Wired on Friday/Carol Power: To help ease the nursing shortage, a hospital in upstate New York is allowing its nursing staff and nurses from other hospitals to bid on the internet for shifts they would like to work.
St Peter's Health Care Services in Albany, New York, sponsored by the Sisters of Mercy (an order founded by Dublin nun Sister Catherine McAuley in 1827), set up RNJobs three years ago at the address rnjobs.stpetershealthcare.org.
The site enables qualified registered nurses (RNs) bid and obtain work on various shifts, similar to the way people can bid on items at sites like priceline.com and eBay.com.
The goal is to fill vacancies with qualified staff by hiring nurses directly through the website.
"The benefits are twofold," said Mr Richard Chady of St Peter's Healthcare Services. "It's a lot easier for our managers to use. If a manager wants to fill a shift, he posts it on the website and someone sees it. We're also realising savings. The system allows us to bring more people into the pool and so we hire fewer agency nurses."
He adds that because: "Two-thirds of the bidders are our employees who get overtime, this allows us to provide greater continuity of care. Most have worked in the units before and that's better for our patients because it's not someone new from an agency looking after them."
Staff in IT, patient care and human resources at St Peter's took two months to design the database system. The site opened to select users on St Peter's staff in December 2000. In the first phase, part-time RN employees (those with less than 40 hours per week) from the intensive care unit and cardiac care could view additional shift openings in those two departments and bid on them via email or telephone. (They must use a password and user ID on the site.)
In April 2001, the site was opened to non-St Peter's employees. The site lists what shifts are open and what skills are required. Nurses may then bid on those jobs. Those without Web access may call a telephone number to learn of vacancies and bid over the phone. The shifts available for bidding are posted to the website as they become identified.
For example, a nurse could see a vacancy at a certain time on a certain date in units like cardiac, intensive care or critical care. The nurse enters his/her name, skill level and a bid price. There are three categories of wages presented by the hospital that a nurse can consider before placing a bid and these range from "most likely to pay", "likely to pay" to "least likely to pay". The operations manager receives the bid and within 24 hours before the beginning of the shift notifies the bidder via email or phone whether it is accepted or rejected.
If rejected, the bidder may be notified that the bid was too high and that a lower one will be considered. Bids are accepted in increments of $0.25. The operations manager decides when to close the bidding and accept one of the offers.
There are four criteria for accepting bids: skill level; shift schedule; past performance; and lowest acceptable bid. The approved nurse works the job.
The average bid at St Peter's is $37 an hour, which is about 30 per cent higher than the base rate paid to RNs but lower than the average $49 an hour agency nurses get. Nurses who are not employed by St Peter's must receive approval in order to bid.
To achieve this, they must complete an online questionnaire, then pass a written test on clinical skills and receive an eight-hour orientation. After that, they receive a user ID and password for the site and may bid as often as they like.
Since 2001, St Peter's has filled more than 127,000 hours and saved more than $1.7 million (€1.36 million) through online bidding. Its vacancy rate for all nurses has dropped from 20 per cent in 2000 to 5 per cent through a combination of online bidding, an ambitious recruitment programme to hire new graduates, the offer of good pay and benefits, and flexible schedules.
The scope of the site has expanded from the intensive care unit and cardiac care to all the units in the hospital (which employs about 800 nurses) to two nursing homes (Villa Mary Immaculate and Our Lady of Mercy Life Centre) and the Community Hospice.
The site is working so well that St Peter's has sold the software programme to two other hospitals: the Mercy Hospital in Pittsburgh which calls its site www.rnbids.com and Mercy Hospital in Miami. All three hospitals belong to Catholic Health East, a Catholic health system located in 11 eastern states stretching from Maine to Florida.
"This system is very successful," Mr Chady said. "It saves us a lot of effort and money and our expenses are minimal. We're now working with a marketing firm to see how we can market it to other hospitals."
An online bidding system such as this one could help alleviate the chronic nursing shortage. The national average vacancy rate for RNjobs is 13 per cent but that figure is expected to grow as the current RN workforce ages and retirements peak this decade.
More than 126,000 nursing positions are unfilled today and health care experts predict that number to skyrocket to about 800,000 positions by 2020 just as 78 million baby boomers place unprecedented demands on America's health care system.
