additional information is available. 

Please note that it has not been possible to implement the optimized RN rotations as planned to date. 

Staff Scheduling Transformation                                                                August 19, 2013

Phase I and II Registered Nurse Regular Relief Rotations as of August 19, 2013 – This information captures the most current information for the creation of regular relief rotations and indicates the new fulltime and part time regular relief positions being created for the units listed.  When implemented these rotations increase the FTE by 59.54 and the headcount by 68.

Relief Rotation Site/Unit FTE Full Time Positions Part Time Positions Headcount
FMC ED 16.80 16 1 17
QEII Psych  2.10 1 2 3
RGH 62 L&D  8.40 6 4 10
SHC WC RN 8hr  8.84 6 6 12
SHC WC RN 12hr  8.40 8 1 9
UAH 5C3 5C4 5F4  4.20 3 2 5
UAH 5D2 5D3 5D4 5E2 5E3  7.50 7 1 8
UAH 5G2 5F2 5E4  3.30 2 2 4
TOTAL 59.54 49 19 68

There are several relief rotations still under development which will result in additional FTE.

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