Common use of SAFE STAFFING LEVELS Clause in Contracts

SAFE STAFFING LEVELS. 3.1.1.1 Health unit sites are to staff to demand in all areas according to the relevant indicator of demand for that setting. 3.1.1.2 In most areas of health unit sites this will mean prospectively staffing in accordance with Excelcare projected hours for each shift period (where the system has been implemented) as well as appropriate consideration of known or likely variations expected to patient number or profiles during that shift. In establishing compliance with this system for staffing, actual staffing levels will be matched to the required staffing levels in each patient care area. The relevant definitions and processes for monitoring, compliance and reporting are set out in the protocols contained at Appendix 1. Should a new information system be introduced to replace Excelcare during the life of this Agreement, the protocols will be updated and amended to reflect the language and functionality of that system but preserving the principles of consultation and agreement over change. 3.1.1.3 DH is considering the replacement of Excelcare by the ▇▇▇▇▇▇▇▇▇▇▇.▇▇ - Clinical Practice Support (CPS) or other similar system. There is no final commitment to the replacement of Excelcare or for the use of the alternate system for staffing purposes as at the time of this agreement being reached. 3.1.1.4 The parties will confer further over any proposals to substitute the new system for Excelcare for the purposes of staffing decision-making. If and when there is agreement between the parties to use the new system to replace Excelcare (where it currently exists) as a staffing tool, health unit sites will staff according to the new system. 3.1.1.5 All relevant sites will maintain Excelcare to ensure that units of care and timings are appropriate. Protocols for the maintenance of Excelcare are attached at Appendix 1. The protocols will be used consistently and updated as necessary by further agreement of the parties to ensure that all parties have a continuing confidence in the validity of Excelcare data. 3.1.1.6 Following the decisions of the DH ICT Steering Committee and/or any other relevant approval processes, the parties will meet to discuss an appropriate timeframe for rollout of any new system, initially across the remaining Excelcare sites. 3.1.1.7 Subject to a business case being approved to extend the application of the new system it will be implemented for health unit sites not presently using Excelcare for staffing purposes. 3.1.1.8 If, in the first 12 months, of the approval of this Agreement by IRCSA, Excelcare can no longer operate at a particular site, that site will staff to no less than the average required daily staffing level for the 2009 calendar year. The daily required staffing will be derived from the sum of the required staffing for each of the shifts worked during any day including, where relevant, the actual staffing level for any period in substitution of the required level where the actual exceeds the required level. If Excelcare can no longer operate at a site after the initial 12 month period the site will staff to no less than the average of the patient care area’s average required daily staffing level for the previous 12 months. 3.1.1.9 In the event that roles, service requirement or change in service volume occur in patient care areas affected by this clause, either the Chief Executive, DH (or delegate) or the ANMF may seek to have the staffing levels adjusted by further agreement. 3.1.1.10 The parties to this Agreement will during the first 6 months of the Agreement, explore the applicability of a nurse/midwife staffing methodology based on nurse/midwife to patient ratios. In the event that agreement is not reached during these discussions: • If Excelcare (or CPS by agreement) is implemented and is functional, the parties will continue to manage staffing decision making in accordance with the provisions of this Agreement in respect of those systems; • If Excelcare (or CPS) is not implemented or functional, either party may seek to have the issues resolved through application of the dispute settlement procedure within this Agreement. 3.1.1.11 In circumstances where staffing levels are not able to meet demand, health unit sites will refer to the agreed shift by shift staffing requirements decision making process as set out in Section 1 of Appendix 2. 3.1.1.12 In wards/units/emergency departments/casualty services of health unit sites, where Excelcare or CPS has not been used to assess demand and staffing, alternative methodologies (e.g. standards, formulae etc) that have been agreed between the parties and set out in Section 2 of Appendix 2 are to be used. Staffing for operating theatres is to be consistent with the ACORN standards, for Emergency Departments with the standards of CENA, ACCCN standards for Intensive Care/High Dependency Units, and GESA standards for Endoscopy Units, that have been used to develop the terms of this section of Appendix 2. Either party may seek to have the alternative methodologies as provided at Appendix 2, Section 2 adjusted by agreement of the other party should any role, service requirement or change in service volume occur in those health unit sites listed in the appendix. 3.1.1.13 The ANMF and DH are to agree, within 3 months of the date of approval of this Agreement by the IRCSA, on staffing levels and arrangements for outpatient services and clinics in all hospitals and health services. At the time of agreement being reached, the parties have identified current staffing levels that will form the basis for these discussions but the adequacy or otherwise of these arrangements had yet to be tested and agreed.