SANTA FE – Adding staffing to hospital floors would not necessarily lead to better patient outcomes or quality of care, according to officials at Christus St. Vincent Regional Medical Center.
And the issues raised by union members over staffing levels have more to do with who has control over staffing than actual bodies on the floor, said hospital CEO Bruce Tassin on Friday.
He said that became clear to him when, after the hospital agreed to set staffing for nurses at the 40th percentile of comparable hospitals, the union upped its proposal to the 50th percentile and called for some kind of policing mechanism to ensure the hospital met that staffing commitment. “That’s a signal to me that it’s not about staffing, but control,” he said. “What the union really wants is control over staffing.”
Officials with Local 1199 NM of the National Union of Hospital and Health Care Employees, though, said, after an initial proposal to guarantee staffing at the 40th percentile, they moved their position up to the 50th percentile in response to workers who said the 40th was too low.
And they want some form of accountability to staffing levels, they said, because they’ve had promises in the past from management that they don’t feel were carried out. Union membership has voted down management contract proposals on each of the last two Sundays, and this week the hospital management rejected an offer from the union to give up incentive pay worth about 5 percent over the next three years in return for staffing with enforcement at the 50th percentile.
The contract that covers some 400 nurses and 100 technicians expired at the end of Thursday, but workers stayed on the job.
Tassin said he does not consider the two sides to be at an impasse and expects negotiations to continue. The two sides are communicating through a federal mediator, he added.
A study done by the New Mexico Hospital Association recently looked at hours of care per patient-day provided by registered nurses in the state. The results ranged from a low of 4.45 hours to a high of 6.39 hours in New Mexico hospitals, Tassin said.
At 5.83, Christus St. Vincent emerged in the middle, he said. “Several years ago, when we had a higher level of staffing, the quality numbers and patient satisfaction was actually lower,” said Christine Kipp, the hospital’s chief nursing officer.
Three years ago, only 49.8 percent of patients gave Christus St. Vincent a rating of 9 or 10 on a 10-point scale, according to Pearl Mohnkern, vice president for human resources. The rate for the year ending June 30 was 52.3 percent, Tassin said, and last month yielded a 64.1 percent satisfaction rate, in line with the national average, he said. “That’s one of the highest months we’ve ever had,” he said, while Mohnkern added that three of the last few months had come up with ratings close to that.
Federal Medicare funding has been linked to various quality measures in recent times, and patient satisfaction has been one of them. Because of Christus St. Vincent’s below-average ranking in that category, the hospital has lost $2.1 million in a year’s time, Tassin said.
That’s why some of the proposed incentive pay in contract negotiations has been linked to improvement in those scores. Union members have said, though, if staffing levels increase, they are certain patient satisfaction scores would go up, because nurses and aides would be able to respond more quickly to patient needs and would be able to spend more time with each patient.