HEALTH SERVICE ASSISTANTS
A collabora3ve approach
Jenny Boak: Bendigo Health John Giudice: Bendigo TAFE
Bendigo Health
Services the Loddon Mallee region • 56,965 square kilometers or 26% of Victoria, with a popula3on
currently reported as 307,405.
• From Gisborne in the South, Echuca in the North, Kyabram in the North East and Mildura in the far North West, the region nestles amongst the State borders of Victoria, South Australia and New South Wales.
Bendigo Health • Provides across the lifespan
• Over more than 40 loca3ons across the region • 653 bed high acuity teaching hospital
• 60 bed rehabilita3on unit • Mental health through hospital, community and outreach
services
• Residen3al aged care facili3es • The largest employer in the region, with around 3100 staff.
• Strong culture of educa3on, Bendigo Health enjoys partnership with La Trobe University and Monash University, both of whom have rural schools on site.
Health Service Assistant Background
• Nursing workforce plan • Pilot program in 2009 (DH supported)
• GAP year opportunity • 12 month program
Other responses to nursing shortage in 2009
• Re-‐entry nursing programs
• Increasing graduate nurse posi3ons • Overseas qualified nurses • Developing Nurse Prac33oner roles • Upskilling Enrolled Nurses
HSA roles
• Medical unit, Rehabilita3on unit, Cri3cal Care and Emergency Department
• Ac3vi3es included; ADL’s, personal hygiene, basic mobility, manual handling, simple feeds, bed making, documenta3on and restocking supplies.
• Over the current nurse-‐pa3ent ra3os
Stakeholder engagement
• ANMF • BRIT (Bendigo TAFE) • Unit Managers
• Project officer
• Department of Health
Aims in 2009 1. Enhance workforce capacity and health service delivery 2. Engage with stakeholders to iden3fy and scope the
trainees role
3. Develop Cer3ficate III course in Health Service Assistants (collabora3on)
4. Enhance the pa3ent experience using addi3onal services
5. Enhance health professional sa3sfac3on and reten3on 6. Expose school leavers to a gap year in the health system
Evalua3on
Internally • Survey of nurses • Focus groups
Externally • Price Waterhouse Coopers
Financial considera3ons • Two financial incen3ves were available in
2009 (total $6250)
• Bendigo Health paid for uniforms, course materials and fees ($1,400)
• Salaries including super $30,790
Support provided to trainees
• Orienta3on to Bendigo Health • Orienta3on to ward by staff (CHERC) and
depar3ng trainee • A coordinator maintains contact to ensure their
pastoral care needs are met • Unit staff, managers and BRIT staff • Uniforms supplied • Study days are paid for • Fees and study requirements paid for
BRIT Cert III Health Services Assistance
Comply with infec3on control policies and procedures
Support the care of clients Assist with client movement
Transport clients Communicate & work effec3vely in health
Par3cipate in Work Health & Safety processes
Interpret & apply medical terminology Perform general cleaning tasks in a clinical seing
Provide support in an acute care environment Handle medical gases safely
BRIT Cert III Health Services Assistance
Blood product transport
Assist with an allied health program Assist nursing team in an acute care environment Contribute to workplace rela3onships
Recognise healthy body systems in a health care context Principles of research Apply first aid
Maintain high standard of client service
Trainees con3nuing to careers in health sector
Year Es(mated number entering health related
courses 2009 3/8 2010 5/8 2011 3/8 2012 5/8 2013 7/10 Total 23/42 = 55%
Staff feedback
• “The HSA’s have become a very important part of the team”
• “Quality of care around the ward has improved when the HSA’s can give 3me to pa3ents”
• “Their ac3ons are vital to keeping nursing staff focused on pa3ent care at the bedside”
Pa3ent impacts
“One pa3ent’s last days were very much enhanced and brightened by his conversa3ons with the HSA”
“Pa3ents love having the HSA’s on the ward as they have 3me to do the liple things that nursing staff can get too busy to do”
Apri3on Apri3on; a problem in 2013 • Reduc3on in salary • Trainees needed another job to support their
income
Apri3on impacts Actual • Increased workload of staff • No trainee to orientate the next • Comple3on payment not made • Increased counselling 3me and effort to retain
trainees • Addi3onal cost of recruitment to replace
Poten3al • Word of mouth that they can leave traineeship • Risk to viability and dependability of program • Risk of not obtaining full funding incen3ve
Strengths
• 50% of trainees have progressed to careers in health professions
• Large majority of trainees talk about the experience in very favourable terms
• Course allows young people a chance at a job in health, with minimum qualifica3on/ experience
• Very good execu3ve support and leadership
Strengths
• Address recruitment of indigenous staff from 2014 onwards
• Con3nuing to maintain a “third 3er” worker capacity
• HSA role demonstrates an investment in support staff
• HSA’s becoming nurses could be more likely to gain a Graduate year at BH
• Contribute to reputa3on as employer of choice
Weaknesses
• The course ini3ally made a lot of work out of “very liple” content. This lead to “behaviour” problems in class.
• Some trainees have demonstrated a lack of employability skills and general maturity.
• In Bendigo, no employment prospects as a qualified Health Service Assistant.
Weaknesses
• Long term efficiencies difficult with 12 month posi3on
• Poten3al for staff sa3sfac3on and morale to be reduced over 3me as HSA become part of the workforce
Recommenda3ons from pilot
• Posi3on descrip3on clarifying the role of HSA and supervision structure
• Con3nue external stakeholder engagement (ANMF)
• Formal debriefing sessions for educa3onal and clinical environments
• Con3nue to inves3gate ongoing feasibility of annual recruitment
2014 and beyond
• Increase in salary • Consider ongoing posi3ons such as AIN model
• Con3nue to support nursing staff • Con3nue to support poten3al health sector
career pathways
Jenny Boak [email protected]
John Giudice [email protected]