CRITICAL CARE NURSING WORKFORCE PROFILE Care Nursing/Critical Care Nursing...Critical Care Workforce Profile — Peer Group 2 Report 6 Critical Care Services Ontario • June 2017

CRITICAL CARE NURSING

WORKFORCE PROFILE

Peer Group Report Peer Group 2 | June 2017

Critical Care Workforce Profile — Peer Group 2 Report

2 Critical Care Services Ontario • June 2017

ACKNOWLEDGMENTSThe 2017 Critical Care Workforce Profile (CCWP) reflects data generated between April 1, 2015 to March 31, 2016. Critical Care Services Ontario would like to thank all Critical Care Stakeholders who have been instrumental in contributing data to complete the 2015/16 Critical Care Workforce Profile Survey. These contributions are vital to informing CCSO’s health human resource planning, efforts and work in identifying emerging challenges and considerations for the critical care workforce.


Critical Care Services Ontario • June 2017 3

TABLE OF CONTENTS

PEER GROUP REPORT OVERVIEW 4

PEER GROUP 2 HIGHLIGHTS 5

UNIT LEVEL RESULTS 7

Nurse Roles and Demographics 7Table 1: Length of Nurse Experience in the Critical Care Unit 7

Table 2: Age Group Distribution of Critical Care Nurse 8

Nurse Staffing Practices 9Table 3: Employment Status Distribution of Critical Care Nurses 9

Table 4: Employment Status Distribution of Critical Care Nurse Earned Hours 10

Table 5: Distribution of Critical Care Nurse Earned Hours by Type 11

Table 6: Overtime Hours as a Proportion of Productive Hours for Critical Care Nurses 13

Table 7: Sick Rate for Critical Care Nurses 14

Table 8: Education Hours as a Proportion of Total Earned Hours for Critical Care Nurses 15

Table 9: Approaches to Manage Short-Term Nursing Shortages 16

Table 10: Critical Care Nurse Worked Hours (including Overtime) per Patient Day 17

Nurse Training 18Table 11: Critical Care Training Attainment Distribution of Critical Care Nurses 18

Table 12: Advance Cardiac Life Support Training Attainment Distribution of CC Nurses 20

Table 13: Approaches to Professional Development Investment in Critical Care Units 21

Nurse Turnover 22Table 14: Critical Care Nurse Turnover, Overall 22

Table 15: Destination of Critical Care Nurses Leaving the Unit or Changing Employment Status 23

Nursing Recruitment 24Table 16: Vacancy Rate for Critical Care Units 24

Allied Health Professionals in Critical Care 25Table 17: Routine Use of Allied Health Professionals in Critical Care Units 25

Table 18: Pharmacist Support Hours per Day in Critical Care Units 26

Table 19: Pharmacist Provision of On-Call Support in Critical Care Units 27

Table 20: Physiotherapist Support Hours per Day in Critical Care Units 28

Table 21: Physiotherapist Provision of On-Call Support in Critical Care Units 29

Table 22: Respiratory Therapist Support Hours per Day in Critical Care Units 30

Table 23: Respiratory Therapist Provision of On-Call Support in Critical Care Units 31

PEER GROUP REPORT APPENDICES 32

Appendix A. Glossary of Terms 32

Appendix B. Calculations Table 33

Appendix C. Online Data Collection Tool 35



PEER GROUP REPORT OVERVIEWThe objective of this peer group report is to offer critical care units a perspective on their current nursing and allied health workforce in comparison with other ‘like’ units from their peer group. Peer level groupings were first launched by CCSO in July 2013 to facilitate comparison of a unit’s performance with ‘like’ units. Assignment to a specific Peer Group took into account factors such as unit designation (Level 2 or Level 3), academic affiliation, and severity of illness of patients managed in the units.

The peer group summary report provides two components of information specific to the peer group.

1. Peer Group Highlights: This section highlights findings that are unique to the peer group when comparing to the overall provincial results. This review considers the following elements of the main provincial report:

• Nurse Demographics covers experience in critical care, age and gender.

• Nurse Staffing Practices covers employment status, overtime, sick time and managing short term nursing shortages as well as nurse productivity.

• Nurse Training covers educational attainment, and specialized critical care training.

• Nurse Turnover covers nurse separations by age group and nurse employee turnover.

• Retention and Employee Engagement covers employee engagement, information on recruitment and recruitment strategies, new hires and vacancy rate.

• Allied Health Professionals in Critical Care covers allied health professionals and reports on the use of the different allied health professionals.

2. Unit Level Results: This section provides results for select measures across the individual critical care units within the peer group.

• Critical care nursing demographics, workforce utilization of both nursing staff and allied health professionals in critical care, and recruitment and retention indicators are reported.

• Data tables for 22 measures and results for all critical care units in the peer group that reported data are provided.



PEER GROUP 2 HIGHLIGHTSPeer Group 2 {Level 3 Community Hospital Medical Surgical ICUs with Ventilator Patient Day Rate above the mean rate of 46.95%} is comprised of 28 Critical Care Units The completeness of data reported for the units in this peer group varies across different dimensions of analysis, depending on the information that was provided through the data collection process.

The following are observations specific to Peer Group 2 (PG2), in relation to the overall provincial results from the Critical Care Workforce Profile:

NURSE STAFFING PRACTICES

• Peer Group 2 reported the highest percentage (5.3%) of overtime hours as a proportion of productive hours for critical care nurses. This percentage is higher than the overall provincial average of 3.9%. (CCWP Provincial Report Figure 20).

• Peer Group 2 reported “rarely/never” (81%) using critical care nursing pools to manage short term nursing shortages compared with 64% provincially. (CCWP Provincial Report Figure 27).

• Peer Group 2 reported that they “frequently” (41%) use agency staffing in their critical care units compared. This is the hghest among all peer groups and compares with 14% on average acorss all units provincially. (CCWP Provincial Report Figure 28).

NURSE TRAINING AND TURNOVER

• All Peer Groups in the province have nurses working in their critical are units who are internationally trained with a provincial average of 7.4%. Peer Group 2 reported one of the highest percentages of internationally trained nurses at 13.4%. (CCWP Provincial Report Figure 32).

• More than half (53%) of the nurses in all adult critical care units across Ontario have had ACLS training in the last two years. Peer Group 2 reported one of the highest percentages of critical care nurses with ACLS training with 70% being trained in the last two years. (CCWP Provincial Report Figure 40).

• Using ‘MOHLTC Support’ to support professional development (e.g. Critical Care Nurse Training Fund) was reported among all Peer Groups. Peer Group 2 reported the highest use of ‘‘MOHLTC Support’ at 95% of units using this strategy frequently or sometimes compared with a provincial average of 64%. (CCWP Provincial Report Figure 45).

• The critical care nurse vacancy rate across Peer Groups is Variable. Peer Group 2 has the highest vacancy rate at 9.1%. The provincial vacancy rate is 5%. (CCWP Provincial Report Figure 55).



ALLIED HEALTH PROFESSIONALS IN CRITICAL CARE

• Peer Group 2 units reported low on-call coverage by physiotherapists on weekends, with coverage in only 22% of units, while provincially the percentages are 68%. (CCWP Provincial Report Figure 64).

• Across the province respiratory therapists are highly used in all Peer Groups on weekdays (average of 16 hours of coverage per day), and in some Peer Groups on weekends (average of 7.2 hours of coverage per day). Peer Group 2 has the second highest level of coverage of respiratory therapists on both weekdays and weekends with 21 hours of coverage per day. (CCWP Provincial Report Figure 65).

The intention of highlighting variation in practice allows peer groups and individual critical care units to understand where difference exists, and to address areas that may be of concern. Such efforts at the unit level will foster a more robust workforce and help ensure patients have access to timely and quality care. The following section provide unit level results for select measures from the 2015/16 results of the Critical Care Workforce Profile.



UNIT LEVEL RESULTSPeer Group data is shown at the provincial, peer group and unit level in table format in the sections that follow. In reviewing data, please note that “0”=true value and “-” =missing value. Reference to the related figures in the CCWP Provincial Report and data source have been noted before each table.

Nurse Roles and Demographics

Table 1: Length of Nurse Experience in the Critical Care UnitCCWP Provincial Report Figure 4: Length of Nurse Experience in the Critical Care Unit

Source: 2015/16 CCWP Online Data Collection Tool, Question 2A

Corporation Name Site Name CCIS Code

Years In Critical Care

< 3 3–5 6–10 11–20 > 20

Ontario 20.6% 17.5% 22.9% 23.6% 15.5%

PG2 21% 14.2% 25% 23.9% 15.8%

North York General Hospital North York General Hospital 003 38.4% 13.4% 22.3% 21.4% 4.5%

Markham Stouffville Hospital Markham Site 010 28% 6.5% 26.9% 28% 10.8%

Lakeridge Health Corporation Oshawa 014 13.1% 17.5% 15.3% 32.1% 21.9%

Peterborough Regional Health Centre

Hospital Drive Site 016 28% 3.2% 26.9% 21.5% 20.4%

Rouge Valley Health SystemCentenary Site 019 26.2% 8.2% 24.6% 6.6% 34.4%

Rouge Valley Ajax & Pickering 020 31.1% 2.2% 20% 15.6% 31.1%

William Osler Health CentreBrampton Campus 029 14.8% 18.9% 28.4% 27.8% 10.1%

Etobicoke Campus 030 8.1% 31.1% 25.7% 24.3% 10.8%

Hopital Montfort Hopital Montfort 037 46.9% 28.6% 16.3% 8.2% 0.0%

Queensway Carleton Hospital Queensway Carleton Hospital 039 20% 8% 24% 18% 30%

Windsor Regional HospitalMetropolitan Campus 062 26.6% 12.5% 39.1% 14.1% 7.8%

Ouellette Campus 234 11.7% 19.1% 24.5% 30.9% 13.8%

Halton Healthcare ServicesOakville Trafalgar Memorial Hospital

091 23.2% 21.1% 14.7% 31.6% 9.5%

Trillium Health PartnersThe Credit Valley Hospital 092 17.1% 25.6% 25.6% 21.4% 10.3%

The Mississauga Hospital 095 15.1% 9.6% 20.5% 26% 28.8%

Grey Bruce Health Services Owen Sound 142 14.3% 19% 19% 23.8% 23.8%

Huron Perth Health Alliance Stratford General Hospital 145 31% 6.9% 24.1% 17.2% 20.7%

St. Joseph's Health Centre (Toronto)


174 22.7% 9.1% 17% 22.7% 28.4%

Toronto East Health Network Michael Garron Hospital 188 14.9% 8.1% 14.9% 41.9% 20.3%

Humber River Regional Hospital

Wilson Site240 26% 13.5% 37.5% 14.6% 8.3%

241 12.2% 5.6% 53.3% 23.3% 5.6%



Table 2: Age Group Distribution of Critical Care NurseCCWP Provincial Report Figure 7: Age Group Distribution of Critical Care Nurse

Source: 2015/16 Human Resources Data Collection Tool, Direct Care Nursing


Age Group

< 30 30-39 40-49 50-59 60-64 65+

Ontario 18.5% 28% 25.3% 21.8% 4.5% 1.8%

PG2 14.7% 28% 28.6% 23% 4.2% 1.5%

North York General HospitalNorth York General Hospital

003 21.9% 23.3% 31.5% 18.6% 2.8% 1.9%

Southlake Regional Health Centre


006 7.1% 41.4% 22.9% 22.9% 2.9% 2.9%

Mackenzie Health Mackenzie Health 009 5.5% 16.4% 45.5% 25.5% 7.3% 0.0%

Markham Stouffville Hospital Markham Site 010 21.8% 34.6% 25.6% 17.9% 0.0% 0.0%

Lakeridge Health Corporation Oshawa 014 14.7% 31.6% 28.7% 22.1% 2.9% -


Hospital Drive Site 016 24.2% 33% 16.5% 24.2% 1.1% 1.1%

Rouge Valley Health System

Centenary Site 019 13.2% 31% 23.3% 26.4% 4.7% 1.6%

Rouge Valley Ajax and Pickering

020 19.6% 27.5% 19.6% 29.4% 3.9% 0.0%

The Scarborough Hospital General Site 024 1.8% 17% 38.4% 29.5% 8.9% 4.5%

William Osler Health Centre Grace Site 026 8.3% 11.7% 26.7% 41.7% 8.3% 3.3%

Hopital Montfort Brampton Campus 029 10.4% 18.8% 35.1% 24.7% 9.1% 1.9%

Windsor Regional Hospital Etobicoke Campus 030 5.4% 27% 35.1% 24.3% 4.1% 4.1%

Halton Healthcare Services Hopital Montfort 037 47.8% 28.3% 19.6% 4.3% - -

Trillium Health PartnersMetropolitan Campus

062 14.8% 29.5% 23% 21.3% 8.2% 3.3%

Grey Bruce Health Services Ouellette Campus 234 10.2% 44.3% 31.8% 12.5% 1.1% -

Huron Perth Health AllianceOakville Trafalgar Memorial Hospital

091 8.9% 33.3% 27.8% 24.4% 5.6% 0.0%


The Credit Valley Hospital

092 11.2% 28.4% 34.5% 20.7% 3.4% 1.7%

Toronto East Health NetworkThe Mississauga Hospital

095 21.1% 32.1% 23.2% 17.4% 4.2% 2.1%

Grand River Hospital Corporation

Owen Sound 142 23.8% 19% 19% 28.6% 9.5% -

St. Mary's General HospitalStratford General Hospital

145 13.8% 27.6% 24.1% 31% - 3.4%

Humber River Regional HospitalSt. Joseph's Health Centre (Toronto)

174 9.6% 26.5% 24.1% 34.9% 3.6% 1.2%



Nurse Staffing Practices

Table 3: Employment Status Distribution of Critical Care NursesCCWP Provincial Report Figure 15: Employment Status Distribution of Critical Care Nurses

Source: 2015/16 CCWP OHRS UPP Data from Finance Department Submission


Total Head Count

Earned Hours Type

Casual Full-Time Part-Time

Ontario 8,435 10.6% 65.9% 23.5%

PG2 2,249 12.3% 64.9% 22.7%


003 114 13.2% 52.6% 34.2%



006 69 4.3% 81.2% 14.5%

Mackenzie Health Mackenzie Health 009 112 25.9% 61.6% 12.5%

Markham Stouffville Hospital Markham Site 010 77 31.2% 36.4% 32.5%

Lakeridge Health Corporation Oshawa 014 136 5.9% 79.4% 14.7%


Hospital Drive Site 016 94 1.1% 67% 31.9%


Centenary Site 019 55 12.7% 52.7% 34.5%


020 46 8.7% 67.4% 23.9%

The Scarborough HospitalGeneral Site 024 110 16.4% 63.6% 20%

Grace Site 026 40 15.1% 58.5% 26.4%

William Osler Health CentreBrampton Campus 029 149 16.8% 62.4% 20.8%

Etobicoke Campus 030 71 15.5% 73.2% 11.3%

Windsor Regional HospitalMetropolitan Campus 062 102 - 58.8% 41.2%

Ouellette Campus 234 100 - 60% 40%


091 89 24.7% 46.1% 29.2%

Trillium Health PartnersThe Credit Valley Hospital 092 117 23.1% 58.1% 18.8%

The Mississauga Hospital 095 191 18.3% 70.2% 11.5%

Grey Bruce Health Services Owen Sound 142 21 4.8% 66.7% 28.6%

Huron Perth Health Alliance Stratford General Hospital 145 30 - 33.3% 66.7%



174 86 15.1% 74.4% 10.5%

Toronto East Health Network Michael Garron Hospital 188 69 11.6% 65.2% 23.2%


Kitchener Waterloo Site 204 91 9.9% 69.2% 20.9%

St. Mary's General Hospital St. Mary's General Hospital 216 41 12.2% 46.3% 41.5%

Humber River Regional Hospital Wilson Site240 104 6.1% 81.2% 12.7%

241 0 - 86.5% 13.5%



Table 4: Employment Status Distribution of Critical Care Nurse Earned HoursCCWP Provincial Report Figure 17: Employment Status Distribution of Critical Care Nurse Earned Hours



Total Earned Hours

Earned Hours Type

Casual Full-Time Part-Time

Ontario 12,875,923 2.7% 79.9% 17.5%

PG2 3,151,943 3.2% 79.9% 16.9%


003 166,660 4.2% 69.6% 26.2%



006 111,116 0.6% 88.5% 10.9%

Mackenzie Health Mackenzie Health 009 153,040 6.8% 84% 9.2%

Markham Stouffville Hospital Markham Site 010 71,545 14.3% 61% 24.7%

Lakeridge Health Corporation Oshawa 014 210,749 1.6% 86.7% 11.7%


Hospital Drive Site 016 151,617 0.2% 73.4% 26.4%


Centenary Site 019 89,668 2.2% 65.3% 32.5%


020 77,693 1.9% 75.8% 22.3%

The Scarborough HospitalGeneral Site 024 165,100 7.6% 76.5% 15.9%

Grace Site 026 56,681 6.5% 77.9% 15.6%

William Osler Health CentreBrampton Campus 029 196,316 - 81.7% 18.3%

Etobicoke Campus 030 110,965 - 87.8% 12.2%

Hopital Montfort Hopital Montfort 037 77,495 - 90.8% 9.2%

Windsor Regional HospitalOuellette Campus 234 65,275 - 69.2% 30.8%

Metropolitan Campus 062 103,646 - 71.1% 28.9%


091 128,429 9.4% 61.6% 29%

Trillium Health PartnersThe Credit Valley Hospital 092 162,267 6.8% 82.1% 11.1%

The Mississauga Hospital 095 278,325 3.3% 89.4% 7.3%

Grey Bruce Health Services Owen Sound 142 32,088 4.5% 82.7% 12.8%

Huron Perth Health Alliance Stratford General Hospital 145 30,878 5% 59% 35.9%



174 150,153 2.6% 89.2% 8.3%

Toronto East Health Network Michael Garron Hospital 188 99,757 - 81.6% 18.4%


Kitchener Waterloo Site 204 144,682 2.5% 79.2% 18.3%

St. Mary's General Hospital St. Mary's General Hospital 216 45,739 1.5% 64.5% 34%


Wilson Site240 143,446 2.6% 87.1% 10.3%

241 128,614 2.6% 87.1% 10.3%



Table 5: Distribution of Critical Care Nurse Earned Hours by TypeCCWP Provincial Report Figure 19: Distribution of Critical Care Nurse Earned Hours by Type

Source: 2015/16 CCWP OHRS Data from Finance Department Submission


Total Earned Hours

Earned Hours Type

Educ

atio

n

Orie

ntat

ion

Oth

er

Ove

r Tim

e

Regu

lar

Wor

ked

Sick

Vaca

tion

Ontario 12,853,341 0.8% 1.8% 4.4% 3.1% 78% 4.7% 7.1%

PG2 3,151,943 0.8% 1.8% 4.5% 4.3% 76.9% 5% 6.6%

North York General Hospital


003 166,660 0.7% 2.9% 4% 0.8% 81.9% 3.2% 6.6%



006 111,116 0.8% 0.2% 3.7% 3.5% 80.6% 4.5% 6.7%

Mackenzie Health Mackenzie Health 009 153,040 - - 4.1% 9.4% 75.7% 4.4% 6.4%

Markham Stouffville Hospital

Markham Site 010 71,545 1.2% 0.8% 3.2% 2.6% 84.1% 2.8% 5.3%

Lakeridge Health Corporation

Oshawa 014 210,749 0.8% 1.2% 5.3% 4.7% 72.4% 7.1% 8.5%


Hospital Drive Site 016 151,617 0.6% 2% 3.2% 3.2% 79.3% 4.9% 6.9%


Centenary Site 019 89,668 0.4% 1.5% 3.6% 2.5% 80.9% 4.8% 6.4%


020 77,693 0.4% 2.3% 3.8% 3.3% 80.4% 2.7% 7%

The Scarborough Hospital

General Site 024 165,100 0.8% 0.8% 4.2% 2.9% 79.8% 4.1% 7.4%

Grace Site 026 56,681 0.2% 1% 6.4% 3.6% 75.9% 5.8% 7.2%

William Osler Health Centre

Brampton Campus 029 196,316 0.3% 0.8% 4.8% 7.6% 73.4% 6.3% 6.8%

Etobicoke Campus 030 110,965 0.8% 1.1% 4.4% 9.3% 71.4% 5.5% 7.6%

Hopital Montfort Hopital Montfort 037 77,495 1.7% 4.4% 3.9% 5.4% 73.2% 4.4% 6.9%

Windsor Regional Hospital

Metropolitan Campus 062 103,646 0.6% 3.5% 5.1% 5.6% 71.1% 7.1% 7.1%

Ouellette Campus 234 65,275 0.0% 0.7% 6.4% 7% 74.4% 6.6% 4.9%

Trillium Health Partners


092 162,267 0.8% 3.3% 4.4% 2.8% 77.4% 4.6% 6.8%

The Mississauga Hospital

095 278,325 1.1% 0.6% 5.5% 6.3% 71.9% 6.8% 7.7%

Grey Bruce Health Services

Owen Sound 142 32,088 0.9% 2.3% 5.4% 1.1% 74.4% 7.6% 8.4%

Huron Perth Health Alliance

Stratford General Hospital

145 30,878 0.1% 4.4% 4.2% 2.4% 79.7% 3.4% 5.7%



174 150,153 0.9% 0.2% 5.6% 3.6% 76.3% 5.2% 8.1%

Toronto East Health Network

Michael Garron Hospital

188 99,757 0.8% 0.6% 4.4% 4.2% 77.8% 4.4% 7.7%




Total Earned Hours

Earned Hours Type

Educ

atio

n

Orie

ntat

ion

Oth

er

Ove

r Tim

e

Regu

lar

Wor

ked

Sick

Vaca

tion


Kitchener Waterloo Site

204 144,682 1.7% 3.3% 4.6% 4.5% 74.5% 4.3% 7.1%

St. Mary's General Hospital

St. Mary's General Hospital

216 45,739 - 3.9% 3.5% 3.9% 79% 3.5% 6.1%


Wilson Site240 143,446 1.4% 4.6% 5% 1.7% 80.4% 4.8% 2.2%

241 128,614 1.4% 4.6% 5% 1.7% 80.4% 4.8% 2.2%



Table 6: Overtime Hours as a Proportion of Productive Hours for Critical Care NursesCCWP Provincial Report Figure 22: Overtime Hours as a Proportion of Productive Hours for Critical Care Nurse

Source: 2015/16 Data: CCWP OHRS UPP Data from Finance Department Submission


Total Earned Hours

Earned Hours Type

Over Time Regular

Ontario 10,329,701 3.9% 96.1%

PG2 2,561,113 5.3% 94.7%

North York General Hospital North York General Hospital 003 137,797 1% 99%



006 93,497 4.2% 95.8%

Mackenzie Health Mackenzie Health 009 130,207 11.1% 88.9%

Markham Stouffville Hospital Markham Site 010 62,025 3% 97%

Lakeridge Health Corporation Oshawa 014 162,483 6% 94%


Hospital Drive Site 016 124,989 3.8% 96.2%


Centenary Site 019 74,717 2.9% 97.1%


020 65,064 4% 96%

The Scarborough HospitalGeneral Site 024 136,541 3.5% 96.5%

Grace Site 026 45,059 4.5% 95.5%

William Osler Health CentreBrampton Campus 029 159,103 9.4% 90.6%

Etobicoke Campus 030 89,495 11.5% 88.5%

Hopital Montfort Hopital Montfort 037 60,927 6.8% 93.2%

Windsor Regional HospitalMetropolitan Campus 062 79,444 7.3% 92.7%

Ouellette Campus 234 53,142 8.6% 91.4%


091 111,966 3.2% 96.8%

Trillium Health PartnersThe Credit Valley Hospital 092 130,101 3.5% 96.5%

The Mississauga Hospital 095 217,804 8.1% 91.9%

Grey Bruce Health Services Owen Sound 142 24,244 1.5% 98.5%

Huron Perth Health Alliance Stratford General Hospital 145 25,368 3% 97%



174 120,008 4.5% 95.5%

Toronto East Health Network Michael Garron Hospital 188 81,792 5.1% 94.9%


Kitchener Waterloo Site 204 114,239 5.7% 94.3%

St. Mary's General Hospital St. Mary's General Hospital 216 37,909 4.7% 95.3%


Wilson Site240 117,679 2% 98%

241 105,512 2% 98%



Table 7: Sick Rate for Critical Care NursesCCWP Provincial Report Figure 23: Sick Rate for Critical Care Nurses



Sick Hours

Total Earned Hours

Sick Rate

Ontario 606,527 12,692,456 4.8%

PG2 158,478 3,151,943 5%

North York General Hospital North York General Hospital 003 5,400 166,660 3.2%



006 5,041 111,116 4.5%

Mackenzie Health Mackenzie Health 009 6,803 153,040 4.4%

Markham Stouffville Hospital Markham Site 010 1,994 71,545 2.8%

Lakeridge Health Corporation Oshawa 014 14,868 210,749 7.1%


Hospital Drive Site 016 7,408 151,617 4.9%


Centenary Site 019 4,298 89,668 4.8%


020 2,119 77,693 2.7%

The Scarborough HospitalGeneral Site 024 6,763 165,100 4.1%

Grace Site 026 3,272 56,681 5.8%

William Osler Health CentreBrampton Campus 029 12,316 196,316 6.3%

Etobicoke Campus 030 6,112 110,965 5.5%

Hopital Montfort Hopital Montfort 037 3,429 77,495 4.4%

Windsor Regional HospitalMetropolitan Campus 062 7,319 103,646 7.1%

Ouellette Campus 234 4,329 65,275 6.6%


091 4,293 128,429 3.3%

Trillium Health PartnersThe Credit Valley Hospital 092 7,410 162,267 4.6%

The Mississauga Hospital 095 18,823 278,325 6.8%

Grey Bruce Health Services Owen Sound 142 2,433 32,088 7.6%

Huron Perth Health Alliance Stratford General Hospital 145 1,047 30,878 3.4%



174 7,823 150,153 5.2%

Toronto East Health Network Michael Garron Hospital 188 4,383 99,757 4.4%


Kitchener Waterloo Site 204 6,213 144,682 4.3%

St. Mary's General Hospital St. Mary's General Hospital 216 1,619 45,739 3.5%

Humber River Regional Hospital Wilson Site240 6,835 143,446 4.8%

241 6,128 128,614 4.8%



Table 8: Education Hours as a Proportion of Total Earned Hours for Critical Care NursesFigure 24: Education Hours as a proportion of Total Earned Hours for Critical Care Nurses – CCWP Provincial Report



Education Hours

Total Earned Hours

Percent Education

Hours

Ontario 106,410 12,853,341 0.8%

PG2 25,107 3,151,943 0.8%

North York General Hospital North York General Hospital 003 1,090 166,660 0.7%



006 887 111,116 0.8%

Markham Stouffville Hospital Markham Site 010 825 71,545 1.2%

Lakeridge Health Corporation Oshawa 014 1,727 210,749 0.8%


Hospital Drive Site 016 942 151,617 0.6%


Centenary Site 019 393 89,668 0.4%


020 319 77,693 0.4%

The Scarborough HospitalGeneral Site 024 1,358 165,100 0.8%

Grace Site 026 135 56,681 0.2%

William Osler Health CentreBrampton Campus 029 497 196,316 0.3%

Etobicoke Campus 030 898 110,965 0.8%

Hopital Montfort Hopital Montfort 037 1,342 77,495 1.7%

Windsor Regional HospitalMetropolitan Campus 062 572 103,646 0.6%

Ouellette Campus 234 24 65,275 0.0%


091 787 128,429 0.6%

Trillium Health PartnersThe Credit Valley Hospital 092 1,279 162,267 0.8%

The Mississauga Hospital 095 3,195 278,325 1.1%

Grey Bruce Health Services Owen Sound 142 287 32,088 0.9%

Huron Perth Health Alliance Stratford General Hospital 145 36 30,878 0.1%



174 1,346 150,153 0.9%

Toronto East Health Network Michael Garron Hospital 188 838 99,757 0.8%


Kitchener Waterloo Site 204 2,476 144,682 1.7%


Wilson Site240 2,033 143,446 1.4%

241 1,822 128,614 1.4%



Table 9: Approaches to Manage Short-Term Nursing ShortagesCCWP Provincial Report Figure 25: Approaches to Manage Short-Term Nursing Shortages

Source: 2015/16 CCWP Online Data Collection Tool, Question 15

1=Frequently Used, 2=Sometimes Used, 3=Rarely/Never Used


Nursing Shortage Coverage Approach

Staf

fing

Pool

Expa

nded

Sta

ff

Ass

ignm

ents

Sche

dule

d Ch

ange

s

Man

dato

ry

Ove

rtim

e

Bed

Clos

ures

Age

ncy

Staf

f

North York General Hospital North York General Hospital 003 2 3 3 3 3 3

Markham Stouffville Hospital Markham Site 010 3 2 3 3 3 1

Lakeridge Health Corporation Oshawa 014 3 2 3 1 3 1


Hospital Drive Site 016 3 2 3 3 3 3


Centenary Site 019 2 3 3 3 3 2


020 2 3 3 3 3 1

William Osler Health CentreBrampton Campus 029 3 3 3 3 2 2

Etobicoke Campus 030 - - - - 2 1

Hopital Montfort Hopital Montfort 037 1 3 3 3 3 3

Queensway Carleton Hospital Queensway Carleton Hospital 039 3 2 1 3 3 3

Windsor Regional HospitalMetropolitan Campus 062 3 1 2 3 2 3

Ouellette Campus 234 3 1 2 3 3 3


091 3 2 3 3 3 1

Trillium Health PartnersThe Credit Valley Hospital 092 3 2 3 3 3 2

The Mississauga Hospital 095 3 3 3 3 3 1

Grey Bruce Health Services Owen Sound 142 3 3 3 3 3 3

Huron Perth Health Alliance Stratford General Hospital 145 3 3 3 3 3 3



174 3 2 3 3 3 1

Toronto East Health Network Michael Garron Hospital 188 3 3 3 3 3 2

St. Mary's General Hospital St. Mary's General Hospital 216 3 2 3 3 3 3


Wilson Site240 3 2 3 3 3 1

241 3 2 3 3 3 1



Table 10: Critical Care Nurse Worked Hours (including Overtime) per Patient DayCCWP Provincial Report Figure 29: Critical Care Nurse Worked Hours (including Overtime) per Patient Day



Total Hours

(inc. OT)

Total Patient

Days

Hours / Patient

Day

Ontario 10,360,357 604,993 17.1

PG2 2,561,113 139,335 18.4

North York General Hospital North York General Hospital 003 137,797 6,230 22.1



006 93,497 4,549 20.6

Mackenzie Health Mackenzie Health 009 130,207 7,479 17.4

Markham Stouffville Hospital Markham Site 010 62,025 3,256 19

Lakeridge Health Corporation Oshawa 014 162,483 8,544 19


Hospital Drive Site 016 124,989 7,730 16.2


Centenary Site 019 74,717 3,906 19.1


020 65,064 3,420 19

The Scarborough HospitalGeneral Site 024 136,541 7,294 18.7

Grace Site 026 45,059 2,501 18

William Osler Health CentreBrampton Campus 029 159,103 7,710 20.6

Etobicoke Campus 030 89,495 5,243 17.1

Hopital Montfort Hopital Montfort 037 60,927 3,769 16.2

Windsor Regional HospitalMetropolitan Campus 062 79,444 6,030 13.2

Ouellette Campus 234 53,142 6,267 8.5


091 111,966 5,602 20

Trillium Health PartnersThe Credit Valley Hospital 092 130,101 6,412 20.3

The Mississauga Hospital 095 217,804 10,864 20

Grey Bruce Health Services Owen Sound 142 24,244 1,471 16.5

Huron Perth Health Alliance Stratford General Hospital 145 25,368 1,148 22.1



174 120,008 5,525 21.7

Toronto East Health Network Michael Garron Hospital 188 81,792 4,533 18


Kitchener Waterloo Site 204 114,239 5,794 19.7

St. Mary's General Hospital St. Mary's General Hospital 216 37,909 2,282 16.6


Wilson Site240 117,679 6,209 19

241 105,512 5,567 19



Nurse Training

Table 11: Critical Care Training Attainment Distribution of Critical Care NursesCCWP Provincial Report Figure 38: Critical Care Training Attainment Distribution of Critical Care Nurses


Corporation Name Site Name CICS Code

Critical Care Training Type

> 300 Hrs. (Ontario CC

Nurse Training Standards)

> 300 Hrs. (CC

Diploma)

> 300 Hrs.

(Other)

< 300 hours

Not Completed / Unknown

Ontario 38.9% 17.3% 19.3% 11.2% 13.3%

PG2 57.2% 15.4% 10.2% 6.6% 10.6%



003 82.1% 0.0% 1.8% 16.1% 0.0%


Markham Site 010 43% 0.0% 0.0% 0.0% 57%


Oshawa 014 67.9% 0.0% 0.0% 27.7% 4.4%


Hospital Drive Site 016 0.0% 89.2% 0.0% 0.0% 10.8%


Centenary Site 019 88.5% 0.0% 11.5% 0.0% 0.0%


020 62.2% 37.8% 0.0% 0.0% 0.0%


Brampton Campus 029 84.6% 0.0% 1.2% 0.0% 14.2%

Etobicoke Campus 030 54.1% 27% - - 18.9%

Hopital Montfort Hopital Montfort 037 - 10.2% 81.6% 8.2% -

Queensway Carleton Hospital


039 41.9% 50% 0.0% 6.5% 1.6%

Windsor Regional Hospital

Metropolitan Campus

062 48.4% 0.0% 0.0% 51.6% 0.0%

Ouellette Campus 234 100% 0.0% 0.0% 0.0% 0.0%

Halton Healthcare Services

Oakville Trafalgar Memorial Hospital

091 18.8% 33.3% 2.1% 16.7% 29.2%

Trillium Health Partners


092 60.7% 13.7% 0.0% 2.6% 23.1%

The Mississauga Hospital

095 76% 15.8% 8.2% 0.0% 0.0%


Owen Sound 142 - 14.3% 85.7% - -


Stratford General Hospital

145 10.3% 48.3% 0.0% 3.4% 37.9%



174 0.0% 0.0% 79.5% 0.0% 20.5%




Critical Care Training Type

> 300 Hrs. (Ontario CC

Nurse Training Standards)

> 300 Hrs. (CC

Diploma)

> 300 Hrs.

(Other)

< 300 hours

Not Completed / Unknown


Michael Garron Hospital

188 27% 43.2% 25.7% 4.1% 0.0%


Wilson Site240 92.7% 2.1% 5.2% 0.0% 0.0%

241 91.1% 1.1% 7.8% 0.0% 0.0%



Table 12: Advance Cardiac Life Support Training Attainment Distribution of CC NursesCCWP Provincial Report Figure 40: Advance Cardiac Life Support Training Attainment Distribution of Critical Care Nurses



ACLS Training

≤ 2 yrs. Ago

> 2 yrs. Ago

Not Completed Unknown

Ontario 53.2% 16.3% 14.6% 15.8%

PG2 69.5% 20.7% 3.9% 5.8%



003 37.3% 7.8% 18.6% 36.3%


Markham Site 010 91.4% 3.2% 5.4% -


Oshawa 014 73% 27% 0.0% 0.0%


Hospital Drive Site 016 94.6% 0.0% 5.4% 0.0%


Centenary Site 019 100% 0.0% 0.0% 0.0%


020 97.8% 2.2% 0.0% 0.0%


Brampton Campus 029 64.5% 34.3% 1.2% 0.0%

Etobicoke Campus 030 97.3% - 1.4% 1.4%

Hopital Montfort Hopital Montfort 037 61.2% 20.4% - 18.4%



039 27.4% 24.2% - 48.4%

Windsor Regional HospitalMetropolitan Campus 062 31.3% 68.8% 0.0% 0.0%

Ouellette Campus 234 26.6% 37.2% 16% 20.2%


091 65.6% 27.1% 3.1% 4.2%

Trillium Health PartnersThe Credit Valley Hospital 092 76.1% 6.8% 12% 5.1%

The Mississauga Hospital 095 100% 0.0% 0.0% 0.0%


Owen Sound 142 100% - - -


Stratford General Hospital 145 82.8% 13.8% 0.0% 3.4%



174 100% 0.0% 0.0% 0.0%


Michael Garron Hospital 188 39.2% 55.4% 5.4% 0.0%

St. Mary's General Hospital St. Mary's General Hospital 216 100% - - -


Wilson Site240 55.3% 43.6% 1.1% 0.0%

241 43.3% 54.4% 2.2% 0.0%



Table 13: Approaches to Professional Development Investment in Critical Care UnitsCCWP Provincial Report Figure 42: Approaches to Professional Development Investment in Critical Care Units


1=Frequently Used, 2=Sometimes Used, 3=Rarely/Never Used


PD Investment Approach

Paid

Con

fere

nce

Org

aniz

atio

nal

Mem

bers

hip

Fees

Paid

Cou

rses

/

Cert

ifica

tions

Burs

arie

s /

Scho

lars

hips

Com

mun

ity /

Fou

ndat

ion

Supp

ort

In-S

ervi

ce (W

ork

Hou

rs)

MO

HLT

C Su

ppor

t (N

TF)

Vend

or S

uppo

rt

Rese

arch

Gra

nts

North York General Hospital North York General Hospital 003 2 3 2 2 2 1 2 3 3

Markham Stouffville Hospital Markham Site 010 3 3 1 1 3 2 1 2 3

Lakeridge Health Corporation Oshawa 014 3 3 1 2 2 1 2 2 3


Hospital Drive Site 016 2 3 1 3 3 1 1 3 3


Centenary Site 019 2 3 1 3 3 1 2 3 3


020 2 2 1 3 3 2 2 2 3

William Osler Health CentreBrampton Campus 029 2 3 1 2 3 1 2 3 3

Etobicoke Campus 030 2 - 1 - - 2 - 3 -

Hopital Montfort Hopital Montfort 037 2 3 1 3 3 1 1 3 3

Queensway Carleton HospitalQueensway Carleton Hospital

039 2 3 1 1 3 1 1 2 3

Windsor Regional HospitalMetropolitan Campus 062 3 3 1 2 3 1 1 3 3

Ouellette Campus 234 3 3 3 3 3 1 2 3 3


091 2 3 1 2 2 1 1 3 3

Trillium Health PartnersThe Credit Valley Hospital 092 3 3 2 3 3 1 1 3 3

The Mississauga Hospital 095 2 3 1 2 3 1 2 2 3

Grey Bruce Health Services Owen Sound 142 3 3 1 - 1 2 1 3 3

Huron Perth Health Alliance Stratford General Hospital 145 3 3 1 3 3 2 2 3 3



174 2 3 3 3 3 1 3 3 3

Toronto East Health Network Michael Garron Hospital 188 3 3 3 3 3 2 2 3 3

St. Mary's General Hospital St. Mary's General Hospital 216 2 3 1 3 3 1 2 2 3


Wilson Site240 3 3 3 3 3 2 2 2 3

241 3 3 3 3 3 2 2 2 3



Nurse Turnover

Table 14: Critical Care Nurse Turnover, OverallCCWP Provincial Report – Nursing Turnover Section

Source: 2015/16 CCWP Human Resources Data Collection Tool, Direct Care Nurses


Total Exits Headcount

Total Workforce Headcount

Turnover Rate

Ontario 690 7,936 8.7%

PG2 210 2,209 9.5%

North York General Hospital North York General Hospital 003 14 107 13%



006 2 70 2.9%

Mackenzie Health Mackenzie Health 009 4 110 3.6%

Markham Stouffville Hospital Markham Site 010 10 78 12.8%

Lakeridge Health Corporation Oshawa 014 3 136 2.2%


Hospital Drive Site 016 14 91 15.4%


Centenary Site 019 11 65 17.1%


020 2 51 3.9%

The Scarborough HospitalGeneral Site 024 7 112 6.3%

Grace Site 026 6 60 10%

William Osler Health CentreBrampton Campus 029 9 154 5.8%

Etobicoke Campus 030 8 74 10.8%

Hopital Montfort Hopital Montfort 037 7 46 15.2%

Windsor Regional HospitalMetropolitan Campus 062 21 61 34.4%

Ouellette Campus 234 10 88 11.4%


091 7 90 7.8%

Trillium Health PartnersThe Credit Valley Hospital 092 7 116 6%

The Mississauga Hospital 095 9 190 4.7%

Grey Bruce Health Services Owen Sound 142 4 21 19%

Huron Perth Health Alliance Stratford General Hospital 145 7 29 24.1%



174 16 83 19.3%

Toronto East Health Network Michael Garron Hospital 188 6 72 8.3%


Kitchener Waterloo Site 204 13 87 14.9%

St. Mary's General Hospital St. Mary's General Hospital 216 3 33 9.1%


Wilson Site240 7 97 7.2%

241 3 88 3.4%



Table 15: Destination of Critical Care Nurses Leaving the Unit or Changing Employment StatusCCWP Provincial Report Figure 50: Destination of Critical Care Nurses Leaving the Unit or Changing Employment Status



Destination of Critical Care Nurses Leaving the Unit or Changing

Employment Status

Remain in ICU

Outside of ICU

Unkown/Other

Ontario 42.6% 21.2% 36.2%

PG2 40.6% 20.5% 39%

North York General Hospital North York General Hospital 003 28.6% 7.1% 64.3%

Markham Stouffville Hospital Markham Site 010 89.5% 0.0% 10.5%

Lakeridge Health Corporation Oshawa 014 100% - -


Hospital Drive Site 016 0.0% 87.5% 12.5%


Centenary Site 019 57.1% 28.6% 14.3%


020 0.0% 20% 80%

William Osler Health CentreBrampton Campus 029 75% 0.0% 25%

Etobicoke Campus 030 37.5% - 62.5%

Hopital Montfort Hopital Montfort 037 25% 37.5% 37.5%

Queensway Carleton Hospital Queensway Carleton Hospital 039 27.3% 72.7% -

Windsor Regional HospitalMetropolitan Campus 062 52.2% 21.7% 26.1%

Ouellette Campus 234 20% 20% 60%


091 17.6% 26.5% 55.9%

Trillium Health PartnersThe Credit Valley Hospital 092 25% 16.7% 58.3%

The Mississauga Hospital 095 26.3% 18.4% 55.3%

Grey Bruce Health Services Owen Sound 142 - 100% -

Huron Perth Health Alliance Stratford General Hospital 145 77.8% 0.0% 22.2%



174 72.7% 9.1% 18.2%

Toronto East Health Network Michael Garron Hospital 188 66.7% - 33.3%

St. Mary's General Hospital St. Mary's General Hospital 216 - - 100%


Wilson Site240 80% 20% 0.0%

241 100% 0.0% 0.0%



Nursing Recruitment

Table 16: Vacancy Rate for Critical Care UnitsCCWP Provincial Report Figure 55: Vacancy Rate for Critical Care Units



Vacant Positions

Total Budgeted Positions

Vacancy Rate

Ontario 473 9536 5%

PG2 185 2,037 9.1%

North York General Hospital North York General Hospital 003 24 136 17.6%

Markham Stouffville Hospital Markham Site 010 14 107 13.1%

Lakeridge Health Corporation Oshawa 014 4 141 2.8%


Hospital Drive Site 016 0 93 0.0%


Centenary Site 019 4 65 6.2%


020 7 52 13.5%

William Osler Health CentreBrampton Campus 029 10 179 5.6%

Etobicoke Campus 030 12 86 14%

Hopital Montfort Hopital Montfort 037 7 56 12.5%

Queensway Carleton Hospital Queensway Carleton Hospital 039 7 69 10.1%

Windsor Regional HospitalMetropolitan Campus 062 2 66 3%

Ouellette Campus 234 3 97 3.1%


091 9 112 8%

Trillium Health PartnersThe Credit Valley Hospital 092 4 121 3.3%

The Mississauga Hospital 095 46 192 24%

Grey Bruce Health Services Owen Sound 142 0 21 0.0%

Huron Perth Health Alliance Stratford General Hospital 145 1 30 3.3%



174 7 95 7.4%

Toronto East Health Network Michael Garron Hospital 188 7 81 8.6%

St. Mary's General Hospital St. Mary's General Hospital 216 2 38 5.3%


Wilson Site240 6 101 5.9%

241 9 99 9.1%



Allied Health Professionals in Critical Care

Table 17: Routine Use of Allied Health Professionals in Critical Care UnitsCCWP Provincial Report Figure 60: Routine Use of Allied Health Professional in Critical Care Units

Source: 2015/16 CCWP Online Data Collection Tool, Question 22A

1=Yes


Allied Health Professionals Routinely Used in Critical Care Units

Chap

lain

/

Spiri

tual

Car

e

Die

titia

n/Cl

inic

al

Nut

ritio

nist

Occ

upat

iona

l Th

erap

ist

Phar

mac

ist

Phys

ioth

erap

ist

Resp

irato

ry

Ther

apis

t

Soci

al W

orke

r

North York General Hospital North York General Hospital 003 1 1 - 1 1 1 1

Markham Stouffville Hospital Markham Site 010 - 1 - 1 1 1 1

Lakeridge Health Corporation Oshawa 014 - 1 - 1 1 1 1


Hospital Drive Site 016 - 1 1 1 1 1 1


Centenary Site 019 - - - 1 1 1 1


020 - 1 - 1 - 1 1

William Osler Health CentreBrampton Campus 029 - 1 - 1 1 1 1

Etobicoke Campus 030 - 1 1 1 1 1 1

Hopital Montfort Hopital Montfort 037 1 1 1 1 1 1 1

Queensway Carleton Hospital Queensway Carleton Hospital 039 1 1 - 1 1 1 1

Windsor Regional HospitalMetropolitan Campus 062 1 1 - 1 1 1 1

Ouellette Campus 234 1 1 1 1 1 1 1


091 - 1 - 1 1 1 -

Trillium Health PartnersThe Credit Valley Hospital 092 1 1 - 1 1 1 1

The Mississauga Hospital 095 1 1 1 1 1 1 1

Grey Bruce Health Services Owen Sound 142 - 1 - 1 1 1 1

Huron Perth Health Alliance Stratford General Hospital 145 - 1 1 1 1 1 1



174 1 1 1 1 1 1 1

Toronto East Health Network Michael Garron Hospital 188 1 1 1 1 1 1 1

St. Mary's General Hospital St. Mary's General Hospital 216 1 1 - 1 1 1 1


Wilson Site240 - 1 - 1 1 1 1

241 - 1 - 1 1 1 1



Table 18: Pharmacist Support Hours per Day in Critical Care UnitsCCWP Provincial Report Figure 61: Pharmacist Support Hours per Day in Critical Care Units

Source: 2015/16 CCWP Data Collection Tool, Question 23


Pharmacy Support

Weekdays Weekends

Days/Week

Hrs/Day

Days/Week

Hrs/Day

Ontario 4.7 7.7 0.9 5.4

PG2 5 7.6 0.7 2.6

North York General Hospital North York General Hospital 003 5 8 1 8

Markham Stouffville Hospital Markham Site 010 5 3 0 0

Lakeridge Health Corporation Oshawa 014 5 8 - -


Hospital Drive Site 016 5 6 2 3


Centenary Site 019 5 5 0 -


020 5 4 1 2

William Osler Health CentreBrampton Campus 029 5 8 0 -

Etobicoke Campus 030 5 - 2 -

Hopital Montfort Hopital Montfort 037 5 8 - -

Queensway Carleton Hospital Queensway Carleton Hospital 039 5 4 - -

Windsor Regional HospitalMetropolitan Campus 062 5 8 0 0

Ouellette Campus 234 5 8 0 0


091 - 14 - 0

Trillium Health PartnersThe Credit Valley Hospital 092 5 8 0 -

The Mississauga Hospital 095 5 8 0 0

Grey Bruce Health Services Owen Sound 142 5 12 0 8

Huron Perth Health Alliance Stratford General Hospital 145 5 8 2 8



174 5 8 0 0

Toronto East Health Network Michael Garron Hospital 188 5 8 2 8

St. Mary's General Hospital St. Mary's General Hospital 216 5 8 2 -


Wilson Site240 5 8 0 0

241 5 8 0 0



Table 19: Pharmacist Provision of On-Call Support in Critical Care UnitsCCWP Provincial Report Figure 62: Pharmacist Provision of On-Call Support in Critical Care Units


0= No On-Call Support, 1=On-Call Support Available


Pharmacy Support

Weekday On-Call

Weekend On-Call

North York General Hospital North York General Hospital 003 0 0

Markham Stouffville Hospital Markham Site 010 1 1

Lakeridge Health Corporation Oshawa 014 - 1


Hospital Drive Site 016 1 1

Rouge Valley Health SystemCentenary Site 019 1 1

Rouge Valley Ajax and Pickering 020 1 1

William Osler Health Centre Brampton Campus 029 1 1

Hopital Montfort Hopital Montfort 037 - 1

Queensway Carleton Hospital Queensway Carleton Hospital 039 1 1

Windsor Regional HospitalMetropolitan Campus 062 0 1

Ouellette Campus 234 0 0


091 1 1

Trillium Health Partners The Mississauga Hospital 095 0 0

Grey Bruce Health Services Owen Sound 142 1 1

Huron Perth Health Alliance Stratford General Hospital 145 1 1



174 1 1

Toronto East Health Network Michael Garron Hospital 188 1 1

St. Mary's General Hospital St. Mary's General Hospital 216 1 1

Humber River Regional Hospital Wilson Site240 1 1

241 1 1



Table 20: Physiotherapist Support Hours per Day in Critical Care UnitsCCWP Provincial Report Figure 63: Physiotherapist Support Hours per Day in Critical Care Units



Physiotherapist Support

Weekdays Weekends

Days/Week

Hrs/Day

Days/Week

Hrs/Day

Ontario 4.7 5.7 1 3.2

PG2 4.8 6.9 1.1 2.9



Lakeridge Health Corporation Oshawa 014 5 8 - -




Centenary Site 019 5 3 0 -


020 0 0 0 0

William Osler Health CentreBrampton Campus 029 5 8 0 -


Hopital Montfort Hopital Montfort 037 5 8 - -

Queensway Carleton Hospital Queensway Carleton Hospital 039 5 8 0 -




091 - 7 - 4

Trillium Health PartnersThe Credit Valley Hospital 092 5 8 2 2






174 5 8 2 4


St. Mary's General Hospital St. Mary's General Hospital 216 5 8 2 2

Humber River Regional Hospital Wilson Site240 5 8 0 0

241 5 8 0 0



Table 21: Physiotherapist Provision of On-Call Support in Critical Care UnitsCCWP Provincial Report Figure 64: Physiotherapist Provision of On-Call Support in Critical Care Units




Physiotherapist Support

Weekday On-Call

Weekend On-Call



Lakeridge Health Corporation Oshawa 014 1 1



Rouge Valley Health SystemCentenary Site 019 1 0


William Osler Health Centre Brampton Campus 029 - 1




091 - 1






174 1 0




241 0 0



Table 22: Respiratory Therapist Support Hours per Day in Critical Care UnitsCCWP Provincial Report Figure 65: Respiratory Therapist Support Hours per Day in Critical Care Units



Respiratory Therapist Support

Weekdays Weekends

Days/Week

Hrs/Day

Days/Week

Hrs/Day

Ontario 4.7 17.2 1.7 17.5

PG2 4.8 22.2 1.9 23



Lakeridge Health Corporation Oshawa 014 5 24 2 24




Centenary Site 019 5 24 1 24


020 1 24 1 24

William Osler Health CentreBrampton Campus 029 - 24 2 24


Hopital Montfort Hopital Montfort 037 5 24 2 24

Queensway Carleton Hospital Queensway Carleton Hospital 039 5 24 2 24




091 - 24 - 24

Trillium Health PartnersThe Credit Valley Hospital 092 5 24 2 24






174 5 8 2 24


St. Mary's General Hospital St. Mary's General Hospital 216 5 24 2 24

Humber River Regional Hospital Wilson Site240 5 24 2 24

241 5 24 2 24



Table 23: Respiratory Therapist Provision of On-Call Support in Critical Care UnitsCCWP Provincial Report Figure 66: Respiratory Therapist Provision of On-Call Support in Critical Care Units




Respiratory Therapist Support

Weekday On-Call

Weekend On-Call



Lakeridge Health Corporation Oshawa 014 1 -



Rouge Valley Health SystemCentenary Site 019 1 -









174 1 1




241 0 0



PEER GROUP REPORT APPENDICES

Appendix A. Glossary of Terms

Direct Care Nurses Intended to capture nursing roles providing direct bedside care to patients. Includes roles such as Registered Nurses or Registered Practical Nurse.

Full-Time Equivalent (FTE) Hours paid to one employee working on a full-time basis. Includes both worked and benefit hours. Does not include overtime hours. In most organizations, 1 FTE = 1,950 hours annually.

Functional Center A department or unit within a hospital to which costs and activity are tracked.

Headcount Count of individuals employed, regardless of FTE allocation. Intended to capture the number of staff, across each nursing and allied health role, associated with the unit/functional centre that support critical care activities.

Management and Operational Support (MOS)

Terms from the Ontario Healthcare Reporting Standards. Staff that are indirectly supporting the core functions of a unit. In the case of critical care units, these staff would include clerical roles, management roles, and indirect care nurses.

Ontario Healthcare Reporting System (OHRS)

OHRS provides the framework for the accounting and reporting of financial and activity data across healthcare organizations in a consistent and standardized way.

Support Nurses Intended to capture roles not directly providing bedside care. Includes roles such as Clinical Nurse Specialist, Nurse Educator, Nurse Manager, Nurse Practitioner.

Unit Producing Personnel (UPP)

Term from the Ontario Healthcare Reporting Standards. Staff that are directly contributing to the core function of a unit. In the case of critical care units, these staff would include staff delivering direct bedside care.



Appendix B. Calculations Table

CALCULATIONS USED IN DATA COLLECTION FOR WORKFORCE PROFILE

Measure

Related Figures from Provincial Report

Definitions Calculation

Response Rate

Figure 1

Table 3

Table 16

A unit was included in the overall response rate if any usable data was provided for the data collection tool.

= [Num. of units Responded] / [Total Number of Units in Group]

UPP Nursing Earned Hours by Type

Figure 19

• UPP regular worked hours (OHRS account 635***2)

• UPP overtime hours (OHRS account 635***1)

• UPP sick hours (OHRS account 635***3)

• UPP vacation hours (OHRS account 635***4)

• UPP education hours (OHRS account 635***5)

• UPP orientation hours (OHRS account 635***6)

• UPP other hours (OHRS account 635***7 and 635***8)

• UPP earned hours (OHRS account 635****)

• Nursing (occupational classes 11-18)

• Includes all employment status groups (e.g. 1-6)

= [UPP nursing hrs. type] / [UPP nursing earned hrs.]

UPP Nursing Overtime Hours as a Proportion of Productive Hours

Figure 20

Figure 21





• Units included in the numerator match units included in the denominator

= [UPP nursing overtime hrs.] / [(UPP nursing regular worked hrs.) + (UPP nursing overtime hrs.)]

UPP Nursing Sick Rate

Figure 22

Figure 23

• UPP sick hours (OHRS account 635***3)





= [UPP nursing sick hrs.] / [UPP nursing earned hrs.]



Measure

Related Figures from Provincial Report

Definitions Calculation

UPP Nursing Education Time

Figure 24

• UPP education hours (OHRS account 635***5)




• Units included in the numerator do not match units included in the denominator. All units reporting earned hours are included in denominator.

= [UPP nursing education hrs.] / [UPP nursing earned hrs.]

UPP Nursing Worked Hours per Patient Day

Figure 29

Figure 30





• Patient days (OHRS account 403****)


= [(UPP nursing regular worked hrs.) + (UPP nursing overtime hrs.)] / [Patient days]

Direct Care Nurse Turnover

Figure 47

Figure 48

• Number of direct care nursing exits (including retirements) as identified in Human Resources data submission for the fiscal year (e.g. April 1 to March 31)

• Number of direct care nurses as identified by Human Resources data submission as of March 31


= [Num. of direct care nursing exits] / [Num. of direct care nurses]

Vacancy Rate

Figure 54

Figure 55

Figure 56

• Number of reported vacant nursing positions as of March 31, 2016 as identified in the online data submission

• Number of nursing staff as identified in question 1 B of the online data submission

• Includes all nursing staff for full-time, part-time and casual positions

= [Num. of vacant nursing positions] / [(Num. of nursing staff) + (Num. of vacant nursing positions)]



Appendix C. Online Data Collection Tool

QUESTIONS RELATED TO THE NURSING WORKFORCE AND TRAINING:

Please answer the questions 1 to 9 relating to the nursing staff employed in your Critical Care unit on March 31, 2016:

1. A. What is the total number of nurses ( i.e.. individuals, not FTEs) on your Critical Care unit in each of the following groupings:

a. Clinical Nurse Specialist (CNS)

b. Nurse Educator

c. Nurse Manager

d. Nurse Practitioner (NP)

e. Permanent charge nurse without a patient assignment

f. Registered Nurse (RN), not included in other groupings listed

g. Registered Practical Nurse (RPN)

h. Other (please specify)______________

1. B. What is the total number of nurses in your Critical Care unit from Question 1A: ____ (Free numeric text)

2. A. Of the X number of nurses on your Critical Care unit, please identify your understanding of how many have been working in THIS particular unit for the following periods of time:

a. Less than 3 years

b. 3 - 5 years

c. 6 - 10 years

d. 11 - 20 years

e. More than 20 years

2. B. Of the X number of nurses on your Critical Care unit, please identify your understanding of how many have been working in Critical Care for the following periods of time:


b. 3 - 5 years

c. 6 - 10 years

d. 11 - 20 years




2. C. Of the X number of nurses on your Critical Care unit, please identify your understanding of how many have been working as a registered nurse for the following periods of time:


b. 3 - 5 years

c. 6 - 10 years

d. 11 - 20 years


3. Of the X number of nurses on your Critical Care unit, please indicate your understanding of the number of nurses whose highest level of education falls into the following categories:

a. Nursing diploma

b. Non-nursing undergraduate degree

c. Nursing undergraduate degree

d. Nursing master’s degree

e. Non-nursing master’s degree

f. Nursing doctorate

g. Non-nursing doctorate

4. Of the X number of nurses on your Critical Care unit, please identify your understanding of the number of nurses who attained their basic nursing training outside of Canada (If there are none please indicate 0):_____ (free numeric text)

5. Of the X number of nurses on your Critical Care unit, please identify your understanding of the number of nurses who have completed a Critical Care Course, according to the following categories:

a. 300+ hours of didactic and clinical training (Ontario Critical Care Nurse Training Standards)

b. 300+ hours of didactic and clinical training (Critical Care Diploma)

c. 300+ hours of didactic and clinical training (Other)

d. < 300 hours of didactic and clinical training

e. Not completed a critical care course

6. Of the X number of nurses on your Critical Care unit, please identify your understanding of the number who have completed Advanced Cardiac Life Support (ACLS) Training, according to the following categories:

a. Have completed ACLS training within the last two (2) years

b. Have completed ACLS training more than two (2) years ago

c. Have not completed ACLS Training

d. Don’t know if ACLS Training has been completed



7. Of the X number of nurses on your Critical Care unit, please identify your understanding of the number who have completed Pediatric Advanced Life Support (PALS) Training, according to the following categories:

a. Have completed PALS training within the last two (2) years

b. Have completed PALS training more than two (2) years ago

c. Have not completed PALS Training

d. Don’t know if PALS Training has been completed

8. Of the X number of nurses on your Critical Care unit, please identify your understanding of the number who have completed Trauma Nursing Core Course (TNCC) Training, according to the following categories:

a. Have completed TNCC training within the last year

b. Have completed TNCC training more than a year ago

c. Have not completed TNCC Training

d. Don’t know if TNCC Training has been completed

9. Of the X number of nurses on your Critical Care unit, please identify your understanding of the number who have completed Critical Care Response Team (CCRT) Training, according to the following categories:

a. Have completed CCRT training within the last year

b. Have completed CCRT training more than a year ago

c. Have not completed CCRT Training

d. Don’t know if CCRT Training has been completed

QUESTIONS RELATED TO NURSING TURNOVER:

Please answer questions 10 to 13 based on staff who left your unit or changed employment status (e.g. went from full-time to casual, etc.) in your Critical Care unit between April 1, 2015 and March 31, 2016.

10. Please identify the total number of nurses who have left or changed employment status (e.g. went from full-time to casual, etc.) in your Critical Care unit between April 1, 2015 and March 31, 2016. Please include nurses in the following categories: Clinical Nurse Specialist (CNS); Nurse Educator; Nurse Manager; Nurse Practitioner (NP); Registered Nurse (RN); Registered Practical Nurse (RPN). ________ (free numeric text)



11. Of the X number of nurses that left or changed employment status (e.g. went from full-time to casual, etc.) in your Critical Care unit between April 1, 2015 and March 31, 2016, please identify your understanding of how many exited their roles for the following reasons:

a. Move to a new nursing role or position

b. Retirement

c. Illness or disability

d. Left to pursue non-nursing education

e. Exit from nursing profession

f. Promotion to another role

g. Personal relocation

h. Not Applicable / Unknown

i. Other

12. Of the X number of nurses that left or changed employment status (e.g. went from full-time to casual, etc.) in your Critical Care unit between April 1, 2015 and March 31, 2016, please identify your understanding of how many moved to the following destinations:

a. Remains in ICU – same unit

b. Remains in ICU - different unit within same hospital

c. Remains in ICU - different hospital

d. Remains in nursing outside of ICU - within same hospital

e. Remains in nursing outside of ICU - different hospital

f. Remain in nursing - outside of hospital setting

g. Promotion to another role

h. Not Applicable / Unknown

i. Other

13. Of the X number of nurses that left or changed employment status (e.g. went from full-time to casual, etc.) in your Critical Care unit between April 1, 2015 and March 31, 2016, please identify your understanding of how many changed their employment status in the following categories:

a. Move from full time to part time

b. Move from full time to casual

c. Move from part time to full time

d. Move from part time to casual

e. Move from casual to a permanent or temporary position

f. End of a temporary assignment

g. Not Applicable / Unknown

h. Other



QUESTIONS RELATED TO RECRUITMENT AND RETENTION

Please answer questions 14 to 18 based on your experience with recruitment and retention in your Critical Care unit between April 1, 2015 and March 31, 2016.

14. On March 31, 2016 please indicate the total number of vacant budgeted RN positions (according to your hospital’s position management system) for your Critical Care unit in the following categories:

a. Full-time

b. Part-time

c. Casual

15. How does your Critical Care unit deal with short-term (shift-to-shift) RN shortages?

Please identify how often each approach is used, according to the scale provided.

Frequently used ( i.e.. >50% of the time)

Sometimes used (i.e.10-50% of the time)

Rarely / never used ( i.e.. <10% of the time)

a. Hospital-wide critical care RN staffing pool

b. Expanded staff assignments

c. Scheduled changes (e.g. cancelling ORs)

d. Mandatory overtime (including weekend staffing)

e. Bed closures

f. Agency staff

g. Other (please specify)____________

16. Please indicate how your Critical Care unit RNs receive support for professional development.





a. Paid conference registration (full or partial)

b. Payment of professional organization membership fees (full or partial)

c. Paid courses and certifications e.g. ACLS (full or partial)

d. Bursaries/scholarships

e. Community/foundation support

f. In-services during work hours

g. MOHLTC support (e.g. Nurse Training Fund)

h. Vendor support (e.g. pharmaceutical, supplies, equipment) support

i. Research grants

j. Other (please specify____________



17 A. What recruitment strategies do you use for nurses within your Critical Care unit?





a. Attending job fairs (either the hospital, or the unit)

b. Internship programs

c. Scholarship programs

d. Employee referral programs

e. Financial incentives

f. Mentorship programs

g. Flexible scheduling opportunities

h. Other (please specify)_____________

17. B. What has proven to be the most effective recruitment strategies you use to hire nurses within your Critical Care unit?

Please identify how effective each strategy is, according to the scale provided.

Completely effective (i.e. identifies hires each time)

Very effective (i.e. identifies hires >50% of the time)

Somewhat effective (i.e. identifies hires 10%-

50% of the time)

Not effective (i.e. identifies hires <10% of the time)

a. Attending job fairs (either the hospital, or the unit)

b. Internship programs

c. Scholarship programs

d. Employee referral programs

e. Financial incentives

f. Mentorship programs

g. Flexible scheduling opportunities

h. Other (please specify)________________



18 A. What retention strategies do you use to keep nursing staff engaged within your Critical Care unit?

Please identify how often each strategy is used, according to the scale provided.

Frequently used ( i.e.10+ times per year)

Periodically used (i.e.3-9 times per year)

Infrequently used (i.e. 1-2 times per year)

Never used

a. Employee recognition events - unit level

b. Long service recognition - unit level

c. Team building events e.g. pot lucks, seasonal events – unit level

d. Staff appreciation events – unit or hospital led

e. Flexible staff scheduling

f. Regular staff meetings with staff leadership

g. Unit council

h. Education/training events for staff

i. Scholarship programs

j. Preceptor program (≤3 months)

k. Preceptor program (> 3 months)

l. Mentorship program

m. Employee wellness initiatives – hospital level

n. Employee wellness initiatives – critical care specific

o. Exit interviews that are acted upon

p. Other (please specify)______________



18. B. What strategies do you believe are most effective for staff retention on your Critical Care unit?

Please identify how effective each strategy is, according to the scale provided.

Very effective (i.e. perceive is valued by >75% of staff)

Somewhat effective (i.e. perceive is valued

by 25% to 75% of staff)

Limited effect (i.e. perceive is valued

by <25% of staff)

Not applicable as this strategy is not

used

a. Employee recognition events (unit level)

b. Long service recognition (unit level)

c. Staff appreciation events

d. Team building events (e.g. pot lucks, seasonal events)

e. Flexible staff scheduling

f. Regular staff meetings with staff leadership

g. Unit council

h. Education/training events for staff

i. Scholarship programs

j. Preceptor program (≤3 months)

k. Preceptor program (> 3 months)

l. Mentorship program

m. Employee wellness initiatives – hospital level

n. Employee wellness initiatives – critical care specific

o. Exit interviews that are acted upon

p. Other (please specify)_____________



QUESTIONS RELATED TO EMPLOYEE ENGAGEMENT

Please answer questions 19 to 21 relating to employee engagement for all staff in your Critical Care unit.

19. A. Does your unit participate in hospital-led employee engagement surveys?

a. Yes – critical care beds represent 50% or more of my unit

b. Yes – critical care beds represent less than 50% of my unit

c. No (please proceed to Q. 22)

d. Other (please specify)

19. B. In which fiscal year was the last staff engagement survey conducted?

a. 2015/16

b. 2014/15

c. Other (please specify)

20. For the last survey conducted, what was the response rate for your unit? ( i.e. what percentage of staff in your unit responded to the employee engagement survey?)

a. Please specify a percent here _________

b. If don’t know, enter zero here_________

21. Please identify the top two (2) improvement opportunities identified for employee engagement within your unit that was outlined in this survey.

a. Job characteristics (e.g. Flexibility in schedule/work hours; Balance of family/personal life with work; Have adequate resources/equipment to do work; Have time to carry out all your work; Get recognition for good work)

b. Training and development (e.g. Opportunity to make improvements in how your work is done; Opportunity to receive education/training; Opportunity to advance in career)

c. Work team (e.g. We have enough staff to handle workload; We work in crisis mode)

d. Senior management (e.g. Senior management acts on staff feedback)

e. Organization (e.g. I feel that I can trust this organization)

f. Other (please specify)

g. Improvement opportunities were not identified per unit



QUESTIONS RELATED TO ALLIED HEALTH PROFESSIONALS

Please answer questions 22 and 23 relating to Allied Health support on your Critical Care unit, referring to the period between April 1, 2015 and March 31, 2016

22 A. Recognizing the many team members that support critical care patients, please identify which allied health team members are routinely (e.g. daily or weekly) involved in care within your Critical Care unit. Please check all that apply. Please do not include assistants or technicians.

a. Chaplain/Spiritual Care/Pastoral Care

b. Dietitian/Clinical Nutritionist

c. Occupational Therapist

d. Pharmacist

e. Physiotherapist

f. Respiratory Therapist

g. Social Worker

h. Other (please specify)

22 B. For the identified disciplines in Q 22A, please identify which are included within your Critical Care unit budget vs. which are allocated from an allied health department budget.

a. Included in nursing unit budget

b. Allocated from allied health department budget

c. Not present in my unit

22 C. For the identified disciplines, please provide your Critical Care unit’s approximate FTE allocation for each. (Between 0.2 FTE to 1+ FTEs or casual as needed). _____(Free numeric text)

23 A. For the identified disciplines, please identify the weekday hours of coverage.

a. Average days per week (Between 0 to 5)

b. Average hours per day on the days with coverage above (Between 0 to 24)

c. Provision of “on-call” (No or Yes)

23 B. For the identified disciplines, please identify the weekend hours of coverage.

a. Average days per week (Between 0 to 2)

b. Average hours per day on the days with coverage above (Between 0 to 24)

c. Provision of “on-call” (No or Yes)

Documents

CRITICAL CARE NURSING WORKFORCE PROFILE Care Nursing/Critical Care Nursing...Critical Care Workforce Profile — Peer Group 2 Report 6 Critical Care Services Ontario • June 2017