At RUSH, we have taken many steps to ensure that our workforce is nimble enough to traverse the ebb and flow that comes with variations in the patient census. These include having an established resource float pool, flexible scheduling, incentives for picking up additional shifts, ongoing recruiting, retention bonuses, sign-on bonuses and partnerships with outside staffing vendors. During the pandemic, RUSH faced unprecedented staffing challenges, including large fluctuations in the census, many unscheduled absences under the Family and Medical Leave Act, health care workers grappling with high levels of fatigue and stress and widespread turnover as employees sought positions with fewer stressors or pursued travel contracts. We addressed these challenges by implementing a layered approach that utilized our own internal resource pool, interval travel nurse contracts, incentives for RUSH nurses to pick up additional shifts and staffing support from the Federal Emergency Management Agency.
Innovation and creativity are needed to update supplemental staffing models of care to meet new conditions and provide safe patient care. In May 2022, we launched a pilot program called the RUSH University System for Health Temporary Employee Program (RUSH TEP). RUSH TEP serves as our own robust internal staffing program and consists of highly trained registered nurses who are hired on short-term contracts. During the pilot phase, which consists of two 13-week contracts, nurses are assigned to RUSH University Medical Center and RUSH Oak Park Hospital. RUSH Copley Medical Center will join the program once it has collectively been decided that the program works for the entire system. The purposes of this program include the following:
- Provide a means for stabilizing staffing while actively recruiting and onboarding new permanent nurses.
- Curb premium labor expenses.
- Match staffing flexibility with census flexibility.
RUSH TEP nurses are centrally interviewed, hired and deployed to a unit for the duration of their contracts. They can float to similar areas, and their schedules are managed by their assigned unit’s director. The RUSH TEP nurses work in the Emergency Department and the critical care, medical surgical and perioperative areas. While the program is still in its infancy, we already are seeing its benefits. In the Division of Nursing, we will have zero external agency contracts by the fall of 2022, our premium labor costs are declining (see graph) and RUSH TEP continues to gain momentum.
Over the last two years, we have taken many steps to bring staffing back into balance and to enact programs and benefits that attract and retain RUSH nurses. Responsibility for these changes includes an open dialogue with front-line staff, our nursing leaders and our unique shared-governance model. Innovation is one of our I CARE values, and the RUSH University System for Health Temporary Employee Program is another innovative idea to help us provide the best quality care for our patients.