McAlester News-Capital, McAlester, OK

Local News

May 5, 2013

CEO at McAlester hospital wants more long-term nurses, fewer agency temps

McALESTER — McAlester Regional Health Center CEO David Keith says he plans to dramatically reduce the amount of temporary agency nurses the hospital hires.

Keith who presented a third quarter report to the McAlester City Council on April 23, also said his goal is to maintain a strong culture of patient safety.

In addition, he spoke with the News-Capital on Wednesday about some of the challenges he feels the hospital faces in the future.

Keith, who said he plans to find  $4 million in cost savings by July 1, said a huge expense has been the hiring of the temporary agency nurses.

“What’s hurting us is the cost of agency personnel,” he said.

“We’ve spent over a million and a-half,” he said.

Why has the hospital been hiring so many nurses through temporary agencies in the first place?

Keith said he was trying to meet the demand. That can occur because of an influx of nurses, individuals being off work or other reasons.

The hospital has been running an average census in the 60s — a reference to the number of patients in hospital beds at one time, according to Keith.

However, at times it’s higher, he said.

“There are days when we have an 80-to-90 average,” he said. Other times, it’s lower, and that’s how having a nursing pool could be an advantage, he said.

However, under the current situation, there have been times when Keith said he had to have more experienced nurses on the floor and that’s when he’s had to go to the temp agencies.

“To get an ICU nurse, we’ve had to go as far as California,” he said. Others may come Oklahoma city, or Tulsa or Dallas, he said.

Also, most nurses hired through temp agencies require a  four or an eight-week contract, he said. They don’t want to make the trip to McAlester for a few days work, he said.

Asked about why he’s had to go to temp agencies to hire temporary nurses when Eastern Oklahoma State College and the Kiamichi Technology Center have nursing programs, Keith said he has to have experienced nurses on the floor with recent graduates.

He said it takes from six to nine months to get a recently graduated nurse fully trained to work in a hospital, even if the nurse has already completed all the school work.

“The average age of our nurses is in the 50s,” he said. “A lot are retiring or doing other jobs.”

One way Keith hopes to meet the demands in the future is through what he called a “nursing pool.” For example, some nurses who have retired or are doing other things may not want a full-time nursing job, but might be willing to come in and work a couple of days a week, he said, presenting one example.

Another thing he’s done is raise the starting pay of nurses, he said, up to approximately $21 an hour for an RN, he said.

That’s not phenomenal, but it’s an improvement, he said.

Earlier on Wednesday, Keith had told the McAlester Regional Health Care Authority Board he planned to reduce the number of full-time employees at the hospital, and followed that with a statement that the hospital had too much management.

Asked how he could reconcile what he called the need for more nurses with his plans to reduce the number of full-time employees at the hospital, Keith stated that he hadn’t said he planned to reduce the number of nurses.

During his earlier report to the city council, Keith said maintaining a strong culture of patient safety includes hand-washing initiatives — having everyone, including medical providers, wash their hands upon entering and upon leaving a patients’ room.

Starting with a baseline of 64 percent — meaning the hand-washing occurred 64 percent of the time — the number grew to 84 percent during the time period from last October to December, according to Keith.

Numbers were reportedly tracked by “secret shoppers,” meaning individuals who were charged with observing the hand-washing in different part of the hospital.

Keith has maintained he wants the number to reach 100 percent in the future.

Also in his report, Keith said Emergency Department outcomes incomes include a Fast track procedure designed to get patients into the Emergency Room more quickly.

That’s resulted in a decrease in the number of patients leaving the Emergency Department — without treatment, Keith said.

That’s a reference to patients who leave the Emergency Room because they get tired of waiting to be seen and treated.

Also, Urgent Care volumes are continuing to increase, with two providers now available for each shift, he said.

On a related note, Keith told the MRHC Authority board on Wednesday that he plans to propose construction of a new Emergency Department and Intensive Care Unit at the hospital.

Contact James Beaty at jbeaty@mcalesternews.com.

For more on this story, see the print or electronic editions of the McAlester News-Capital. Click here for print edition home delivery or click here to see the Smart Edition for your computer, tablet, e-reader or smartphone.

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