A new way to reduce unscheduled overtime that undermines the morale of troops in the health network? Info-Santé nurses, overwhelmed with calls since the pandemic, are testing a new mobile application to manage their own schedules, plan their holidays and exchange shifts to avoid overtime.
It’s a small revolution for nurses, this service offered 24 hours a day and seven days a week, which has been literally taken by storm since March 2020 and which continues to face a very high number of calls.
Since October 3, the Info-Santé 811 service, attached to the CIUSSS de la Capitale-Nationale, has turned to co-management to solve the problems related to the lack of personnel. Thanks to a new mobile application, the 85 nurses in the department can now notify their superiors by clicking on their phone that they agree to replace an absent colleague, that they must be absent for leave or that they are sick.
“It’s really a co-management of schedules, shared between employers and employees, where the latter play a very active part in planning work schedules and solving problems that arise,” explains Marigil Fortier, program manager and head of human resources department of the CIUSSS de la Capitale-Nationale.
Since the pandemic, half of Info-Santé’s nurses have been teleworking, and the others are working on site. But some shifts, especially evening shifts, continue to be more difficult to fill, given the difficulty of balancing work and family at the end of the day.
“The other day, I received a message on my telephone advising that there were seven evening nurses missing and that there was a day surplus. I immediately said yes, that encouraged me to help,” explains Cathy Martineau, day nurse at Info-Santé.
Using the Voilà! mobile application, developed in Quebec City, now allows the entire team to know in real time what the needs and unmet shifts are, and to respond immediately to a replacement request reported on their phones.
“There, everyone sees the reality thanks to the notifications sent by the application. It makes all employees aware of shifts that are understaffed. Everyone can click to volunteer, but also see who is volunteering,” explains Mélisande Gauvin, Head of Service for 811.
Previously, only nurses on the call-back list could be contacted, and managers would go through the list until an employee agreed over the phone to fill a vacant shift. “We no longer use this list at all,” says Marigil Fortier. It’s very user-friendly: in a few clicks, we authorize a change of schedule,” she adds.
In 2021-2022, more than 4,000 hours were worked in overtime at Info-Santé to cover all unfilled shifts. Managers have also resorted to “half-shifts” to fill uncovered hours, departing from traditional rules. In these cases, the burden of overtime is shared between the nurse on the previous shift agreeing to remain on duty for four hours overtime and the nurse on the next shift, who arrived four hours in advance.
Since the app went live just a month ago, 101 shifts have been filled, including 47 full shifts and 54 half shifts, according to Marigil Fortier. ” That’s wonderful. The mobile application has integrated the use of half-shifts.
The impact of this pilot project on the use of overtime will be assessed in six months. This project was deployed within the framework of a letter of agreement signed by the CIUSSS with the Fédération interprofessionnelle de la santé du Québec (FIQ). “We are on the side that it will help retain staff, adds Marigil Fortin. The more predictable the schedule, the more it promotes stability and work-family balance. »
Culture change
“It’s a total culture change for our nurses. Co-management is a real “empowerment“compared to the previous situation,” says Mélisande Gauvin.
For a simple leave, the nurses had to print an authorization form, fill it out and send it by e-mail to their superiors. “It could take several days to get an answer. Last week, I clicked on the tab to make my request and I got my answer one or two hours later,” explains Cathy Martineau.
Volunteers who participate in the Info-Santé service as part of the Je Contribue platform can also use the application. “Before, volunteers gave us their availability without knowing our needs. A lady volunteer said she was very satisfied to be able to see the needs arise in real time and to be able to respond to them,” explains Ms.me Gauvin.
“We know that’s not going to solve the labor shortage. But [ça] aims to offer a better quality of life and ensure that our employees are happier at work,” says Annie Ouellet, communications manager for the CIUSSS de la Capitale-Nationale.
According to information obtained by the Ministry of Health and Social Services (MSSS), the application is also used by the CISSS de la Montérégie Est, the CIUSSS de l’Ouest-de-l’ile-Montréal and that of the Center -South of Montreal. More than 10,000 shifts were granted through this application between June 20, 2022 and October 20, 2022, according to Caroline Doucet, media relations advisor for the CISSS Montérégie-Est.
In addition to nurses, almost all categories of employees of this CISSS use this tool, including nursing assistants, beneficiary attendants and social workers in crisis centers and youth centres. The CIUSSS du Centre-Sud says it has initiated discussions on this tool, but does not use it for the moment.
Asked about this new way of doing things, the Ministry of Health and Social Services (MSSS) indicated that it did not intend to deploy it in all its establishments and said that it had heard of “no problem” related to its use. According to the MSSS, the use of this application was validated by the Cyber Defense Operational Center (COCD) of the health network before its introduction, to ensure that it meets all security tests and “avoid transversal attacks between systems. »