Data Trails

Healthcare has seen some major changes over the last several years, and the nursing profession has changed along with it. The result has been a reduction in the supply of qualified, experienced nurses. Those who remain are working under conditions of larger  case loads, complex technology complexity and increased knowledge of patients. A medical issue which once warranted a lengthy in-patient stay is now treated on an out-patient basis, because of managed care requirements.

The nurse’s role of patient care is still the same, but the importance level  has risen. Since hospital stays have become shorter, a patient who undergoes surgery used to stay for one week, but now only stays two to three days. Nurses must now assist the patient to bring him or her to a functioning level and put together an exit plan to support the patient and assure quality care, while discharging the patient earlier. This makes efficiency and quality of work vital. Nurses have always said, when talking about the changing environment, that the problem has been the actual working conditions. These conditions include too few nurses, lack of support, an uncertain future, and forced overtime.

The role that the patient’s family plays has also changed in the last decade. Both patients and their families are more educated and involved in the process now. Families used to trust the care of the patient to physicians and nurses; now it is normal for family members to stay 24 hours a day, ask questions about the care, and put more demands on the nurses.

Article written by Mike Pumphrey – OnShift

The mood of the American Health Care Association’s annual meeting was unlike years past. At the keynote address, AHCA President and CEO Mark Parkinson proclaimed that massive cuts to Medicare and Medicaid have providers “fighting for their survival.” This was a much different tone than years past where a 1 or 2 percent change in funding was the main topic of conversation. Providers realize that the time to react is now.

This sense of urgency translated to a lot of show floor activity. Providers proactively sought out solutions that can help them improve care, increase efficiencies and reduce costs. This wasn’t a crowd focused on tchotchkes. They were focused on finding answers.

OnShift’s booth was bustling with providers. These providers understood that the most effective way to offset these massive funding cuts is to get control of their largest expense – labor. OnShift staff scheduling and shift management software allows long-term care providers to automate scheduling, prevent overtime before it occurs, and increase efficiencies through open shift management. Our booth was filled with a common reaction … “Wow”. Providers were blown away by how easy it is to use and the amount of money that they can save.

AHCA’s annual meeting gave us a forum to focus, learn and develop strategies to help this industry. That’s just what we’ve done. Because we understand the challenges ahead, OnShift is now offering reduced pricing. We hope this offer will make long-term care providers cost control efforts a little easier — and a lot more impactful.

Believe it or not, there is a shortage of nurses. The current shortage in qualified, experienced nurses is not predicted to get any better during next several years. Add to that, most of the senior level nurses and nurse managers are getting close to retirement. When they leave, a small number of nurses will be available or even willing to take on a management role. The current climate of understaffing, 24-hour shifts and increased management responsibility leaves younger nurses reluctant to fill the gap.

Picture originally posted in www.scrubsmag.com

Dean Munro sees the problem continuing. “Most nurses are around 45 years old, white, suburban women, 80% of whom are currently working full-time. As they retire, they often leave because they’re burnt out; unfortunately, there are simply not enough nurses to replace them.”

Not long ago, industry analysts were saying that there were too many nurses – not so anymore. Why aren’t there enough nurses to replace those who are retiring or leaving the profession? Hiring managers are finding that younger Baby Boomers and Generation Xers are no longer viewing nursing as a viable profession because of the difficult work environment combined with a desire for more control, quality and balance in their lives. Sounds like we are lazy. In addition, women have more choices of fields to enter. There are more options open to women interested in healthcare; before there was only nursing. To many, the working conditions are bad, the responsibility is very large and the workload  is heavy.

The average age of new nurses used to be around 21 or 22; now graduates have varied ages, often well into the 30’s. For many, nursing is a second choice career. They enter into a more acute clinical environment, the patients are sicker and more complex. Many schools have changed the curriculum, but still entry level grads have only basic skills.

Hospitals are in competition with each other to attract and retain nurses in a very competitive market. Some hospitals are using programs similar to internships for doctors to ease the transition of recent college graduates into fast-paced, technologically complex clinical settings. Since the new grads need more experience, many hospitals create a professional development transition program. Starting with a week-long orientation, this program combines classroom time, and hands-on time with an experienced staff member for six months. Preceptors are compensated while they are trained Mentors are sometimes volunteers. It is a supportive atmosphere and has received a very positive results.

Hospitals have been forced to be very flexible in their approach to overcome the shortage of nurses. Some use travel nurses to fills gaps wherever needed. Many nurses often work “per diem” to keep working without the pressure of a full-time commitment. Other approaches include sign-on bonuses worth several thousands of dollars, referral bonuses, and flexible hours. Flexibility of hours may allow nurses to work three 16-hour days.

Many  hospitals are now focusing their efforts on retention. It is becoming critical to pay attention to all factors that are important to RNs in the clinical setting: having a voice and the ability to have some control over the practice of nursing. For example, a unit council meeting takes place on a regular basis and identifies problems and concerns in regards to patient care. Years ago the nurse manager addressed this issue. Now TQM mandates that more people are involved in the resolution and decision-making. Staff members are more involved in operational issues these days.

The professional relationship between the nurses and physicians is a factor concerning the retention of nurses. If there is a positive relationship, one that is consultative, respectful, and supportive, then job satisfaction is at a high level. On the other hand, if the relationship is negative, turnover is high.

Benjamin Franklin once said, “You may delay, but time will not.” As part of the human race we are all getting older with time. As time passes, we are in positions to take care of our elderly loved ones. Sometimes it becomes necessary to place them in a long term care facility to better watch over them. Whether it is a parent, a grandparent, or an elderly uncle, we want to make sure we create the best environment for them.

The first, and probably most familiar, type of LTC facility is the Nursing home. Nursing Homes are the only LTC facilities that have mandatory around the clock supervised nursing care, specialized therapy services, and nutrition management. These facilities will more than likely have minimum nurse scheduling requirements. Most of the time, the people needing the highest level of care are residents of nursing homes. Residents in a Nursing Home will usually be paired two to a room.

The second type of LTC facility is sometimes referred to as Boarding Homes. Normally these facilities are called Assisted Living facilities or Senior Living and are available for more independent residents. These facilities charge for room and board and sometimes charge extra for personal care services like bathing, dressing, and medication distribution. It is not mandatory for these Assisted Living Homes to provide nursing services, although some usually do have nurses on staff.

Adult Family Homes are like residential homes or apartments. They are allowed to care for up to six residents. They provide room and board, laundry, necessary supervision, assistance with activities of daily living, personal care, and social services. Single and double rooms are available.

The most important aspect in finding the right LTC facility for your loved one is to research and choose the one that fits the specific needs of the individual. Everyone is different, and every LTC facility will be too, with its own identity and culture.

Let’s face it; we’re all getting older. Although some people try an assortment of ways to delay the process, we are all headed in one direction. As we get older, so do our parents, or even grandparents, if they are still around. If circumstances get to the point where it is necessary to place our elderly loved ones in a long term care facility, how do we decide which one?

Just like anything else, it is very important to gather as much information as you possibly can. This way you are educated. Talk to people who have placed their loved ones into senior living or a nursing home. Choosing the right LTC facility is an important decision.

First, look into the facility’s track record. You can get access to the state’s report on that particular facility, which will include any complaints against the facility, or any actions the state had to take to enforce compliance.

Second, visit the facility. Look around, talk to some of the current residents. Ask about the facilities stand on staffing levels and nursing hours per patient day (HPPD). These things normally lend to the quality of care. Identify the particular needs of your loved one. Every situation is different, so it is important to match the needs with the services of the facility.

Finally, there are some options as far as what type of LTC facility. Some facilities provide 24 hour care with a nursing staff. Others are for more independent residents and provide “assisted care” and may or may not have nurses on the premises at all times. And still others are more of a residential type with some or limited assistance.

Article written by Mark Woodka, CEO – OnShift

Originally posted on www.onshift.com

Nursing homes in Ohio are facing a bleak reality. The two-year budget that Governor Kasich just signed reduces Medicaid rates to nursing homes by nearly 6%.

While total Medicaid spending in Ohio will creep up a bit, the climb will benefit home and community care, which tends to be more cost-effective and popular with seniors.

But what’ s interesting in Ohio’s approach is that the budget calls for incentives for nursing homes that meet quality benchmarks. These measures are expected to include things like staffing levels and patient satisfaction. The bottom line on all of this is that if you run a high quality, operationally efficient nursing home delivering great care, you will be rewarded.

The focus on staffing levels is critical for two reasons. First – if you truly gain control over your staff scheduling, ensuring the right people are where and when you need them, then your organization, and your residents, win. Secondly, providing proper staffing levels not only helps to ensure care, but it also controls labor costs. Keep a close eye on your nurse staffing levels, at all times, and you uncover opportunities to reduce overtime and over-staffing.

Long-term care providers in Ohio are wading through the details today, figuring out what this means to them and what the next steps are. With drastic cuts sweeping the industry across the nation, this is a wake-up call to providers to optimize their businesses and provide great care. Strategic staffing practices can help get you there, and deliver immediate benefits. Take a look at The Executive’s Guide to Staffing Best Practices for specific tips that make a big difference in today’s environment.