Category: Featured

How Do You Create an Effective Hospital Culture?
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How Do You Create an Effective Hospital Culture?

iStock 000019180736XSmall How Do You Create an Effective Hospital Culture?It’s proven that hospitals with an effective culture provide better patient care and outperform competitors.  To achieve a desired hospital culture, you must identify what kind of culture you currently have, decide what you want your culture to be, and shift everyone toward the preferred culture.

The easiest way to assess current culture is to simply observe. How does your staffing act? Are they respectful toward higher authority? Do they have the patient’s best interest in mind? How is the temporary staff being treated? Look for common conduct and visible signs. Listen to what your nurses, doctors and patients are telling you. Read reviews of your hospitals. Surveys. And more surveys. Performing initial in-depth surveys for patients is the easiest way to evaluate your culture. Then, continue to conduct follow-up surveys to evaluate progress. These will all give you an idea of what your current hospital culture is like.

What did you learn from your observations? Did you find that your hospital values safely, effective care, respecting the dignity of all who come through your doors? If you said yes to all these, then your hospital is on the right track. If not, then you certainly have some work to do. From here, you can decide what you like about your current culture and, of course, what you need to change.

Things to strive for in a hospital culture:

  • Ensuring patient safety
  • Attitude of teamwork and open communication
  • Equality of staff
  • Comfortability in reporting potential hazards without fear of reprimanding

After you’ve decided on a solid hospital culture, it’s now time to move your staffing in that direction. This is definitely a difficult task in the healthcare staffing world with a plethora of temporary staffing and travel nurses coming and going.  These are some steps to start with:

  • Have a staff meeting. Clearly communicate the culture to your employees and the results you’d like to achieve, and then over communicate and remind them daily.
  • Have fun with it by providing incentives for complying with the hospital culture.
  • Make the staff feel like they are personally responsible for the successfulness of the hospital.
  • Be the leader! The culture will not survive if the authority is not setting the example

Keep it up. Your culture isn’t something you start and then ignore. A strong culture is a result of care and enforcement. How do you know that you are progressing in the right direction? Go back to step 1. Observe, listen and survey. Hopefully you will see the progression from where you started.

Remember you can create the idea of the culture you want, but only your staff can make it a reality.

 

 

 

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LinkedIn, are you using it to recruit?

LinkedIn has become the #1 social media network among recruiters, with over 120 million members. With it’s easy search of keywords, skills, specialties and recommendations, it alleviates a lot of the previous steps to finding the right candidate.

Are your recruiters using it to search for potential healthcare staff?

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What is your hospital doing to keep nurses happy?

With the current nurse shortage, it’s no surprise that hospitals should be doing all they can to keep their nurses happy.

Maintaining an environment where the nurse wants to work is critical for not only nurse retention, but also patient quality. The overall stress accompanied by an uncomfortable and disrespectful work environment can send nurses running for the door. The key is finding out what makes nurses happy enough to stay.

The Nursing Organizations Alliance developed a set of principles to help hospitals and other health care entities create positive work environments. More than 40 nurse organizations have endorsed these principles. So, what are you doing to keep your nurses happy?

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Evaluating a Healthcare Staffing Company's Cost

iStock 000004994931XSmall 1 Evaluating a Healthcare Staffing Company's CostOf course no evaluation of healthcare staffing companies would be complete without a look at cost. However, we have saved cost for last because it is really a combination of the first two factors the quality of the candidate and the system of its delivery.

Obviously cost is a complicated and may be more than we should tackle in a single post, but we will give it a shot. First off though we will assume that you are already past the mindset that “travel nurses cost too much”. The cost of temporary healthcare staff is not expensive compared to what it costs to staff your hospital with a permanent staff member, you can learn more in this post about Can travel healthcare staff actually save you money? Sure there are times when it makes to use travelers and times when you flat out don’t need them, in this case we will assume you have made the decision that you do need them and you are merely comparing one travel nursing company to another.

There are some things you need to consider when looking at a cost. There is obviously not a lot of information available on individual companies policy towards determining bill rates so this will be a fairly generic overview, but it should give you a few things to consider when you are evaluating travel nursing companies costs.

Areas of Expense Affecting Healthcare Staffing Company’s Bill Rates

First remember that there are a lot of factors that go into determining bill rates and they will vary from company to company, but some of the most common areas of expense affecting bill rates are:

  • Rate of pay
  • Vacations, holidays
  • Worker’s compensation
  • Unemployment
  • Social security (FICA)
  • federal state and local taxes
  • Bookkeeping costs
  • Recruiting
  • Advertising
  • OSHA bloodborne training
  • HIPAA training, drug screens
  • Hep-B screen testing
  • Malpractice insurance
  • Housing
  • Other traveler benefits
  • Costs of hospital’s protocols (i.e. screening requirements and background checks required by the hospital.
  •  The length of the contract
  • The number of guaranteed hours
  • VMS involvement

Considerations When Evaluating a Healthcare Staffing Company’s Bill Rates

Based on these somewhat standard items that you need to keep in mind, you then need to look at the service you receive from the travel nursing or the travel allied health company and the quality of candidates from the point of view of what you are willing to pay for them.

So in conjunction with cost you need to consider the importance you place on the following areas:

  • Quality of candidates
  • Thoroughness of screening processes
  • Good communication with the nurse by the staffing company
  • The level of communication you want with the staffing company (not the VMS)
  • Customer service you want from the staffing company

Conclusion about Evaluating Healthcare Staffing Company’s Bill Rates

All of these areas are indirectly tied to the bill rates of the healthcare staffing company. For you HR and nurse managers making the decisions, the difference may be seen in a few dollars difference per hour either way, but can have bigger impacts than that. The question is, is that difference worth lower quality candidates or not having direct contact with the staffing company (both areas we discussed in the previous two posts in this series)? Or conversely is that extra service really worth the greater expense?

Conclusion about Evaluating a Healthcare Staffing Company’s Processes

The key thing to remember when evaluating a healthcare staffing company to work with is to think of your needs and what is going to be the best fit for your hospital. Just because a company has a slick sales presentation or is the biggest doesn’t mean they are going to be the best fit for your facility. There are a lot of factors that going into finding that right partnership for you and your hospital.

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Why should I use one company over another to meet my healthcare staffing needs?

iStock 000007424729Small 5 Why should I use one company over another to meet my healthcare staffing needs?There are a lot of factors to look at when it comes to determining what travel nursing company you think will meet the needs of your hospital best. We looked at these partially earlier in two posts, one about evaluate the healthcare staffing vendors and another about  healthcare staffing providers financially stability, but now we will take a look at how to compare companies when you are looking for new ones to work with.

Several factors need consideration when working with individual healthcare staffing companies, but they all basically center on their ability to provide you with what you need, qualified and caring nurses or allied health professionals at a cost that provides value to your hospital and patients.

The key thing to remember when evaluating a healthcare staffing company to work with is to think of your needs and what is going to be the best fit for your hospital. Just because a company has a slick sales presentation or is the biggest doesn’t mean they are going to be the best fit for your facility. There are a lot of factors that going into finding that right partnership for you and your hospital.

Over the next three weeks we will be looking at three important parts of this evaluation:

  1. Evaluating a Company’s Nursing and Allied Health Candidates 
  2. Evaluating a Healthcare Staffing Company’s Processes
  3. Evaluating a Healthcare Staffing Company’s Cost
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Nurse leaders are making due and getting better for it

A recent benchmarking survey discussed at The Leaders’ Lounge looked at impact that the economy’s downturn had on nursing units, with some not all too surprising results, but some that do have a direct impact on healthcare staffing, including nurse managers:

  • Cutting back on educational travel
  • Delaying filling open positions
  • Renegotiating supply costs and contracts
  • Cutting back on overtime

They even had to do things like:

  • Implement mandatory paid time off a couple days through the year
  • Decrease employee’s pension contributions
  • Eliminate  bonuses for management
  • Stop matching retirement fund (401k) contributions

Actions like this had the not surprising effect apparently of reducing the nursing staff’s morale, which led the nurse managers surveyed to rely on actions like:

  • Making verbal recognition from leadership a priority
  • Writing thank-you notes to staff
  • Creating formal employee of the month or similar recognition programs
  • On the upside though the survey showed that nurse managers are expecting to see spending in hiring and travel increase in the next year, with 74% saying their facility is hiring right now, and 65% planning to travel to a couple of conferences in 2010.

    Based on these findings it looks like that despite the negative effects of the economy over the last year, there were also improvements in employee engagement, efficiency and retention efforts. Which coupled with smart hiring practices and smart use of temporary staff as the recession ends should help improve patient care and reduce nurse burnout over the next year.

    What are your thoughts and experiences over this last year?

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    Are your healthcare staffing providers financially stable?

    Awhile ago we looked at how to evaluate the healthcare staffing vendors you work with so you can make sure you can working with the best ones and getting the most value out of them. Well, in light of recent news of a major healthcare staffing company reporting that it may have to file for bankruptcy it made me think of one other thing you need to look at when evaluating travel nursing or travel allied companies, their financial stability.

    The last thing you want to do is to become heavily dependent on one company only to have that company go out of business and leave you with the hassle of dealing with temporary nurses, therapists or techs who no longer have a company behind them. In addition if this were to happen to a company you were working with you may find yourself suddenly either scrambling to find a new healthcare staffing company or forced to working with an unfamiliar company that bought out your contingent staffing company.

    This is not to say that you should only work with “big” travel nursing or travel therapy companies. Because being bigger does not necessarily mean more stable. Instead you need take a closer look at their financial standing. Here is a basic list of some of the actions you can take when you are looking at new companies to staff your hospital or skilled nursing facility:

    • If they are publicly traded visit their corporate website and check out their annual reports to see their balance sheet
    • If they are a private company look for recognized signs of growth like Inc 500 awards or fastest growing industry and area awards
    • See how many employees they have, it needs to be large enough to handle things like billing, doing background and reference checks and providing your hospital with the support it needs
    • Find out how long the travel nursing or travel therapy company has been in existence
    • Find out if they ever have payroll issues
    • Ask for references from other hospitals and healthcare facilities they work with

    What about you? Do you have any other questions you ask to gauge the stability of a contingent staffing company?

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    9 Easy Ways to Welcome Travel Nurses to Your Unit

    Daily life in a hospital unit can be busy and hectic, especially one in need of temporary staff, but one of the best ways to get the most out of the travel nurses that come to work for you is make them feel welcomed.

    They are there to help you and your staff so why not do a few things to celebrate them. We are not talking a party here (but hey, who doesn’t love a party), but just some simple steps you can take to show them you are glad they are there.

    Here are a few ideas:

    1. Give them a small gift on their first day
    2. Make a welcome sign they see when they walk in on their first day
    3. Set them up with a travel nurse buddy
    4. Have some of the team take them to lunch
    5. Check in with them a couple times during the day
    6. Give them a list of the best places to eat in the area for lunch
    7. Give them a guidebook to your city
    8. Plan a night out with the team
    9. Have a breakfast/snack reception

    What about in your unit? What things do you do when a new travel nurse, or perm nurse for that matter, start in your unit?

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    Time to examine your healthcare staffing companies

    In past posts we have discussed how effective temporary staffing can be at improving the quality of care, reducing costs and improving revenue at your hospital or healthcare facility if it is viewed as and made part of your overall staffing plan, rather than a last resort.

    One aspect of this plan should be a formal vendor review process where you can rate the effectiveness of the staffing vendors your hospital works with. After all if you are not measuring it, how do you know how well or poorly it is meeting your needs?

    Implementing this process, whether you work with many travel nursing companies, just a few or with a VMS will help you answer questions regarding the staffing companies’ quality, cost and efficiency. And help you make changes that maximize this resource for you.

    A benefit of having this process in place, which we will discuss later in this post, is that it gives the healthcare staffing companies you work with an upfront set of expectations you believe they should meet and creates an equal playing field for all to start on.

    There are some basic things you will want to keep in mind as you build your Staffing Vendor Evaluation Program:

    • You need to build a system that allows smaller providers to be represented fairly alongside larger ones
    • You should include both qualitative discussions about the candidates and quantitative measurement tools about the staffing company
    • You will want to include a tool that measures the overall quality of the healthcare staffing companies

    To put this plan in place for your hospital, skilled nursing facility or ambulatory care center, let’s take a look at these three areas.

    How do you build a system that allows small providers to compete with the larger ones?
    This can be accomplished by looking not at how many submittals a company provides but what is their rate of success. You can determine this by first establishing a baseline level of success your hospital expects from a healthcare staffing company. So if you believe that one out of every eight candidates should be interviewed and one out of every 20 candidate submitted should be placed for larger staffing companies, then it would be reasonable to expect that same rate of success from a smaller travel nursing company, just at a smaller scale.

    How do you measure quality of candidates?
    This is where great internal communication at your hospital or healthcare facility comes into play. If you are at a smaller to midsized hospital where you are both the hiring manager and nurse manager working with the contingent nurse or therapist then this is simple as asking yourself how well they worked out, would you hire them again, etc. However if you are at a larger hospital with a hiring manager responsible for hiring for many different units you will want to make sure you have a formal process in place that includes both a standard list of questions or survey that gauge performance that the manager completes and a direct feedback session between the department using the staff and the hiring professional.

    How do you evaluate the overall quality of the staffing company?
    This should happen during some sort of set direct feedback meeting and be at least quarterly meeting where you evaluate the companies you are working with and determining their status for the next quarter. Whatever the schedule is, during the meeting and evaluation process should be a thorough evaluation of the travel healthcare companies or VMS you are working with that looks at them from a holistic view and evaluates them based on a set list of criteria that includes items like:

    • Bill Rates – This measures how competitive they are in comparison to their competitors and in relation to their quality
    • Fill Rate – This looks at how many jobs they fill versus the number of chances they have to fill them
    • Candidate Quality – This should be completed by the unit manager and looks at the overall quality of the candidates submitted
    • On the Job Performance – This should be completed by the unit manager and looks at the ability of the past hired candidates to do the jobs they were hire for
    • Time to Fill – This evaluates the speed a healthcare staffing company or VMS can fill your open positions
    • Response Rate – This is the number of requests for staff by your hospital divided by the responses the company provides
    • Number of Submittals – This is a measure of how many nurse resumes did they send in for each open job
    • Accounts Receivable – This is looking at how fast invoices are received from the travel nursing company or VMS

    By using all these variables in a scorecard type of format you will make sure you don’t have tunnel vision on the value of one company over another. For example, from a hiring manager’s point of view this can help avoid focusing on one vendor who may be easy to work with, but provides bad candidates. Or from a nurse managers point of view it can prevent falling in love with a company that provides great candidates, but takes forever to fill needs and is even slower to bill you. By aggregating all these scored categories in one area you will get a complete view of the healthcare staffing companies you are working with and give yourself a starting point to improve them.

    How can you use this scorecard to improve the healthcare staffing companies you work with you ask. Simply share the information with them, both before you work with and after each evaluation. Most, the good ones anyway, want to improve their service to your hospital, so sharing their results with them gives them a snapshot of their performance for your hospital and alerts them to areas to improve on. This will only improve the quality of your relationship as well as saving you money.

    The next step is to formalize the follow up of this process. After you share a healthcare vendors score with them you should designate a reasonable time-frame for them to improve on their score, however if no improvement is made you need to add that vendor to a Do Not Use List. This is where this process will save you time and money in the long run.

    What about you? What type of evaluations tools do you use?

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    Makeover your unit by integrating travel nurses

    iStock 000002060886XSmall 2 Makeover your unit by integrating travel nursesTravel nurses are great at stepping in right away and helping out. But any little thing you as a nurse manager can do to help speed up that process will help her acclimate faster and in the end help your unit perform better.

    Integrating a travel nurse into your unit is really just a matter of making sure four things happen.

    1. They know they are welcome
    2. They know your policies, procedures and systems
    3. They know what is expected of them
    4. They know the doctors

    Aside from the standard travel nurse orientation program, one of the most simple ways to do this is through designating a travel nursing buddy for your travel nurses.

    What does a travel nurse buddy do? Creating this role is really just formalizing what you would hope is going on anyway, that someone is there to answer a travel nurses questions, help her with any new systems she may not be familiar with and just be a friend.

    There are multiple ways to do this, but a few options are:

    • Choose an experienced nurse for each traveling nurse to pair up with and let them know that they are someone they can go to when you are not available and give each traveler their own buddy
    • Choose an experienced nurse who can be the go to nurse for all the travelers

    There are pros and cons of both approaches, and they are by no means the only options out there, it really just depends on your units situation, but whatever approach you use the key is to make sure the travel nurse buddy is aware of the four goals of the program and has the kind of personality that makes people feel welcome and experienced enough to handle it.

    This can also be a great way to empower your permanent nursing staff and give the some leadership experience, which will only make them better nurses.

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