Changes to staffing levels at Edmonton-area seniors’ facilities are being designed to save money and better meet the needs of patients, according to health officials, but critics say the move will compromise care.
A cut-back of five full-time equivalent nursing and therapeutic staff positions is one of the changes afoot for three Edmonton-area seniors’ facilities, including Youville Home.
Covenant Health announced the realignment, which will affect more than 650 staff at the Edmonton General Continuing Care Centre, St. Joseph’s Auxiliary Hospital and Youville Home, on Monday.
Primary changes will be to the staff rotations of licensed practical nurses and health care aides. Across the three sites, there will be a net reduction of five full-time equivalent nursing and therapeutic staff.
Staff reduction equates to 2.65 full-time positions at Youville Home.
“There was long-term discussion about what changes we could make that would continue to allow us to be sustainable in our budgets but also meet the needs of our residents,” said Cecilia Marion, senior director of operations for Youville Home and St. Joseph’s Auxiliary Hospital.
Changing patient populations requires a revision to the “staff mix,” she said.
Seven years ago, the average stay for a resident at Youville was two years, while today the stay is an average of six months and care is largely centred around end-of-life, explains Marion.
The staff changes are aimed at allowing nurses to work to their full scope of practice – licensed practical nurses to manage daily care and registered nurses for their expertise, such as in palliative care.
Around 174 staff at Youville will be affected by the changes, including four registered nurses and 37 licensed practical nurses.
In the majority of cases, staff will have an opportunity to select into another position or another rotation based on seniority, in accordance with their union agreement.
Residents will notice changes in their care providers, said Marion.
“Hopefully they will see a change in more accessibility to care when they need it,” she said.
The implementation of the realignment will take place March 27, 2015.
Changes to staff rotations are part of a greater “culture change” in long-term care toward a patient-centred care model, said Marion.
One of the goals is to provide more “individualized care.”
“What that means is if someone wants to sleep in until 10 o’clock, they can sleep in until 10 o’clock. If they get up, they can still have a cup of coffee and something to eat even if it’s only an hour before lunch,” explains Marion.
“In the past, we’ve been fairly rigid and institutionalized where … everybody up at a certain time and ready for breakfast.”
Staffing levels are highest in the mornings for meals, bathing and assessments, says Marion. Under the new model, staff will be spread out more evenly throughout the day.
Critics say the changes are likely to have a negative impact on patient safety and the quality of patient care.
“They can tout it however they want, but at the end of the day there is going to be less care,” said Jane Sustrik, vice-president of the United Nurses of Alberta.
The changes may result in fragmentation of care with a patient population that has more complex needs.
If healthcare aides take care of daily living such as bathing, licensed practical nurses take vital signs and administer medications, and a registered nurse does certain procedures and overall co-ordination of care – “nobody has a full picture any longer,” says Sustrik.
“There is no overall picture of what is happening with patients … and we’re getting near-misses.”
The group believes changes will result in the elimination of six registered nursing positions.
It said the elimination of five full-time equivalent positions could not add up to $1.4 million in savings estimated by Covenant Health, the “impact will be far more serious.”
Have questions or concerns?
A resident and family council meeting will be held at Youville Home on Tuesday, Dec. 2 at 3:15 p.m. in the main auditorium.