The 12-hospital, Mishawaka, Ind.-based Franciscan Well being system designed an in-house journey nurse program to unravel their nurse scarcity challenges with out utilizing an exterior staffing company. Like many hospitals, Franciscan Well being struggled with staffing shortages and rising prices throughout and after the COVID-19 pandemic. Franciscan projected growing exterior nurse spending from 2022 to 2023 by 36 %. After counting on outdoors staffing businesses, Franciscan launched its journey nurse program in the summertime of 2022. Since then, 300 nurses signed on. Now, Franciscan expects exterior nurse spending to lower by 22 % year-over-year.
Healthcare Innovation lately spoke with Franciscan’s Ellen Web page, director of expertise acquisition.
What made you determine to make use of this journey program?
In early 2022, we have been greedy at any modern concepts to convey extra nurses in. We’ve twelve hospitals, so now we have important staffing. We put a committee collectively to brainstorm totally different concepts that may interact nurses. As many nurses as we employed have been leaving as effectively. As you understand, this was the period of nice resignation. We got here up with totally different concepts, and certainly one of them was the journey program.
Was this program primarily based on an present mannequin?
No, it’s model new.
What are the mechanics of this system?
We have been going to usher in nurses from outdoors Indiana and Illinois, after which we realized we have been beginning to change into a staffing company, and we didn’t wish to try this. We paired it down a bit bit to regional journey. We’ve hospitals within the northwest a part of the state, the central a part of the state, and the southern half in Indiana. We determined simply to recruit native nurses into this program, however they needed to commit that they might journey between services in that exact area. Then, we did not have to fret about housing, stipends, or different journey incentives that outdoors businesses have been utilizing. They’re at the next charge of pay, with out advantages. We made the plan very versatile. We have been like, choose your shift, choose your project, choose your size of project, and let’s go. We have been astonished by all these skilled nurses making use of – skilled nurses, which we weren’t seeing in different methods. They could simply wish to work Friday and Saturday or work for 13 weeks after which take six weeks off. The flexibleness of it was so engaging that it simply exploded. We’ve a terrific crew that is managing these nurses. They transfer the nurses round as wanted. They could have a four-week project in a single facility and a thirteen-week project in one other.
I feel it’s key to be on the forefront of assembly the wants of the nurses within the labor market, not how we did it ten years in the past. I feel that’s been the toughest factor for our administration groups to get used to as a result of healthcare could be very conservative. You will have somebody who works from 7 am to 7 pm and who has a companion who works from 7 pm to 7 am. We’re pushing the managers to assume outdoors the field and be modern within the scheduling as a result of that’s what these nurses need.
We’ve transformed some from the journey program to an everyday place. There’s satisfaction, each for the supervisor and the nurse.
Did you do a pilot program?
We did, and I’ve to confess, I used to be the individual saying we’re by no means going to get nurses to return right here. Different healthcare techniques’ applications in Indiana weren’t profitable. However at the moment, journey nurses have been making some huge cash. They may go wherever they needed. We did a pilot in Indianapolis. We might rent 40 nurses, and we did that inside six weeks.
We had simply gone stay with Phenom on the identical time, which is our recruiting advertising platform, and the 2 collectively have been great. With Phenom, we obtained the phrase out that we had this program. Nurses might apply very simply, after which we might take it from there and rent them. This system was so profitable, I feel, earlier than we even completed the pilot, we might transfer on to a different area. Then, we went to our Western area, which is Lafayette, Ind. Then, we moved as much as the north a part of the state, near Chicago. We’ve added respiratory, central sterile processing, and imaging technicians. We’re not getting the identical quantity from these tech positions as a result of they’re so wanted that they are getting the incentives to remain of their hospitals.
Was the pilot program for one division, for instance, the ICU?
Any; now we have totally different tiers. If you apply primarily based in your ability set, we put you in a sure tier, for instance, ICU, acute care, or procedural. That is type of grown as we have taken off on this journey.
Did you’ve gotten inner employees nurses making use of for the journey program?
If you wish to ask about an impediment, that may most likely be certainly one of them. We’ve a coverage that should you depart Franciscan, you can’t come again to work for us as an outdoor company nurse for a 12 months. When the pandemic began, individuals needed to go to New York to earn $5000 per week after which come again. We have been left hanging throughout our essential shortages as effectively. We made the coverage you could’t switch into this program should you’re an lively worker. If you happen to resign, you need to wait a minimal of six months to return again. We needed to actually craft our communication once we despatched it out so all people understood what this system was.
What number of nurses are concerned in this system?
We’re nearly at 300. The overall variety of nurses at Franciscan is round 4,000.
Do you’ve gotten any metrics on value financial savings and satisfaction charges from the nurses?
I haven’t got true metrics on the satisfaction charges, however the nurses appear to find it irresistible. What’s to not love; you aren’t getting within the division’s drama.
Total, it has impacted at the very least $3 million in financial savings, if no more. We have diminished our outdoors company prices by 22 % over final 12 months. This can be a massive piece of it as a result of we will launch an outdoor company nurse that we pay between $100 and $120.00 an hour and change them with our personal staff. We did charge reductions. We did rather a lot to affect that quantity as a result of spending over $100 million in labor prices isn’t sustainable. All of the hospitals are in the identical boat. All people did what they needed to do once they needed to do it, however it’s simply not sustainable. We’re more than happy with the affect of this system.
Do you utilize knowledge analytics to trace hours to make sure nurses are environment friendly?
Nurses observe their hours as a result of that is a part of their ROI that they are consistently reporting on. Effectivity comes from the supervisor as a result of they consider these nurses. A few of them beforehand labored for us, so that they’re all skilled and know Franciscan. There’s much less coaching wanted.
Who presides over this system?
I’m over it so far as the HR piece of recruitment, onboarding, offboarding, and any points that we run into with nurses. We’ve a scientific crew that schedules them, orientates them, and makes positive that they meet the necessities for the unit they’re going to. We’ve a huddle weekly as a result of there are such a lot of individuals in this system.
What would you say your greatest hurdle was?
I’d say the managers’ acceptance of it. We did not do plenty of communication about it. In these first few months, even generally now, you’re feeling like a used automobile salesman, such as you’re making an attempt to promote them this company individual. They usually’re like, I’m good, I’m absolutely staffed. However they’re absolutely staffed with outdoors company individuals. It’s taken rather a lot for them to grasp. A few of these outdoors company nurses have been with us for greater than a 12 months. They really feel like a part of the household. That’s been the toughest half for managers, to let go of a few of these company nurses as a result of they then need to retrain. However once we give them an skilled nurse as a alternative, then we’re profitable in lots of areas.
What can be your recommendation for different hospitals that wish to implement the same program?
I’d say that whenever you’re going to develop this program, you need to be modern. You need to do one thing totally different to draw nurses. Some don’t want advantages and could wish to work two days per week. I feel what shocked us essentially the most was the standard of the nurses. A few of them had left nursing due to burnout. Some had left due to childcare and didn’t assume they may come again. But when we work round their schedule, then that’s a win-win. As soon as we discovered that piece of it, it modified the entire means we did issues. A few of my friends reposted the identical employees job and referred to as it a journey place. They only didn’t get any traction. I’d like to say we have been sensible and knew precisely what we have been doing, however we weren’t holding anyone to that type of constrictive scheduling. We’ve nurses who’re going to have infants, or now we have male nurses whose wives are going to have infants, and so they can work as much as the date. Then, they’ll take 13 weeks off and are available proper again.
We’ve heard rather a lot about how a lot nurses study by floating between hospitals and totally different models and acuity ranges. It might take years for them to get that type of on-the-job studying. We’ve not had too many unfavourable issues about it as soon as we obtained by way of among the kinks to start with. Now, it is all all people’s speaking about as a result of they’ll see its affect throughout the system.
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