Nursing Demonstration Project in Nursing Human Resources

Planning

Building Capacity in Nursing Human Resource Planning

A Best Practice Resource for Nursing Managers

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The Challenge….

RetirementsOver 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

InstabilityUnstable employment patterns, heavy workloads and fewer supports for entry to practice negatively impact retention in the profession

Gaps in CapacityEmployers lack the capacity to identify their own HR needs

Need for Change in PracticesEmployment practices and labour agreements impact rates of full-time employment among new graduates. 14% of RPNS and 40% of RNS secured fulltime employment in 2005.

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

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Goals of Demonstration Projects

Contribute to the development of a ‘blueprint’ for Health HumanResources Planning that balances:

1. Nursing Human Resources2. Organization Outcomes3. System Outcomes4. 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

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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

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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.

6Toolkit Project Framework

7Who 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

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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

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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

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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

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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 2007-2008

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Nurse Manager Workshop

• There were 52 participants present at the workshop

• The majority were first line nursing managers

• 83% submitted an evaluation

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Workshop Day OverallWorkshop Day Overall

0%

20%

40%

60%

80%

100%

120%

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Is relevant to my work 95%

Enabled me to achieve thestated objectives 79%

Allowed sufficient time foraudience participation96%Will alter my practice 76%

Format was appropriate88%

Length was sufficient 89%

Audio visuals wereeffective 89%

Handouts containedvaluable information 98%

Organization was effective86%

Overall, this workshop metmy expectations 96%

14Toolkit 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

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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

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Key RecommendationsFunding for future initiatives should be aimed at supporting theuptake and implementation of initiatives identified in theevidence and toolkit to advance the capacity of nursing humanresource planning at the organization and unit level.

Role expectations, educational preparation and opportunitiesfor professional development for first-line managers varyamong organizations. Evidence suggests that there are specificleadership and management competencies for first-line nursingmanagers that are tied to outcomes for nurses, patients andorganizations. Future initiatives should be aimed at definingcore competencies and providing formal mechanisms to assistnursing managers to achieve them.

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Key Recommendations

Organizations should ensure that adequate training is provided tofirst-line nursing managers to ensure they are developing skills ineffective human resource management including planning andforecasting, recruitment including interviewing, bias free hiring,and use of different types of recruitment and retention strategies.

Organizations should provide structures for internal and externalnetworking for first-line managers. First-line managers identifypeer mentoring and access to, and support from their directsupervisor as the most common mechanisms for attainingcompetency in nursing HR planning and other leadership andmanagement skills. Organizations should consider developingformal mentorship and support programs for first-line managers.

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Key Recommendations

Organizations should provide nursing managers withconsolidated and consistent reports of humanresource information in order to assist nursingmanagers to effectively manage and plan for nursinghuman resources. Currently information tends tocome from disparate sources and informationsystems and source at different time intervals.Strategies that seek to consolidate information inregular reports would improve the planning andevaluation cycle of nursing human resourcemanagement.

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Key Recommendations

Nursing managers should be provided withguidance in the understanding, analysis andutilization of reports on human resourceplanning and encouraged to review their planning on aregular basis.

Regular reviews of staffing and scheduling proceduresare recommended (minimum yearly) in order to beresponsive to the recruitment and retention issues. Inaddition, triggers such as staff complaints, increasedsick time or overtime may warrant a review andfurther action.

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Key Recommendations

In our interviews with experts, all nursing managersstated that in learning about staffing and scheduling,most had relied on their colleagues for support ortaught themselves - formal mechanisms for learningstaffing and scheduling techniques would have beenvery helpful to them as new nursing managers.

Creating healthy workplace environments, providingadequate training opportunities for new nurses, aswell as supporting professional development areimportant steps in both the recruitment and retentionprocess.

21Toolkit Project Expert Panel