Expert nursing panel makes dozens of recommendations to KHSC

Kingston General Hospital (KGH), a Kingston Health Sciences Centre (KHSC) site. Photo by Benson Kua.

After the Ontario Nurses’ Association (ONA) called in an Independent Assessment Committee (IAC) to investigate staffing levels and care quality at a Kingston Health Sciences Centre (KHSC) site late last year, dozens of recommendations have been made to improve patient care and working conditions for nurses and other health care professionals.

According to a release from ONA, this is the second time the IAC, a panel made up of nurse experts, has made this type of recommendation to KHSC. An IAC panel reviewed mental health and addictions programs at KHSC in late 2022.

“It is unprecedented that an employer is brought in front of an Independent Assessment Committee not once, but twice, in such a short period of time,” said ONA President Erin Ariss.

“ONA registered nurses have raised concerns with their employer for years, with zero action from the hospital. It is well past time for this employer to work collaboratively with ONA to address and resolve these issues once and for all.”

This most recent IAC report, released earlier this month, makes 99 unanimous recommendations for the Connell 10 medicine unit at Kingston General Hospital (KGH), including the urgent need to employ the number of registered nurses and registered practical nurses required for safe nurse-to-patient ratios; ensuring there are enough resources to support and bolster recruitment; including nurses in education decisions; and many concrete recommendations related to communications, leadership, and staffing.

The IAC report notes that although there is a provincial, national, and global nursing shortage, the hospital should not use this messaging as its first response to nurses’ concerns.

“We all know that there is a nursing shortage,” Ariss stated.

“This employer should stop making excuses and instead focus on improving working conditions to help retain and attract nurses. Implementing the recommendations in this report would be an excellent way to improve nurse retention efforts.”

According to the ONA, IACs are considered to be a last resort in resolving practice issues. This report virtually mirrors the December 2022 IAC report from its review of the Mental Health and Addiction Care Program at Kingston Health Sciences Centre (KHSC).

“Nurse staffing and retention efforts as well as communications must improve immediately to support quality care,” Ariss said.

“We are ready to work together with KHSC to enact the recommendations the nursing expert panel has made to support nurses and health-care professionals in providing the best patient care possible.”

ONA represents 68,000 registered nurses and health-care professionals, as well as more than 18,000 nursing student affiliates, providing care in hospitals, long-term care facilities, public health, the community, clinics, and industry.

KHSC responds to report

In an interview with Kingstonist on Monday, Jan. 29, 2024, Jason Hann, Executive Vice-President of Patient Care and Chief Nursing Executive for KHSC, noted that while the report includes a number of recommendations for KHSC to implement within Connell 10, there were positives for the local organization as well.

“There’s always an opportunity for improvement in everything that we do, but included in the report written by the panel [is an acknowledgement] that the quality of care on Connell 10 has been maintained and has continued to improve,” Hann remarked.

The report did note that, due to KHSC’s implementation of an “interim nurse staffing plan and model of care,” as well as additional staff supports, “there is evidence that quality of care on Connell 10 has been maintained and/or has continued to improve.”

Hann added, “We’ve made progress in reducing the shortfall of nurses on Connell 10 and will continue our efforts to recruit and retain… We’ve shared data that we’ve made steady progress and that we’re committed to recruiting nurses and reducing the nursing shortfall on Connell 10.”

He pointed out other positive highlights within the report, including KHSC’s Undergraduate Nursing Employee (UNE) position. According to the IAC report, “This paid position was developed to attract and recruit students to select inpatient medicine for their final consolidation placement of nursing programs.” Hann emphasized that this program is unique to KHSC.

“We’re the first Ontario hospital to introduce the undergraduate nursing employee position. So there’s a lot of good work in what we’ve done,” he said.

As for how KHSC will implement the recommendations of the report, Hann noted the organization has already begun working on ways to address issues related to nursing recruitment and retention.

“If we look at our nursing vacancy rate as of the first of October this past year, we were at 13 per cent. In March of last year, we were at 17.5 per cent. So our nursing vacancy rate at KHSC is lower than the overall Ontario East average,” he said.

Hann added the organization is also working to further incentivize nurses to join KHSC, while offering support for existing staff.

“We’re offering recruitment incentives. If a nurse comes to work at KHSC, there’s an incentive to recruit as well as relocation assistance,” he said.

“[For] nurses that are already here… we’ve done a nursing mentorship for all of our new nurses. We implemented that [mentorship program] in July of 2022, and we’re already seeing good success; as you’re hired, you have a nursing manager that supports you in your growth and development.”

As the press release from ONA noted, this latest report marks the second time in as many years KHSC has been brought before an IAC. When asked what has contributed to this “unprecedented” situation, Hann noted the many challenges nurses and health-care providers have faced in recent years.

“The common issue… between this [report] and the mental health one [is that] there are health human resources challenges which we’ve seen across Canada. KHSC, and every other hospital. That’s the reality that we face,” he said.

“This is continuous work; it’s a process that can be followed. I have to say, in this report there’s a lot of positives for KHSC. And I appreciate [that] ONA has to advocate for their members, [but there’s] a lot of evidence in that report of the great work KHSC has done to improve as a place to work. As well, we’ve seen significant improvements in patient care outcomes.”

As for how the report will influence the direction of KHSC moving forward concerning nurse staffing and retention, Hann explained the report is currently being reviewed by a wide range of teams at the hospital.

“Then we will meet with the staff and we’ll review the recommendations and we’ll use that as a guide in our discussions — the things that we’re working on and the things that we plan to implement and work on together. So we’ll use [the report] as a tool to guide those discussions,” he said.

With files from Jessica Foley.

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