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  • 1.
    • Jan Currie
    • Vice President and Chief Nursing Officer
    • Winnipeg Regional Health Authority
    The Big Picture in Winnipeg Regional Health Authority
  • 2. 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
  • 3. Background-the 90’s
    • 1999
      • Winnipeg Regional Health Authority(WRHA)
      • created by amalgamating Winnipeg Hospital
      • Authority and Winnipeg Community Authority.
  • 4. 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
  • 5. Winnipeg Regional Health Authority (WRHA)
    • Provides services to approximately
    • 1 million people in catchment area
    • Also provides services to many
    • Manitobans who live outside the
    • Regional boundaries but receive
    • healthcare services from WRHA.
  • 6. Background
    • In February 2001 there were 1021 vacant RN positions in WRHA
    • Graduating nurses had fallen to 200 in 1999 from 700 in 1992
  • 7. 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
  • 8. 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
  • 9. 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
  • 10. 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
  • 11. 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
  • 12. Retention Strategies - Regional
    • RN Nursing graduates are surveyed annually to determine employment preferences.
    • Vacancy data is posted on University of Manitoba website.
  • 13. Retention Strategies - Regional
    • Aboriginal Initiatives
      • Representative workforce
      • Self-declaration process
    Francophone Initiatives
  • 14. 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
  • 15. 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.
  • 16. WRHA Nursing Overtime Premium Dollars Paid
  • 17. 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
  • 18. 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
  • 19. 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
  • 20. 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
  • 21. 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
  • 22. Retention Strategies -Regional
    • Preceptoring/Mentoring
      • Need for formal preceptor education programs
        • Workshops available through facilities or University of Manitoba Faculty of Nursing
  • 23. Transition Facilitator
      • Transition Facilitator
        • assumes mentoring role for new graduates
        • 2003 Nursing Sector Study – 72% of RN graduates are retained in MB
  • 24. 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
  • 25. 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.
  • 26. 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
  • 27. 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
  • 28.
    • Challenges for the future…………
  • 29.
    • In September 2005 there were
    • 518 vacant RN positions
  • 30.
    • Continue to identify need for nurses based on vacancy reports, retirement projections and the projected numbers of new graduates
  • 31.
    • Considerable concern about the number of nurses eligible to retire in the near future
  • 32. Projected Nursing Retirements in WRHA
  • 33. 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
  • 34. 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
  • 35. 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
  • 36.
    • Need to identify new strategies to:
      • Retain new graduates in the workforce
      • Retain experienced nurses in the workforce
  • 37.
    • Continue to develop HHR forecasting tools such as RN Projection Model
  • 38.
    • “ Even if you are on the right track you will get run over if you just sit there”
          • Mark Twain