Moving to agency-free nursing will improve the ‘quality of care’ at MSH

By Gene Pereira, Local Journalism Initiative reporter

There’ll be more familiar faces on your next visit to the Markham Stouffville Hospital.

As of Sept. 30, Oak Valley Health announced the local hospital is an agency-free organization, aligning with other hospitals across Ontario that are reducing reliance on agency staffing.

The local health care organization, which also includes the Uxbridge Hospital, had relied on nursing agencies to help them cover staffing shortages during pressure periods, such as the pandemic and annual flu season.

The stopgap measure filled much-needed shifts but came at an excessive cost, financially and in terms of patient experience. Just last year, Oak Valley Health had to staff roughly 3,800 shifts at premium hourly rates.

“At the peak of the pandemic, we were logging hundreds of hours of agency nursing to staff our emergency departments, our medicine units, and a number of the services in the hospital,” said Oak Valley Health President and CEO Mark Fam. “We were spending about $4.6 million, at worst case, which is a high cost of how we want to spend public dollars to care for our community.

“So, it’s been a real effort over the last 12 months, especially, to really push hard to create teams that want to work here, to create great places for nurses, RNs (Registered Nurses), and RPNs (Registered Practical Nurses) who want to make Oak Valley their home, and to really help improve the quality of our care as well by having committed team members.”  

Fam believes the move will also allow the healthcare organization to build a more stable, cohesive workforce that is connected to its mission, values, and community.

“We had great care delivered by agency nurses, so we couldn’t have done it without them, truly,” said Fam. “But for a patient to have the same nurse caring for them day after day, it makes all the difference for their experience.

“As a team, to be able to have team members they know, as opposed to teams changing every day, it really makes a difference in terms of how teams come together for that consistent, high-quality care we want to deliver.”

The move, says Fam, will also benefit those looking to get into healthcare.

“We’ve also created so many more jobs and opportunities for nurses coming into health care,” he said. “(Those) who want to create a great career ahead.”

Beyond the expense, unfamiliarity with internal processes, culture, and team dynamics sometimes impacted collaboration and continuity of care.

Fam explained that the healthcare organization is on a journey to become a High Reliability organization, which is “right there, right place, right time, but the same consistent care, great standards, great quality.”

While they do that every day, he says it can get better. Team members who are part of Oak Valley are committed to the journey.

“We have a real focus on culture here at Oak Valley Health,” the CEO explained. “We actually kind of named our culture ‘Honour to Care,’ because all of us are in health care to really be able to just care for our patients, care for our community. That honour to care is something you want to instill in all of our team members.

“I know our agency nurses cared a lot too, but to have someone who can come and be part of the team every day, they can really learn what that culture means. Emulate and grow the culture, that’s what we’re excited about.”

That familiarity amongst the staff will also help make a difference when those high-pressure situations arrive, such as a pandemic.

“The more you know each other, the more you can trust each other and lean on each other,” said Fam.

Also, the more they can rely on the standard protocol. From everything down to where the equipment and tools are, to how they do their documentation and patient charts.

“All that makes a difference in terms of being able to respond quickly if we are in a crisis,” said Fam. “That’s part of what our objective has been. For sure, there’s financial savings, but really, it’s about team consistency and culture.”

Oak Valley Health can now redirect funds from agency staffing to more effective uses.

“It will,” said Fam. “The communities we serve across York and Durham Regions are some of the fastest growing communities in our province, and the demand we have from our community every day, in terms of the needs for patient care, will outstrip our existing funding and support.

“So, the more we can do to run efficiently and not spend dollars in this case on agency, and instead be able to invest in our community, that’s better for our community. That’s better for us, and for our teams.”

Those savings can be reinvested in recruitment, onboarding, and education for frontline teams. It can also be used to expand patient programs, such as cardiac, stroke, and nephrology care.

“We have a rapidly growing community, so we’re looking at how do we expand our services to meet that community need, while also recognizing the broader economy we’re in,” said Fam. “We want to make sure we can grow to meet the services our community needs.

“This lets us put our strategic energy and our nursing leadership energy into those kinds of services.”

Fam says he has a great appreciation for all of their nursing teams who have “done this lift.”

“It means everyone is stepping up,” he said. “We appreciate all the support our agency teams have brought in, but for the teams who call Oak Valley Health, they’re all stepping up every day to make this happen.

“To deliver not only the care to the communities, but also to make sure we can staff it ourselves and build that team. Just a great appreciation to all of our nursing teams who are enabling us.”