Professional Responsibility success at Glenrose Rehabilitation Hospital

Members of United Nurses of Alberta Local 32 have made several recommendations to improve working conditions following staffing mix changes introduced by Alberta Health Services in 2013.

Local 32 members met with AHS CEO-designate Deb Gordon late last year to discuss the changes on three units at the Glenrose Rehabilitation Hospital in Edmonton. An evaluation conducted by AHS in 2016 identified the changes in the staff mix, which included a decrease in professional nursing staff, as potentially having a negative impact on patient outcomes, staff safety and satisfaction, and an increased financial burden for the facility. 

UNA members raised a number of concerns, including role clarity issues, particularly for the role of health care aides, missed breaks, decreased morale, lack of professional nursing staff, orientation issues, baseline staffing not being maintained, and overall quality of care issues. 

Actions taken by AHS based on recommendations made by UNA to improve the situation include: 

• An increase to Registered Nurse staffing by 1.0 FTE for one of the units. 
• UNA participation in a Staff Mix Working Group created for the site. RN education sessions around leadership were completed, HCA education sessions are ongoing, and LPN sessions will commence in the fall. 
• A common patient assessment tool is being looked at to enable consistent practices and reduce ambiguity between the units. 
• Central intake for Geriatrics and Transition Services in the zone taking a more active role in the referral process to the Glenrose. 
• Changing the practice around narcotic co-signing – where an independent double check policy was implemented across the site. 
• A staffing decision tool was created to assist units in augmenting staff above baseline based on increases in patient complexity. 
• Implementation of a patient satisfaction tool for the site with results shared transparently with UNA.

Although not all of the recommendations presented to AHS have been implemented, UNA acknowledges that significant work has been done to address most of the concerns raised. Local 32 also acknowledges the transparency and professionalism displayed by the employer by meeting with UNA members on a regular basis to provide updates and sharing information that is relevant to the concerns that were raised. 

The Local is continuing to work collaboratively with the employer to monitor the progress of the outstanding commitments.