New RAH Medical Directorate Inpatient Wing Staffing

Transcription

1 New RAH Medical Directorate Inpatient Wing Staffing

2 Environment Design principles Inpatient overview Contents Business Rules Directorate Structure Proposed Staffing Model Staffing Review & Next Steps

3 Inpatient Medical Footprint

4 Design Principles of Each Wing Provides an environment which supports safe care including reduction in noise, support for infection control measures and improved patient management Facilitates treatment and therapy being undertaken in the patient bedroom and bathroom Provides maximum patient privacy and dignity Provides an environment to facilitate communication between Clinical Staff and the patient, including handover at the bedside, and taking full advantage of opportunities for the patient s involvement in their own care

5 Design Principles of Each Wing Provides views and natural light for all patients Facilitates the involvement of family and carers Supports a dignified dying process Provides maximum flexibility and efficiency of the inpatient wings in terms of patient flow and occupancy Facilitates short travel distances between discrete spaces and services Has technology which supports access to information and data entry requirements of staff and patients All patients and staff have direct access (< 2 minutes) to Blue Space and Green Space from the inpatient areas

6 Inpatient Wing Overview Generally, the inpatient accommodation is configured in triangular layouts of 16 patient rooms (forming a wing), however in some circumstances i.e. Infectious diseases, respiratory and neurology, where the care needs for patients are specific, alternative layouts have been created. Wings are modular and identical in design and layout that house all the functions and general equipment to support the delivery of care to patients. This enables efficient use of time and space.

7 Inpatient Wing Overview Included within each of the standard wings are: Single patient rooms Clean and dirty utility rooms Staff hubs Multi-purpose rooms Distributed Store Automatic Dispensing Cabinet (Pharmacy) All functions have been grouped into a wing to minimise staff walking requirements and associated fatigue. Corridor widths allow for the easy passing of two inpatient beds, associated equipment and staff to ensure minimal obstruction in staff accessing patient rooms.

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9 SA Nursing / Midwifery Enterprise Agreement Business Rules The Business rules provide (NMEA 2016 Appendix 13): Process to support the application of the staffing model Process to review the staffing model for new or changing patient care areas NMEA 2016 clause and Appendix 2 set out the detail of minimum staffing levels for inpatient areas

10 NHPPD Review Process Triggers for Business Rules staffing review: Changes to the patient population Changes in practice, equipment or to models of care they may impact on the required nursing numbers Changes to the distribution of work across times of the day and / or days of the week Changes to the environment

11 NewRAH Staffing Review In accordance with the business rules, CALHN and the ANMF have commenced discussions regarding the review of safe staffing levels for the newrah Medical Directorate inpatient Wings Things that we know are changing Geography Models of care Technology ACD, Imprest store, robotics, equipment etc PSSA role

12 Proposed Medical Structure at the new Royal Adelaide Hospital Nursing Co-Director & Director of Nursing The Queen Elizabeth Hospital Nursing Director Cardiology Nursing Director Complex Medicine Nursing Director Medical Specialities Nursing Director Acute Medicine & Support Services

13 Proposed Cardiology inpatients at the new Royal Adelaide Hospital Nursing Director Cardiology Current Nursing Director Cardiology Proposed Units A4 A/B5 A6 Units 4F wing 1 4E wing 1 & 4F wing 2 4E wing 2 AAU 2G/2F Wing 1

14 Proposed Complex Medicine inpatients at the new Royal Adelaide Hospital Nursing Director Complex Medicine Current Nursing Director Acute Medicine & Support Services Units S8 Geriatrics Units 9F Wing 2

15 Proposed Medical Specialties inpatients at the new Royal Adelaide Hospital Nursing Director Medical Specialties Current Nursing Director Medical Specialties Proposed Units S2 B7 Units 8E Wings 1 & 2 9G Wings 1& 2

16 Proposed Acute Medicine & Support Services inpatients at the new Royal Adelaide Hospital Nursing Director Acute Medicine & Support Services Current Nursing Director Acute Medicine & Support Services Proposed Units 1) AMU T3 2) S8 Infectious Diseases 3) R7 4) R8 5) Q8 6) S7 Units 1) AAU Wings 2G wing 1 to 2F wing 1 2) 6G Wing 3 3) 8G Wings 1&2 4) 8F Wings 1&2 5) 9F Wing 1&2 6) 9E Wing 2 &1

17 Proposed Staffing Model for each Wing NUM s The Medical Directorate is proposing in most part an allocation of 1 NUM per 2 Inpatient wings in the belief that it will provide: 1 point of accountability and responsibility for: Expert clinician oversight to a contained specialised group of patients Expert NCs are alerted to the admission of patients which fall under their specific clinical care cohorts eg Chronic diseases management NCs Management of patient oversight able to focus on patient safety and quality care outcomes Management of human resources Management of budget Ensuring staff capability / development Creating a positive work environment Fostering and building strong collaborative working relationships between nursing, medical and MDT s Support and succession planning AsNUM s

18 Proposed Staffing Model Cardiology 4FW2 (6 beds) NUM AsNUM NC 1 FTE 2 FTE over a seven day roster per wing 1 FTE Complex Cardiology; shared across cardiology CN RN:EN Proposed shift plan / nhppd As per personal reclassification 100%RN 3:3:2 = nhppd ES. Inclusive of shift coordinator

19 Proposed Staffing Model for Cardiothoracic / Cardiology - 4FW1-16 beds Nurse Unit Manager 1FTE AsNUM 2 FTE over a seven day roster NC CN 1 FTE : DOSA 1FTE : Complex Cardiology - shared As per personal reclassification RN:EN 80 :20 Proposed shift plan / nhppd 6:6:4 = 8.5nhppd ES, inclusive of shift coordinator

20 Proposed Staffing Model for Cardiology - 4EW2-16 beds Nurse Unit Manager 1FTE AsNUM 2 FTE over a seven day roster NC CN 1 FTE Complex Cardiology; shared across cardiology As per personal reclassification RN:EN 70:30 Proposed shift plan / nhppd 5:5:3 = 6.88 ES, inclusive of shift coordinator

21 Proposed Staffing Model for Cardiology - 4EW1-16 beds Nurse Unit Manager 1FTE AsNUM 2 FTE over a seven day roster NC CN 1 FTE Complex Cardiology; shared across cardiology As per personal reclassification RN:EN 70:30 Proposed shift plan / nhppd 5:5:3 = 6.88 ES, inclusive of shift coordinator

22 Proposed Staffing Model for Neurology 9GW1 16 beds Nurse Unit Manager 1FTE shared with 9GW2 AsNUM 2 FTE over a seven day roster. Nurse Consultant CN 2 Stroke, 2 TIA, 1 Neuro, 1 PD, 1 N.P. epilepsy shared with 9GW2 As per personal reclassification RN:EN 70:30 skill mix Proposed shift plan/ nhppd 5:5:3 = 6.88 ES inclusive of shift coordinator

23 Proposed Staffing Model for Neurology 9GW2 8 beds Nurse Unit Manager 1FTE shared with 9GW1 AsNUM 2 FTE over a seven day roster. Nurse Consultant 2 Stroke, 2 TIA, 1 Neuro, 1 PD, 1 N.P. epilepsy shared with 9GW1 CN As per personal reclassification RN:EN 70:30 skill mix Proposed shift plan/ nhppd 3:3:2 = 8.5 ES inclusive of shift coordinator

24 Proposed Staffing Model - Respiratory -8EW1 12 beds NUM 1 FTE shared with 8EW2 AsNUM 2 FTE over a seven day roster NC CN 4 FTE Covering COPD/Pulm Rehab/Home Oxygen & Asthma/Lung transplant + CF team As per personal reclassification RN:EN 70:30 skill mix Proposed shift plan / nhppd 4:4:3 = 8.55 ES inclusive of shift coordinator

25 Proposed Staffing Model - Respiratory -8EW2 16 beds NUM 1 FTE shared with 8EW1 AsNUM 2 FTE over a seven day roster NC CN 4 FTE Covering COPD/Pulm Rehab/Home Oxygen & Asthma/Lung transplant + CF team As per personal reclassification RN:EN 70:30 skill mix Proposed shift plan / nhppd 5:5:3 = 6.88 ES inclusive of shift coordinator

26 Proposed Staffing Model - General Medicine AAU 2G /2F 36 beds NUM AsNUM NC CN 1 FTE Medical and 1 FTE Surgical 4 FTE over a seven day roster. 1FTE across AAU As per personal reclassification RN:EN 70:30 Proposed staff plan / nhppd 1:3 for an early 1:3 for a late 1:6 for Night duty As per current NMEA 2016 excluding specials, does not include shift Team Leader

27 Proposed Staffing Model - Acute Medicine 6GW3-6 beds Bed numbers under discussion NUM 1 FTE AsNUM 2 FTE over a seven day roster NC 2 FTE shared with other Gen Med wings CN As per personal reclassification RN:EN 70:30 skill mix Proposed shift plan / nhppd 3:3:2 = ES inclusive of shift coordinator

28 Proposed Staffing Model - General Medicine -8GW1&2 32 beds NUM 1 FTE shared between both wings AsNUM 4 FTE over a seven day roster.(2 FTE per wing) NC CN 1FTE Shared across 8 th level General Medicine Wings As per personal reclassification RN:EN 70:30 skill mix Proposed staff plan / nhppd 5:5:3 = 6.88 ES inclusive of shift coordinator

29 Proposed Staffing Model - General Medicine -8FW1&2 32 beds NUM 1 FTE shared between both wings AsNUM 4 FTE over a seven day roster.(2 FTE per wing) NC CN 1FTE Shared across 8 th level General Medicine Wings As per personal reclassification RN:EN 70:30 skill mix Proposed staff plan / nhppd 5:5:3 = 6.88 ES inclusive of shift coordinator

30 Proposed Staffing Model - General Medicine -9FW1 6 beds NUM 1 FTE shared with 9FW2 AsNUM 4 FTE over a seven day roster.(2 FTE per wing) NC CN 1FTE Shared across 9 th level General Medicine Wings As per personal reclassification RN:EN 70:30 skill mix Proposed staff plan / nhppd 3:3:2 = ES inclusive of shift coordinator

31 Proposed Staffing Model - General Medicine -9FW2 16 beds NUM 1 FTE shared with 9FW1 AsNUM 4 FTE over a seven day roster (2 FTE per wing) NC CN 1FTE Shared across 9 th level General Medicine Wings As per personal reclassification RN:EN 70:30 skill mix Proposed staff plan / nhppd 5:5:3 = 6.88 ES inclusive of shift coordinator

32 Proposed Staffing Model - General Medicine -9EW2 16 beds NUM 1 FTE AsNUM 2 FTE over a seven day roster NC CN RN:EN 1FTE Shared across 9 th level General Medicine Wings As per personal reclassification 70:30 skill mix Proposed staff plan / nhppd 5:5:3 = 6.88 ES inclusive of shift coordinator

33 Proposed Staffing Model - Neuro Trauma -5GW2 12 beds Timing of move under discussion NUM 1 FTE AsNUM 2 FTE over a seven day roster CN As per personal reclassification RN:EN 70:30 skill mix Proposed staff plan / nhppd 5.5 :4.5: 3 = 9.17 ES inclusive of shift coordinator

34 Staffing Review Process Consultation multi level process CALHN discussion with staff ANMF (SA Branch) discussion with members Considerations Staff plan does it meet patient care needs and requirements? Are there any changes that are impacting the staffing requirements? Are there any other relevant factors to consider?

35 Next Steps Ongoing consultation with staff and ANMF Consider feedback with possible review and refinement Reach Agreement with subsequent endorsement on wing staffing numbers LHN ANMF (SA Branch) Staff allocation to Wings

36 Questions?