In working with hospice around the country there are two things that contribute the most to nurse burn-out and dissatisfaction ultimately leading to nurses leaving an organization and this weakening the core. Those things being after-hour call duty and doing admissions. These two factor have been identified as issues related to nurse retention.

Here are a few counter measures to help solve the problem. What are your thoughts?

There is an on-call company that specializes in handling after hours and weekend hospice calls. Hospice-On-Call is a Chicago based company that works with 100s of hospices across the country to handle after hours calls. They can alleviate call volumes as about 60% of after-hours and weekend calls are non-clinical in nature. The other 40% clinical calls are triaged so as to achieve better outcomes. The cost to this service is between $11-$12 per patient per week or $1.57 to $1.71 PPD. I not only view this as a cost for a good service but a nurse retention expense to ensure a strong core. A strategy worth exploring.

The other core building strategy applies to those hospices who have a census approaching 60 to 70. These hospices are in a position to develop an admission nurse function which does a few things. One, eases the pressure for Nurse Care Manager from having to do an admission. An admission function would handle 70% to 80% of the admissions. Case Managers will be able to focus more on managing their 12 to 14 patient caseloads. These factors will also help enhance retention. The other benefit of having a dedicated admission function is an ability to get a patient admitted sooner. If a Case Manager gets an admission request the end of the day or even better Friday afternoon, there is a chance that admission will be pushed off a day or two. This is not only a loss of revenue but an opportunity to serve a patient and family in need. Case Managers recognize this and it contributes to their stress and burn-out and potential leaving the organization.
These are two strategies worth pushing to help build the core strengthen of your hospice, the Nurse Case Manager. What are your thoughts?

The Best!