Hospital managers should “over-recruit” nursing staff by 10% in order to ensure the best quality care for patients, according to a former nurse who is now chief executive of one of the UK’s leading acute trusts.
Dame Julie Moore, chief executive at University Hospitals Birmingham Foundation Trust, urged nursing directors to be bold and employ more staff in her keynote speech to the Florence Nightingale Foundation annual conference on Friday.
She said the policy, which meant wards were staffed by permanent employees rather than agency staff, not only led to better quality care but could also save trusts hundreds of thousands each year.
However, she said many nursing managers acted like this was “the hardest thing in the world”.
“I tell them to over-recruit but they’re not,” she said. “It’s like it is impossible to over-recruit because it is engrained in them not to go over their establishment.”
“If you interview two good staff nurses for one job then employ them both”
She advised managers to aim for 10% over-recruitment with the expectation they would end up about 5% over.
“Never allow a good person not to be recruited,” she told the conference. “If you interview two good staff nurses for one job then employ them both.”
Dame Julie, a nurse by background, said she recalled the days when nursing chiefs were actively encouraged to employ around 20% agency staff.
But she said it was now clear that over-reliance on agency nurses harmed standards of care.
Dame Julie Moore
“More than two agency staff per shift on a ward can result in lower quality of care,” she said. “They are unfamiliar with the patients, unfamiliar with the ward and unfamiliar with the overall culture.”
She showed delegates how her own trust’s strong performance had faltered over the winter when a surge in patients meant it was forced to employ more agency staff.
Dame Julie also called on nursing professionals to embrace IT systems with the potential to dramatically improve the safety, efficiency and quality of care.
She said her trust had seen the number of prescription errors plummet after introducing a computerised system that actively stopped doctors and nurse prescribers making mistakes.
IT had also helped increase the speed of referrals and treatment and reduce the number of unnecessary tests.
“Electronically held data can be far more secure than a cardboard folder”
The use of “clinical dashboards” meant nursing managers could get up to date information about each ward’s performance and compare that across the trust, according to Dame Julie.
“Ward sisters spend quite a lot of time looking at other areas,” she said. “They’re asking questions like ‘How do you get your assessments done so quickly?’ and there’s quite a lot of good competition going on.”
Despite concerns about the confidentiality of electronic patient records, she said she believed “security can be far more rigorous with IT”.
“We have had several high profile patients in our organisations and I think electronically held data can be far more secure than a cardboard folder that gets carried around,” she told delegates.