Town Hall Transcript

We have hired 10 former HCAs into SC roles.

The short answer is they shouldn’t be. If you see this happening, please take a screenshot and share with your manager for review and follow up on a case-by-case basis.

We are asking for these to be addressed at community level for the moment, as we don’t have a structure in place right now. We recognize that there is a significant volume of calls coming in, and we have met with client relations on this and are working together to determine how to manage moving forward.  In future, there may be capacity in different areas and we will let you know.

Regarding values:

Thank you for bringing this forward, because our values are important – they are our guide on the path to doing the right thing, they tell others who we are, and we need to walk the talk. We hear you that this hasn’t gone well, and the home care leadership team, with the support of the executive team, are working to implement your ideas and suggestions.

We are working to be accountable to and transparent with you, through these meetings and ongoing engagement efforts.

We want to keep focus on the clients and our staff, and we need to work together to do that.

Regarding cancellations:

Over the week leading up to this meeting, we’ve reworked some assignments so staff are primarily working in one area of the city, to help address cancellations. We also continue to expedite hiring.

There could be a conflict of interest, and in those cases, they would need to fill out a conflict of interest form, as other staff across the organization do, and strategies will be put in place to address it (i.e. HCA not scheduling in the same area they’re working).

Relationships have come up a lot over these three town halls and in the questions and comments received through the feedback form. Working relationships have changed with the new model, and we are committed to working on fostering strong relationships between staff as we move forward. We want to work with you, and hear your thoughts and ideas on how we can rebuild relationships, because they are so important to the work we do.

We are also committed to continuing to meet with specific groups of staff who haven’t had a dedicated town hall yet, including HBCCs, DSS, DSNs, and CCs.

We will take this away to discuss and get back to you regarding a process.

We are increasing the number of staff available to take phone calls. We are monitoring call wait time data, including average call time and longest wait, to monitor progress on improving these. We know staff are feeling that this data does not accurately reflect their experience, and we are working with our telecom partner to address that.

When you experience a long wait time, please continue to send screenshots to your manager, as we can review individual phone calls to identify and address issues.

Staff safety is one of our main priorities. If you are finding you are running into safety-related situations, we should have safe visit plans for those clients. If one is not shared when it should be, we will investigate. We are working on implementing safevisit (SVP) onto the Procura app. This is being finalized over the next few weeks.

We recognize that multiple changes over a shift would be hard to manage with being constantly on the go. We will take away for discussion how to improve communication pathways for schedule changes.

Tail ends is an ongoing issue, and this is unfortunately a part of home care that likely can’t be mitigated.

Thank you for the comments and for being upfront and honest about how things are going. This hasn’t gone well, and we’re addressing many things after the fact. We should have been more proactive, and we apologize for that.

We recognize that this has been a loss for both community areas and scheduling staff, and those feelings are important for us to take away and consider how we can build communications pathways to maintain those existing relationships.

Thank you for sharing that. It speaks to the overall frustration and impact this has had for everyone in the program as well as those we serve.

Moving forward, we want to give everyone the chance to look under the hood, understand what work is happening and provide feedback along the way.

We are working to create a place on Insite and the Professionals’ site where this type of information will live. We want to ensure you are aware of what the goals and associated actions and timelines are. There are weekly updates going out with key metrics, which are also posted on the Professionals’ site. If there are other specific metrics you want to see, please let us know.

A lot of work has been done to get scheduling staff, including NSCs, into a regular assignment, so that should contribute to improving knowledge of who is working in your area. There are also challenges for NSCs to know who the NRC covering is. The default is the planner as the central communication point, and the consistency has helped us. We will put this in writing in a process and share this with staff, and app admins are currently working on a report for daily nursing report that includes who is working in area, their phone number and other info required.  

We also are bringing together a working group of NRCs to develop further processes that address communication and other gaps in the new model.

The standard training time is two weeks. Now they have a hybrid model where they are paired with another scheduler, and we have an opportunity with the computer lab and experts on site to do hands-on training that is helping.  

We are also regularly posting resources like Quick Reference Guides and Standard Operating Procedures on Insite to support new staff.

Ultimately, goal of centralization is to ensure standardization of processes. The variation across areas is a concern and we are aiming to streamline this. Your question highlights why we are moving forward with centralization.

There are new Quick Reference Guides on Insite as a resource to support staff, and we will continue to update those to address concerns. We are working to update the Standard Operating Procedures, but with things moving so quickly, the Quick Reference Guides are a great source of information right now.

We are developing flow plans for each of the community areas with directions and locations of specific needs, and nurses now have key scan access to all community offices in the city.

Yes. We are trying to make less emails/phone calls, but we will do this.  

A routine for schedulers is being established. We have a mixture of days and evenings, and when fully staffed, there would be 12. We are short staffed right now, and many SCs are also training on nursing scheduling. We are having daily huddles, but some of the other elements will take time to get established as new staff are trained and join. We are going to look into urgent tasks not being addressed, and if you see something that isn’t being addressed, please escalate to Kristina Ernst Gasenze.

Nurses now have key card access to all community offices.

Absolutely. This used to be a major part of the process, and we had programs like “Take Your Friend to Work” day. We are looking at options to implement shadowing in the new model, because it has immense value. We already have UHCAs shadowing as part of their training.

In addition to the change, we’ve seen a high number of nursing coordinator vacancies, which has partially led to the need for remote and partial coverage, and cross coordination of who can support and how. The first step is getting the vacancies filled, which will contribute to reducing workload.

The most recent nursing orientation was full, and we continue to focus on recruitment.

Retention is also key in this being successful, and workload does impact retention.

We are gathering data on nursing workload, and are looking into doing a workload review to understand how we can better allocate resources when looking at the big picture. The goal is ultimately to free up nurses’ time so they can spend more time in the community.

Rotation alignment and workforce planning have been flagged for follow-up in the coming months; a more detailed timeline will be shared as current operations stabilize.

The goal is to get to a place where being in the community is possible, and there is adequate support and coverage while you are out with your team.

We are actively reviewing cancellations and receiving daily cancellation reports now as well.

When we were designing this model and planning for the role out, we genuinely thought we were engaging with staff, but hearing from you and reflecting on it, we recognize we didn’t do this effectively to where you felt heard and included in the process.  

We understand that this has broken trust between leadership and staff, and that we need to rebuild. We want to improve and realize the full potential of this model, and in order to do that, we have to work hand-in-hand with staff.  

We are reviewing all of your feedback, and we ask that you please continue to share your questions, concerns and suggestions with us as we move forward.  

We are now providing weekly updates to staff, and will be creating and updating an action log documenting our progress on addressing feedback and issues you’ve raised. All of this information will also be shared on Insite and the Professionals’ site on a regular basis.

When working with unions, there is a large labour process that can inhibit piloting transformational change such as this. There are definitely lessons learned, and this experience will impact how we launch change like this in the future – there will be a review of this process to understand how we can manage changes like this within a collective agreement.

This was put in place originally to manage the number of sick time or similar calls. We are moving towards having people assigned to specific types of calls. We have also shared a document with an escalation process for these types of calls. If you are seeing something that hasn’t been worked on, please notify your manager or supervisor.

This is an important point and a priority for us. The expectation is that we have a respectful workplace where all staff feel safe and valued.  

We can take this away and look into additional customer service training. We also ask that you please escalate these instances to your manager and bring them forward to the scheduling office as well – we have to work together to hold each other to the standards of the respectful workplace policy.

We are monitoring client cancellation rates closely, and they are coming down to pre-transition levels. Ultimately, our goal is not to cancel any visits, and it’s something we’ve continuously been working towards since before this transition.

The expectation for scheduling is that staff follow priority codes. Ideally, we would not be pulling staff from one block to another, but it is sometimes necessary to ensure priority clients are addressed. We are looking into where there could be improvements to communication with clients in these cases.

Managers have access to the cancellation dashboard, which includes historical cancellation data, and we want it to be transparent and accessible. If this is something you are interested in, you can follow up with them for specific metrics. We are also including the cancellation rates in the weekly update, and are open to adding additional metrics if there are others you want to see. The stats are done by Jim Legeros.

Cluster groups have been recreated within the centralized system, so that familiarity with clients and community areas specific needs can be maintained as much as possible. Every day we meet and float people based on staffing, and there are some new staff joining us now, but we’re working to keep staff in their prior groups.

We have a revised who to call document, to reflect feedback from staff and clarify some of the points of confusion. It will be shared shortly, and ongoing feedback is encouraged as we move through this.

We did meet with scheduling clerks in person at 80 Sutherland, and also have meeting with scheduling supervisors planned. We’ll be going back to meet with the scheduling clerks in a few weeks to let them know how we’ve moved forward with their feedback.

Over the past few weeks, we have shifted work depending on what is needed. We will recirculate the form to provide the option, and we will take away for review the idea of having RCs pick up scheduling work in the community offices.

There was a review done of Southern Health’s model.

We are aware that this is an issue – if we don’t have direct service staff to do the work, we can’t add new clients. There has been some disruption since the transition where clients are getting cancelled, or are being seen by multiple staff.  

We continue to work on hiring more staff, including DSS, and have processes in place for both internal and external hiring. All the DSS orientations are currently full, and we can look at coordinating orientation spots where there are more needs – if you’re seeing need in your area, please notify your manager.

Yes, it is expected to clear the planner as much as possible. We acknowledge that the first few weeks were difficult as we had many people trying to help, and some things got missed.

Runs should not be left in the planner day-to-day. We are working to implement processes to reduce errors.

It has been a challenge based on staffing, and with the hiring happening, we are hopeful there will be improved coverage, and capacity to clear the planner, moving forward.

We are working through the processes adapted for the new model with scheduling clerks to ensure they have the resources to appropriately schedule DSS. Many of the community offices had adapted processes for their area, and we are working to align the centralized process back to core scheduling values. We understand the frustration and issues for DSS resulting from last minute changes, and we will take that back to review with scheduling clerks.

Staff retention is a priority for us, but we also want to allow staff opportunities for growth within the WRHA. Of the 18 SCs who left their position, 1 retired, and 10 moved within the WRHA community program, including 5 who were promoted to RCs.

We have adjusted the “Who to Call” document to clarify that staff are to report full refusals and “Cancel short notice.”

As far as not having to report certain tasks that have been done, we are asking DSS to document on the Procura app, and CCs are going to get a report that is being finalized right now. We moved to this process so we could reduce call redundancy.    

We went back to Digital Health to ask for help creating a report that was user-friendly in order to alleviate pressures on DSS, while still giving CCs the information they needed. This wasn’t originally part of the app’s functionality, but we went back to the developers to make it happen.