Desperate to retain frontline health-care workers and reduce burnout among stressed and overworked staff, a non-profit health agency is offering monetary prizes for workers to come up with innovative ideas to ease the workplace crisis.
The Health Workforce Innovation Challenge (HWIC), launched earlier this year by Healthcare Excellence Canada (HEC), a not-for-profit charity funded by Health Canada, offers up to $122,000 per team to help with retention and staff satisfaction.
More than 100 teams across Canada have submitted applications to the year-long contest; some have already been awarded funding. Along with monetary awards, teams get access to resources, coaching and networks. All teams include representatives from frontline staff and people with lived experience.
- The Mobile Integrated Health Program (MHIP) in Saskatchewan, which supports eight programs, adapted shift schedules to allow for improved and scheduled time off, breaks during working hours and better co-ordination among teams during work hours.
When paramedics transitioned from 9-1-1 models to community paramedicine, they were working fewer shift hours, affecting staff benefits like time off. Programs in the MIHP portfolio operate under contracts – different start times, schedules and locations – without easy remedies for teams to crossover during work hours.
“Through this initiative, we were able to, with some of the prize money, expand their hours to a full 12-hour shift,” says Ryan Omichinski, site lead. “With those expanded hours, we were able to provide dedicated breaks in another one of our programs, which is for paramedics supporting police service detention.”
Previously, paramedics in detention could get called back during their break. Now, coverage from the community paramedics serves the needs of both teams and enhances collaboration within MHIP. Police Services also has opened its fitness facility to paramedics, helping staff to recharge at work.
“It provides an opportunity for other paramedics to maybe look at diversifying, you know, their practice, as a paramedic,” says MHIP manager, Angela Sereda. It starts with understanding staff needs. “What are they wanting? How can we work to retain them?”
The unit is considering benefits for another team, the Healthcare Health Bus. The bus staffs nurse practitioners and paramedics to support community health. They work six-hour shifts but with team-sharing, could increase hours, staff well-being and overall retention.
- When it entered the HWIC challenge, leadership at Runnymede, an Ontario hospital, was dealing with its 2021 employee satisfaction survey that showed lower staff engagement than in previous years.
Hospital leadership and unions worked to change shift schedules to allow more consistent time off during weekends. Another area for improvement was visible leadership. Senior leadership responded with regular rounding to build presence and recognize individual staff members.
“In the beginning, the entire team (would be recognized). Of course, we want to recognize the entire team, but is there anybody who comes to mind who lives up to the values [of Runnymede]? Tell me who that person is, and then, usually one or two names pop up. And then I would ask them to explain why,” says Karimah Alidina, Chief Nursing Executive.
“What are they wanting? How can we work to retain them?”
After rounding, Alidina goes back to her office and handwrites a thank-you note. She hand-delivers it to staff with a voucher for the coffee shop as a token of appreciation. Alidina says she plans to standardize the practice across the organization.
- Employee satisfaction is top of mind at Halton Healthcare. The medical lab has more than 100 staff, across three sites. The pandemic impacted medical lab technologists (MLT) with the implementation of coronavirus testing as well as many retirements across the country. The 24/7 service works behind the scenes at hospitals, staffed by shift workers with sub-specialties including transfusion medicine and microbiology, but also quality improvement and information systems.
Staff engagement surveys at Halton Healthcare identified career development as an area for improvement. In response, Halton began a weekly lunch-and-learn along with internal and external training opportunities. Samira Ahmed, team lead, has noticed a big difference. At shift change, staff eagerly wait for her to arrive to talk about updates or ask questions. “When any initiative is driven by the lab staff, the engagement level is completely different,” Ahmed says.
- Another team is using a time in motion study to collect data. Nurses on a medical unit were observed during direct tasks with patients, indirect tasks for patients and non-value-added tasks like looking for equipment or checking supplies.
Once the team from McGill University Health Centres (MUHC) completes its analysis, it will share its findings with nurses to help do more of what they do best – caring for patients. The goal is to divert 30 minutes to an hour each shift from non-value-added tasks to direct care.
“We can all assume we know what they’re doing, but we don’t really know until we actually get in there and see what they’re doing and what they’re dealing with on a daily basis,” says Jasmine Hill, a nurse on the team.
- Victoria Casas-Alcuaz, a clinical nurse specialist, and her team at Fraser Health are implementing the Working Mind, a tool to facilitate group sessions for staff to share their challenges. Casas-Alcuaz says she hopes to give front-line staff space to share their experiences.
Casas-Alcuaz says she knows that the 45,000 staff members at Fraser Health can’t meditate their way out of burnouts or staffing shortages and wants to bring the voices of the frontline nurses with her to each conversation. “We can’t shut down [the hospital]. We can’t all leave,” she says.
Equity, Diversity and Inclusion (EDI) strategies
- In a recent article in BMJ Leader, co-authors Bilal Khan and Marlena Dang-Nguyen from Toronto evaluated EDI strategies in health care at three city hospitals. They found that hospitals need sustained organizational support, rather than one-time events, committees or funding, for EDI strategies to be implemented. Despite being on different timelines, each hospital they evaluated took similar steps to understand community needs.
The HEC requirement to collaborate with people with lived experience is invaluable for team success, they say. “When you ask those communities, and then you try to implement something that they’ve suggested, it tends to be more successful,” Khan adds.
|· A long-term care home in Nova Scotia is installing wireless doorbells at resident rooms to improve relationships with staff. Residents gain agency and can refuse staff entry or invite them into their rooms.
|· A Manitoba team will be refurbishing the staff break room.
|· An Alberta ER is setting up a lending library.
|· A national network will implement grief and bereavement care for staff and clients
|· Some teams are looking to support staff with child care, healthy snacks, gas stipends or float teams to improve staff coverage.