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March 18, 2004
Deloitte & Touche staffing review implementation cause for concern
The Vancouver Coastal Health Authority (VCHA) is implementing changes to staffing across the authority which involves nurses and other health care providers. The health authority contracted with Deloitte & Touche last year to evaluate current staffing levels and make recommendations for change. These recommendations are now being acted upon. To date, the plan is to reduce RNs at Kiwanis Care Centre and replace them with LPNs. At VGH/UBC, the plan involves eliminating vacancies and displacing a number of registered nurses.
Full and complete information not yet available
As with many major restructuring schemes, it is very difficult to get a full and complete picture of the changes and the impact they will have on BCNU members. BCNU was not involved in the Deloitte & Touche initiative and was only given limited information after the review was complete. BCNU does not know yet where the displacements or elimination of vacancies will occur. The Union is attempting to engage the employer in on-going discussions in order to evaluate changes as they occur and take any necessary action to protect both patients and nurses.
Concerns being raised
BCNU has a number of concerns with the Deloitte & Touche initiative:
- few front line, general duty RNs were consulted; Nurses had no opportunity to provide information regarding special patient needs or problems that would affect staffing levels
- Deloitte & Touche relied on a workload evaluation tool, the use of which has been consistently discredited as inaccurate, or not acted upon when the results called for increased staff
- when looking at staffing levels in long term care facilities, direct care nursing hours were compared with peer facilities across Canada, but the actual quality of the care was not compared; for example no rates of resident falls, bed sores or infections were evaluated
- skill-mix changes will be implemented without an evidence-based rationale
- the elimination of current vacant registered nursing positions will have a long term impact on workload
- the elimination of other health care professionals such as social workers and occupational therapists will have a detrimental impact on patients and the workload of registered nurses
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BCNU does know that skill mix changes are now occurring and will continue in the future.
Your BCNU regional executives and stewards will be calling on you to help find out where specific changes to staffing levels are occurring.
Further information will be provided as it becomes available.
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