Managing the Shortage of Highly Skilled Knowledge Workers: Role of an Interdisciplinary Preceptorshi

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Managing the Shortage of Highly Skilled Knowledge
Workers Role of an Interdisciplinary
Preceptorship Program as a Key Integration and
Retention Strategy
Presented by
Val Stove, RN, BN, MHA Senior Project
Coordinator Office of Professional
Practice Halton Healthcare Services Oakville,
Ontario
Friday, December 9th, 2005
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Presentation Overview

• Precipitating Factors
• Target Population
• Interdisciplinary Professional Practice Structure
• Preceptorship Program Framework
• Funding and Support
• Program Outcomes and Challenges
• Program Sustainability
• Recruitment and Retention Initiatives
• Next Steps

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Setting the Stage .

• Internal Environment
• high RN/RPN vacancy and turnover, ? new grads
• Succession Planning Survey (gt55 years) showed
  high numbers of retirements pending
• avg.. staff age 47.5
• 40 of nursing leadership eligible to retire in
  next 2-4 years
• recruitment and retention challenges facing all
  professional disciplines
• inconsistent orientation processes within and
  across 2 Hospital sites

• External Environment
• rapidly growing community increasing demand for
  inpatient and outpatient services
• Scarcity of experienced professional staff,
  especially in specialty areas (e.g. ICU, ED RNs)
• competitive marketplace
• signing bonuses
• other perks

Has anything changed 5 years later?
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Recruitment and Retention Initiatives

• Implemented a variety of initiatives
• Staff Satisfaction Survey (2000/2004)
• Redesigned Self Scheduling System/revised
  Scheduling Policies
• Improved FTRPT ratios (67 33)
• Web-based recruitment process
• Recruitment bonus for existing staff
• Tuition Assistance Program
• Multidisciplinary Preceptorship Program
• Grow Your Own Program for specialty RNs
• Creative advertising strategies (theatre ads)
• Competency-based Orientation Program
• Clinical Leadership Program

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Preceptorship Program Target Population

• Initially, Program envisioned for nurses
• Identified similar recruitment, retention, and
  orientation issues for all professions
• Strong support for interdisciplinary approach
  from VP, Programs and Professional Practice / Sr.
  Management
• Planning initiated with multidisciplinary focus
• Dearth of references in preceptorship literature
  for other disciplines/ multidisciplinary approach

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Interdisciplinary Professional Practice Structure

• Professional Practice structure developed to
  support professional disciplines including
• Office of Professional Practice
• Interdisciplinary Professional Practice Model
• Interdisciplinary Professional Practice Advisory
  Council (IPPAC)
• Co-chaired by Program Leader (Nurse) and
  Physiotherapist
• VP Programs and Professional Practice
  (ex-officio)
• Interdisciplinary Preceptorship Program
• Unit/Department-based Councils

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Preceptorship Model
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Preceptorship Program Framework

• Formal invitations for 1 day Workshop issued
  through Office of Professional Practice
• signed by VP
• package includes pre-reading assignment
• Workshop content combines theory with real-life
  case-based scenarios
• Brain Gym (identifies learning styles)
• Professionalism and Preceptorship
• Effective tools for communication and listening
• Importance of Learning Partnerships
• Management of conflict
• Preceptorship Tool Kit
• Team Building exercises
• Based on principles of adult learning
• Fast paced, humour-filled day

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Preceptorship Tool Kit

• Learning Needs Assessment
• Learning Plan
• Daily Journal
• Evaluations
• Preceptor evaluation of Orientee
• Orientee evaluation of Preceptor
• Evaluation of Preceptorship/Orientation
  experience
• Application of Tools using Case-based scenarios

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Funding and Support

• Program funding
• Units/Departments
• 7.5 hour day for Workshop
• Preceptor stipend (200 for each preceptorship)
• provides incentive to retain staff to reduce
  costs
• Office of Professional Practice
• Workshop expenses
• Materials
• Catering
• Preceptorship pins
• Strong support at Senior Management and
  management level

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Program Successes/Outcomes

• gt 300 staff trained since Program inception
• Improved consistency in training, orientation,
  and across disciplines and between sites
• Enhanced partnerships between staff in various
  departments/programs
• Selective matching of Preceptors/ Preceptees
• partnered for 3 weeks to 3 months (same schedule)
• Continuing positive evaluations and waiting list
  for Workshops
• Compensation seen as positive recognition for
  additional responsibilities/ workload

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Program Successes

• Increasingly important tool in support of new
  graduates
• Decreased turnover rates (Nursing and other
  disciplines)
• Before initiation of R/R Program 10 -12 per
  year
• Industry average 10-15
• RN rate for past 4 years - 8 - 10.6
• RPNs - 0 2004/05
• Turnover rates rising province wide
• External hire rate ? over past 5 years (20.7
  ?17.3)
• EAP rates 5.4 (Industry average 8 )

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Preceptorship Program Challenges

• Consistent application of Preceptor Program
  selection criteria
• Protecting the Preceptor/Preceptee day without a
  patient/workload assignment
• Adequately supporting the growing orientation
  needs of new graduates
• 
  
• Follow-up with/between
• Preceptors and Preceptees
• PCMs / PPCs /Department
• Heads with new hires and preceptors
• Return of Preceptorship evaluations

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Sustainability of Results

• Formal evaluation of Preceptorship Program
• In 2005, we surveyed
• existing Preceptors
• recent new staff
• staff hired 2-3 years ago
• Managers/Department Heads
• Response rate 33

• Respondents told us
• 100 felt Preceptor role essential to successful
  integration of new staff
• gt 90 reported ? confidence in own abilities as
  Preceptor after attending Workshop
• Program assisted in understanding Preceptors
  learning and teaching styles
• Learning Tool Kit invaluable in guiding
  Orientees Learning Plan

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Next Steps

• Continue to
• enhance interdisciplinary Program focus
• integrate new tools supporting enhanced
  Competency Based Orientation Program.
• work with Managers, Clinicians, Preceptors/
  Preceptees to support
• 1 day without patient/workload assignment
• regular meetings throughout orientation period
• consistency in application of remuneration Policy
• evaluate and enhance Preceptorship role and
  Program to meet changing workplace realities
  (e.g., needs of new graduates).
• build Mentorship Program to provide long term
  support and career development for staff
• new grad support and experienced staff succession
  planning
• applied for MOHLTC funding to develop Program.

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Questions and Comments?