COUNTY OF SAN MATEO

Inter-Departmental Correspondence

San Mateo Medical Center

 

DATE:

June 21, 2004

BOARD MEETING DATE:

July 6, 2004

 

TO:

Honorable Board of Supervisors

FROM:

Nancy J. Steiger, Chief Executive Officer, San Mateo Medical Center

 

SUBJECT:

Agreements with AMN Healthcare, Inc., Arcadia Health Services, Inc., Cross Country Travcorps, Inc., First Call Nursing Services, Medstaff, Nurse Providers, Nurses PRN, Pelican Resources Registry, Relief Nursing Services, Stat Nurses International, and United Nursing International

 

Recommendation

Adopt a resolution authorizing the President of the Board to execute Agreements AMN Healthcare, Inc., Arcadia Health Services, Inc., Cross Country Travcorps, Inc., First Call Nursing Services, Medstaff, Nurse Providers, Nurses PRN, Pelican Resources Registry, Relief Nursing Services, Stat Nurses International, and United Nursing International

 

Background

San Mateo Medical Center uses nursing registries to augment permanent Nursing staff. Registries are used to fill nursing vacancies, meeting unexpected increases in census and patient acuity, and as substitution for employees’ illnesses, extended leaves of absences, and workers’ compensation.

 

Discussion

Registries provide San Mateo Medical Center (SMMC) and Health Services with access to nursing staff available to fill in for vacancies when necessary. Because nurses usually register with only one registry at a time, agreements with several registries are maintained to have maximum access to the available work force.

The Medical Center is experiencing a greater than 12% vacancy rate in the nursing department. The majority of vacancies are in the critical care areas of Emergency Department (ED), the Intensive Care Unit (ICU), and the Operating Room (OR). Vacancies also exist in all other nursing units. The Medical Center uses an average of 8 “Traveler Registered Nurses (RNs)” (contract RNs who work an 8-13 week contract) to cover shortages in the ED, ICU, some OR and Medical/Surgical units. The ED has experienced a 30% increase in the number of patients seen and the ICU is staffed to support a census of 6.

All nursing units also use day-to-day registry (an RN, LVN or CNA who works one shift at a time) for the following reasons: 1.) To cover medical leaves, education, sick days and resignations; 2.) To staff 1:1 and 1:2 patients in the medical surgical area; 3.) Additional registry staffing has been needed to provide support to the Burlingame HealthCare Center; 4.) Registry staff is also used to avoid emergency department diversion by providing staff for units to accept patients from the Emergency Department in a timely manner so as to improve patient flow and decrease patient wait times; 5.) To provide quality care to existing patients; and
6.) To adjust to quick increases in census.

The implementation of the Nursing Ratio Legislation in January of 2004 has caused the Medical Center to increase access to this type of short-term registry staff to meet the required ratios and avoid citations and fines from the Department of Health Services who will be monitoring this issue closely.

A Request for Proposals process for nursing and ancillary registries was sent to 40 registries in February of this year. Eleven registries were selected out of 26 registries that responded to the RFP. These 11 registries were determined to meet SMMC’s needs.

County Counsel and Risk Management have reviewed and approved these agreements.

 

Vision Alignment

These agreements keep the commitment to Ensure Basic Health and Safety for All and goal number 5: Provide residents access to healthcare and preventive care. The Agreements contribute to this commitment and goal by continuing to provide nurse coverage where needed at San Mateo Medical Center.

 

Fiscal Impact

The term of the eleven agreements is from July 1, 2004 through June 30, 2006. The maximum amount the County shall be obligated to pay collectively for all eleven agreements is $1,645,000. Funds to cover this cost have been included in SMMC’s and in the Health Services (AIDS Program) budgets for FY2004-05. Funds will be included in SMMC’s and Health Services’ FY2005-06 budget requests.

Exhibit A

1.

General Description of RFP

Three proposals for short term, long term, and permanent placement registry personnel.

2.

List key evaluation criteria

1. Salary requirements

2. Personnel policies

3. Quality

4. Regulatory requirements

5. Experience

6. County Requirements

3.

Where advertised

Not advertised.

4.

In addition to any advertisement, list others to whom RFP was sent

The RFP was sent to 40 registries.

5.

Total number sent to prospective proposers

40 registries

6.

Number of proposals received

26 Proposals

7.

Who evaluated the proposals

Kathi Palange, VP, Patient Care Services

Tony Laureano, Administrative Nursing Supervisor

8.

In alphabetical order, names of proposers (or finalists, if applicable) and location

AMN Healthcare, Inc.

12400 High Bluff Dr.

San Diego, CA 92130

Arcadia Health Services, Inc.

2677 Central Park Blvd.

Suite 200

Southfield, MI 48076

Cross Country TravCorps, Inc.

6551 Park of Commerce Blvd., Suite 200

Boca Raton, FL 94030

First Call Nursing Services

1115 South Park Victoria Drive

Milpitas, CA 95035

Medstaff, Inc

1700 California St., Ste. 475

San Francisco, CA 94109

Nurse Providers

355 Gellert Blvd., Ste. 152

Daly City, CA 94015

Nurses PRN

400 29th Street, Ste. 403

Oakland, CA 94609

Pelican Resources Registry

475 El Camino Real, Ste. 206

Millbrae, CA 94030

Relief Nursing Services

1405 Huntington Ave., Ste. 170

So. San Francisco, CA 94080

Stat Nurses International

950 Harrison St., Ste. 104

San Francisco, CA 94107

United Nursing International

44 Montgomery St., Ste. 740

San Francisco, CA 94104