Take Action

Implement Leading Practices

Implement New and Innovative Approaches to Workload and Staffing Systems

Implement effective, formal staffing plans. Such plans should be specific to the unit, ward, or program and the needs of its constantly changing patients; the experience levels of staff who work there, and which other professionals and support services the organization can provide. The plan needs to address staffing needs required for quality healthcare delivery; be formed in consultation with staff, using a shared governance model; and should spell out options, repercussions, and alternatives when staffing goals are not met.
Consider overstaffing by a small margin in anticipation of absences; this strategy is known to result in decreased overall cost compared to traditional staffing methods.
Link staffing initiatives with management concepts that create quality work environments that encourage and sustain: transformational leadership structures; collaborative work among all healthcare team members; professional autonomy and control over practice; use of technology, innovation, and research to improve work processes and patient/client outcomes; and research to generate evidence for "best" practices.
Create more full-time positions to increase team stability.
Ask staff what their preferable work status is and build strategies for maximizing employee satisfaction with their employment status.
Respect collective agreement language and work towards complementary structures and processes to support innovative approaches.

Current staffing conditions demand immediate attention, as they have become increasingly inadequate and can result in unacceptable compromises to patients/clients and providers.

Unit productivity/utilization levels should target 85 per cent plus or minus five per cent. Levels higher than this lead to higher costs, poorer patient care, and poorer nurse outcomes.

The odds of an adverse event are three times higher when RNs work shifts longer than 12.5 hours.37 Every additional patient beyond an average hospital nurse's workload of four patients increases the risk of death following common surgical procedures by 7 per cent.

Strategies to reduce workload among health professionals will likely lead to improved patient outcomes.

Registered Nurses Association of Ontario (RNAO) advocates for a 70:30 FT/PT staffing model.