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INQUIRY: Quality Committee Agenda 

 

Would any of you be willing to share a sample of what your Quality Committee agenda looks like?   

 

Responses:

  • Pioneer Medical Center: Agenda
    • The committee reports include a brief verbal update of what is going on in that committee. I believe most of the committees have an agenda and minutes for their meetings. Quarterly reports are given orally at every 3rd month at QIC meetings. So in January everyone will report on Oct. - Dec. 2014. We use every 3rd meeting for just departmental reports but not the other committee reports. Not enough time to do both. We also report on the goals for the next qtr.
       
  • Crow/Northern Cheyenne Indian Hospital: Agenda
     
  • Sidney: I have rotating topics: Strategic Plan Review, Customer complaints, HCAHPS, Service recovery, on the agenda once per quarter.
     

    • 1. Patient safety

      Safety stories

      Falls and Med error data

       

      2. Department Reports (departments report twice a year)

                                                                        

      3. Compliance reporting

      Safety Minutes

      Medical Necessity Issues -

      Payer Audits -

       

      4. Customer Service

                Connect report (our automated calling program to discharged patients)

                Patient and Family Centered Care Update -

        


       

       

  

INQUIRY: On Call Nursing Staff  

 

I am looking for some ideas on how to have a nurse on-call 24 hours a day with very limited nursing staff?   Do all facilities have on-call staff around the clock?

  • Pioneer: Our nurse supervisors take call on day shift till 6p then the nurses take call for nights 6p-6a and on weekends (days and Days). They sign up for call and are paid  $2.00/hour for call time.
     
  • At Deer Lodge Medical Center we do not have anyone on call.
     
  • Glendive Medical Center: We do not have on-call staff, unless needed due to low census.
     
  • Daniels Memorial Healthcare: We do have an on-call RN 24/7 .  We have just started using an LPN who is IV certified to help us take call and then we just make sure that another RN would be available if needed.  It is not always easy to get the call shifts covered.  Each nurse who is close enough to take call takes 24 hour call shifts (sometimes will split and take a 12 hour call shift).  We pay 2.50/hr for being on call and time and a  half if called back in.
     
  • CMMC: We do not always have a RN on call. When we need extra help we start calling. 
    We have a couple RN's who are willing to come in extra and that is where we start.
     
  •  At Clark Fork Valley Hospital we have 1 call nurse on call every night from 7p-7a.  If they are needed then they are called in and paid time and a half. No one is on call during the day because there are 3 nurses staffed versus 2 at night.  Call is a definite source of contention for staff and understandable so, I have contemplated doing away with it and hoping people will come in if called but I'm afraid that person would always be me
    .
     
  •  Liberty Medical Center: I schedule a nurse on call from Friday evening at 7pm until Monday at 7am  (this doesn't always work out because of requests for time off, etc).  They are paid $2 per hour for being on call, and if called in, are paid a call-in wage of $30 for the first hour, and their regular wage (OT if applicable) plus $2.50 additional per hour call-back pay.  The nurses would rather not do this, of course.  I started by posting a calendar for volunteer sign-up, which did not work out at all, so I started scheduling weekends.  Each nurse is on call about one weekend every 7 or 8 weeks.  As for the rest of the week (Mon 7am - Fri 7pm) and any weekends that are not covered, I as DON am on call 24h/d.
     
     

INQUIRY: Holiday Schedules 

 

I am looking at our Holiday schedule and wanted to see how other places do theirs, i.e. do you group Christmas and Christmas eve the same year or give the staff the option to choose certain schedule.

  • I did a progress move a few years ago in a large hospital setting. I "grouped" the holidays so if you got assigned a holiday it automatically came with the eve. So for example if you were assigned Christmas you automatically knew you were working Christmas Eve. This was done because of the historical issues with night shift and day shift feeling "cheated". It was a universal change and applied to all shifts. The upside was...it only applied to the big three. Thanksgiving, Christmas and New Year's. You only got assigned to one each year on a rotating basis. So if you got Christmas this year, you would know you did not have to do it again for two years. That did away with the "blackout" issues historically for vacation. So if my staff wanted to plan a Disney Christmas cruise, they could do so without worry. The first year everyone freaked out and did some trading, which I allowed...but did not honor two year immunity for the trade if they split the eves with a co-worker (that would create a short staff issue). It takes some work, but the staff grew to love the security of the schedule and it was an administrative winner. You will always have people that hate it. I was shooting for 80% satisfaction.
     
  • I believe that our nursing staff does group Christmas and Christmas Eve together.  I know in the laboratory department, they have worked out a rotating holiday schedule where each Med Tech is responsible for at least one holiday per year (6 holidays total).  If the Med Tech is on the holiday, they are responsible for the day before and the day after to work.  They also rotate two other Med Techs to be available for the day before and the day after.  If they want it off, it is their responsibility to make the trade.  I know it sounds a little confusing, but it actually works well.  You know which holidays you are responsible for way in advance and this eliminates everyone requesting time off over one holiday. 

     

  • We have had a holiday rotation here that includes all of our holiday pay dates for several years - probably close to 10 years.   Christmas and New Year's Eve are bundled with the day.  We have a different  staff than when we implemented and some of them requested we split the holidays fall of 2013.  Since we had already worked all the other holidays, we decided to leave it and vote in January of 2014.  After the holiday season was completed, we offered a vote in January.   By January, no one even wanted to vote.  They wanted it left as it was.  Our staff works 4 holidays per/year.  We pay at least time and a half for all of them.  We pay double time for July 4th, Christmas and New Year's.  All of our holiday pay is now calculated midnight to midnight except Christmas and New Year's.  We begin holiday pay at 1700 on the "eve" and end it at midnight on the "day".  

    We currently do not tie the day before or after to the holiday for scheduling purposes.  We may have to...
     

     

  • We have a holiday rotation so you know which holiday you work...forever. If someone leaves and is replaced, they assume that spot. Our staff wanted to have Xmas eve and Xmas day as well as new years put together as one holiday.
     

  • I think your pay policy is fair. Here at FMDH, the holiday rotation includes New Years, Easter, 4th of July, Thanksgiving and Christmas. I include the day before and day after as the expectation that an employee should expect that they may be scheduled to work that holiday- if you do not do that, as you know, the staff will request every day around the actual day off which is impossible to staff. We group them together so people are able to travel away if is their holiday off.