SENIOR BEHAVIORAL HEALTH

Lori KuhlmanOttawa University

OAD 49500 Seminar in Applied Healthcare ManagementDecember 6, 2015

STAFFING CHALLENGES IN HEALTHCARE

Via Christi is a not-for-profit healthcare organization that is the largest in Kansas. Senior Behavioral Geriatric Unit has 30 beds and is unique to Wichita. Nurse staffing levels, patient reported missing care and retention of quality staff is a continuing problem. Alternatives, solutions and recommendations will be addressed in this power point presentation.

Tasks Duties

Knowledge Skills Abilities

VS

PATIENT PERSPECTIVE

NURSE OUTCOME

SENIOR BEHAVIORAL HEALTH STAFFING

Evaluation

●Appropriate ratio of Nurse/CNA to patient

●Ethical assessment & interventions towards staffing and patient care

● Staffing Shortage Lead to Negative Impact on Quality, Safety & Service Outcomes

Alternative

Forecast DemandIdentify Policy

Evaluate Staff TalentTrain & Educate Staff

Fix Leadership GapsStaff Retention & Hiring

By 2029, 78 million Baby Boomers in the United States will be 65 years of age, experts predict a

dementia epidemic

More than 60 percent of adults ages 50 to 64 who work or have a working spouse have at least one chronic healthcondition, such as arthritis, cancer, diabetes, heart disease or hypertension

Supportive Care, In-home, Community andInstitutional Locations

BABY BOOMER PATIENT PSYCHIATRIC NEEDS

THE RAPID INCREASE IN HEALTH CARE COSTS PLUS NUMBER OF BABY BOOMERS ENTERING RETIREMENT WILL CAUSE

TRILLIONS IN UNFUNDED MEDICARE LIABILITIES!

Payment Policies Include Incentives to Achieve Thresholds of Quality

Fewer Uninsured Patients and More

Covered by Medicare, Government

Medicaid/CHIP as a Result of Aging

FINANCIAL PRESSURESDEMOGRAPHIC CHANGES

COMPETITION

Penalties for UnintendedComplications, Poor Outcomes

EXCESS STAFF = SURPLUS PRODUCTIVITY ABOVE BUDGET CENSUS BELOW BUDGET NUMBERS ACUITY BELOW BUDGET HOURS

PER PATIENT DAY

POLICY

LWA (LOW WORK ACTIVITY) FAIR AND COSISTENT MANNER

ASSOCIATES UNDERSTAND BENEFITS

ALTERNATIVE #1 EVALUATION

● NURSE BURN OUT

● ERRORS OF OMISSION

● PATIENT BIAS EVENT

ALTERNATIVE #2 EVALUATION

EMPOWERMENT

WORK DESIGN

PROCESS IMPROVEMENT

ALTERNATIVE #3EVALUATION

FIX LEADERSHIP GAPS

STAFF RETENTION & HIRING

ADVISING, DEFLECTING,

PROBING, REFLECTING

NURSE TO PATIENT

STAFFING GUIDELINES

ENVIRONMENTOF CARE

NURSING HOURSPER PATIENT DAY

ACUITY TIEDTO STAFFING

ORIENTING, TRAINING,EDUCATING

Implementation Plan Advanced financial data capabilities with the ability to provide real-time insights to support Senior Behavioral Health staffing decisions.

Ability to measure and demonstrate value and results based on comprehensive data across the care continuum (both acute and non-acute care).

Full participation in mental health information patient for quality

improvement, population health interventions and results

measurement.

Filling Leadership Gaps Educating and engaging RN’s & Psychiatrists on policy.

Advancing Organizational scenario-based strategic staffing and patient ratios.

Feedback

References

ASHHRA Thought Leader Forum-Projected Benefits Landscape (2013).Retrieved from: www.ashhrs.org/about/governance/files/ASHHRA_TLF_ProjectedBenefitLandscape_12-13-13.pdf

Dabney, B., Kalisch, B., Nurse staffing levels and patient reported missed nursing care (2015). Journal of Nursing Quality, Vol. 30, No. 4., pp. 306-312. Wolters Kluwer Health, Inc. Flint, MI.

Schaeffer, R., Wicker, T., Stevens, C., Hyde, S., (2015). Waking up a sleepingelephant: Arizona’s staffing initiative. Nursing Management, Vol. 46,Issue 8, pp. 24-29. Lippincott, Williams & Williams. Danvers, MA.