QUESTION
What is New York City Health and Hospitals' (H&H) current vacancy rate, and how is staffing determined?
0:24:53
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174 sec
New York City Health and Hospitals reports a 9% nursing vacancy rate and emphasizes a dynamic staffing model based on patient needs rather than fixed positions.
- New York City Health and Hospitals operates on a different model from traditional city departments, with staffing based on insurance reimbursements.
- Staffing for nursing is determined by patient-to-nurse ratios to ensure enough resources at the bedside.
- For positions that cannot be filled permanently, the effort shifts from offering overtime to employing individuals from internal or external registries.
- John Ulberg highlights a dynamic budgeting approach that adjusts to patient admission and discharge volumes to maintain necessary resources.
Mercedes Narcisse
0:24:53
What H and H's current vacancy rate?
0:24:56
Can you provide the vacancy rates by job title such as for physician, registered nurses, and residents.
Mitch Katz
0:25:06
So I'll let John talk about technical, but I think it's important for transparency to explain to people who are listening that because of health and hospitals is an agency.
0:25:19
Our positions are not the same as the city positions.
0:25:22
Right?
0:25:23
So the the city traditionally a true city department will say, department a, you have 800 positions.
0:25:30
Department b, you have a 1000 positions.
0:25:33
And then those positions are filled or vacant.
0:25:36
Health and hospitals because we are primarily a revenue department.
0:25:40
We primarily get revenue from insurance companies for taking care of our patients, and we have to have the appropriate staff.
0:25:49
So all of our nursing, for example, a topic you're passionate about is based on ratios of this many patients should equal this number of nurses.
0:26:00
If we don't have that number of nurses in permanent positions, We're going to first ask people if they want overtime, then we're going to go to our internal registry, then we're gonna go to an external registry.
0:26:15
Same with doctors.
0:26:16
We're gonna ask them to do sessional work.
0:26:18
If we can't get sessional work, then we will go to a locums or a contract.
0:26:24
So for us, a vacancy is not exactly a vacancy because we we can't have a trauma center, and I'm sorry there's a vacancy.
0:26:33
There always has to be a doctor, a nurse, a social worker.
0:26:37
Right?
0:26:38
So can you provide a better sense of the actual numbers?
John Ulberg
0:26:42
Yeah.
0:26:43
I think we do report a number of about 9% for nursing.
0:26:47
But as Doctor.
0:26:49
Katz had indicated, we've moved more to a dynamic budget.
0:26:53
So we try to make sure that there's enough resources at the bedside all the time.
0:26:59
And the nurse ratio is, I think, a good example of that.
0:27:02
We actually appreciate budgeting based on a ratio where we have to have a prescribed number of nurses to meet the needs of that bad.
0:27:11
And as our volumes go up and we have more discharges and admissions, we allow the budget to go up with it.
0:27:18
And that's a little bit different, right, as Doctor.
0:27:20
Cass had indicated versus other city agencies or maybe even the way other hospitals.
0:27:25
Right, develop their budget.
0:27:26
But we think it's very important that there's always the resources needed at the bedside and that's nursing and food service and all the other services that are required to meet and provide quality care.
Mercedes Narcisse
0:27:39
Is that possible you can broke that down?
0:27:41
By hospitals?
John Ulberg
0:27:43
Break down the vacancies.
Mercedes Narcisse
0:27:44
Yeah.
Mitch Katz
0:27:45
We can break that down.
0:27:46
Mhmm.
