Sunday April 20, 2014

Rising overtime costs at hospital hit $3 million

'It affects employee health and well-being as well as the finances'

Overtime hours for staff at Royal Inland Hospital cost almost $3 million last year, 10 per cent more than three years before.

Numbers provided by Interior Health show staff worked 45,682 overtime hours in the 2012/13 fiscal year, compared with 43,792 hours in 2009/10.

On a broader scale, overtime for all of Interior Health amounted to 270,995 hours in 2012/13, which cost $18.2 million — up 26 per cent from 2009/10.

“Overtime is a part of our business,” hospital administrator Marg Brown said Thursday.

“But reducing overtime is important. It affects employee health and well-being as well as the finances.”

While there are measures being taken to try to bring overtime under control, it’s difficult to do when the hospital surpasses 100 per cent capacity with patients.

Brown believes the sheer volume of patients going through RIH is a major part of why overtime is as high as it is.

“It does take its toll. When we have huge volumes of people we need to care for and only so many rotations on units . . . it will accrue over time,” she said.

The hospital isn’t funded for overtime, and Brown doesn’t deal with the entire RIH budget. Her portion covers $70 million.

“Managers are cognizant of working with their budgets and being accountable. They do spend time going through it. Any OT approvals have to go through a manager, along with a rationale,” she said.

“It’s pretty well based on patient care.”

Staff are asked to plan their time off well in advance, and look at trading where they can.

Brown suspects a lot of the overtime is to replace sick employees. If a specialized worker such as an emergency room nurse is sick, a float nurse can’t be sent in as a replacement. Instead, it means overtime for another ER nurse if a qualified fill-in can’t be found.

“The business doesn’t go away. The patients coming in don’t go away. And you have a highly specialized area and they’re difficult to recruit. It doesn’t take much to burn up a fair bit of overtime. And staff need their time off to refresh and rejuvenate themselves,” she said.

Managers do look over attendance records and see if any employees are taking a lot of unexplained sick time. It’s called the attendance promotion program and is aimed at ensuring staff are only using sick time for legitimate reasons.

Those who stand out will have a meeting with the manager, someone from human resources and possibly a union representative, Brown said.

“It’s the unexplained sick time that seems to be of regular use,” she said.

That said, nurses also have an obligation to turn down overtime if they are tired or feel they can’t deliver safe care to patients.

And there are staff who work a lot of overtime. In the 2012-13 fiscal year, one worker accumulated 672 hours of overtime, at a cost of $55,759. The highest for IHA was 1,080 hours for $54,911.

Brown said a strategy was brought in this year to create a 37.5-hour work week, which allowed more positions to be put in. She expects that will help reduce some overtime.

Opening a 20-bed medical unit is also making a difference, she said.

“If you look at how occupancy has changed over the last four years, it’s significantly risen. We’re dealing with a whole lot more patients, a whole lot more procedures going through,” she said.

On the positive side, having the nursing school at Thompson Rivers University creates some opportunities, Brown said. With a significant part of the workforce facing retirement in the coming years, that will become even more important.

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