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The Joint
Commission on Accreditation
of Healthcare Organizations (JCAHO) has recently set new standards for
healthcare staffing agencies. The new certification process will mean big
changes in the travel nursing field. What does this means for staffing
companies? New standards have been placed on the travel staffing companies
and on travel nurses.
The staffing
companies will have to clearly define the company leadership hierarchy.
Administrator and director of nursing services will be first and foremost on
the top of the list with the travel nurses at the bottom of the list. Also
in the mix will be the accountant, pay roll supervisor, information systems
technician, human resources, and a housing supervisor.
This budget
will include costs of certifications, cost of management, cost of the
nurses, costs of the benefits, and how that amount compares with the
accounts receivable through the hospital bill rate. With the implementation
of JCAHO certifications, the cost of owning a travel nursing or staffing
company just sky rocketed. Most certainly not all staffing companies will be
able to survive all these costs; therefore, companies either will have to do
more subcontracting through companies which can afford the JCAHO
certification or the smaller companies will have to fold.
According to
the travel nurses that I have talked to, the majority believe that this will
lead to Cross Country Trav Corp, Intelistaf, and AMN becoming the Walmart,
Kmart, and Target of travel companies with the smaller companies like
Midwest Staffing, Nursing Options, and Big Sky Nursing fighting to keep
alive.
Nurses know
that they get better service with the smaller companies, but we also know
that jobs with these smaller companies are few. A code of ethics? As a
nurse, I expect companies to treat me like a name, and not a number.
JCAHO
standards also involve continuing education. Continuing education as well as
experiences is what makes a good nurse even better. A nurses skills must be
kept up to date and new education opportunities taken advantage of in the
area of expertise.
When these
quality measures become issues, then a staffing company must have an
organized approach to improve the nurses’ performance. If required verbal
warnings, written warnings, and termination may be inevitable if these
opportunities are not taken advantage of. When I asked Reginald Helms of All
Health Staffing (www.allhealthstaffing.com) about the quality assurance, he
stated, “Frankly, I think that the issue is not with the agency, but with
accountability from the hospitals ensuring that any nurse sent by the agency
is as stated on paper. In my opinion, agencies as a whole do a pretty good
job of getting qualified nurses. If there is a conflict between what is
stated on paper and what the nurse’s performance is, the hospital has the
responsibility to report it to the staffing agency.”
Another
issue addressed by JCAHO is addressing conflicts of interest including
contract discrepancies, making your travel assignment your permanent
assignment, and other conflicts between the hospital and the nurse. (Nurses,
this is why we MUST read our contracts word for word). Conflicts can also
occur when a nurse wants to continue on as a permanent staffing member
instead of travel. When there are problems with the nurse’s performance, the
hospital has a right to terminate that contract, but there is usually a
conflict between how much the employee is penalized monetarily for housing
and travel. The problems that do occur must be promptly solved. The longer
the problems linger, the greater the problem becomes.
The next big
issue is that of quality nursing care. Quality must be assured by skills
checklists, orientation skills checked off, and standard safety skills.
Safety issues are addressed initially with the use of skills checklists,
which are completed by the nurse upon application for the position. If a
hospital reports that clinically a nurse is not able to perform as stated,
then it is the agencies job to work with the nurse to either find different
placement or help the nurse to obtain the credentials.
One of the
biggest safety issues that are a prominent concern is nurse to patient
ratios. It is the travel nurse’s responsibility to assure they are not being
put into an unsafe situation, during the interview with the hospital. It is
the staffing agencies responsibility to stand behind the nurse with these
staffing issues. If the nurse to patient ratio is not as stated in the
interview, then the staffing company and nurse need to do some conflict
resolvement with the hospitals management team.
Evaluations
from supervisors are also an important tool in safety and quality of care.
These evaluations are used to determine if the job is really going as well
as the travel nurse states it is, or as bad as the nurse states that it is.
JCAHO standards also involve continuing education. Continuing education as
well as experiences is what makes a good nurse even better. The records of
each nurse must be safeguarded. The information must be available to the
nurse if needed for other staffing opportunities.
Profiles
only need to be submitted on approval of the nurse. What is the future of
travel nursing? Staffing agencies will have to be JCAHO certified to place
nurses in JCAHO certified hospitals. The cost of this certification will not
increase the bill rate to the hospital, yet it will be taken out the nurses
pay rate and benefits. Over all travel nurses are quality nurses who have
great expectations placed on them. I believe that these regulations were
created to assure quality of care that is provided to the hospitals which
use travel nurses.
To check out the staffing
agencies that are currently certified, please check out the JCAHO website
at:
http://www.jcaho.org/dscc/hcss/index.htm |
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