OSH success story a model of collaboration

Front-line care providers and the new Superintendent of the Oregon State Hospital have come together to find a way to successfully resolve the dangerously low staffing levels at OSH. We are very optimistic that a new staffing pattern will improve patient care and working conditions and reduce overtime costs in these tough budgetary times.

Over the years, front-line workers have fought hard to improve the quality of care at OSH. They have expressed alarm over the systematic short-staffing at the hospital that compromised patient and staff safety. Workers were not able to provide the care they wanted to because of large amounts of mandatory overtime. Workers would go to work at 8 a.m. and in the middle of the afternoon be told that they had to work until midnight because of short-staffing on the next shift. Two mandatory OT shifts a week were not uncommon.

Workers have shared extraordinary stories of trying to do the right thing with a patient who was having a crisis. The right thing is to have several mental health therapists work with such a patient. However, a solitary worker was often left responsible for a large number of patients, which is a very unsafe situation for both patients and for workers. One worker told the story of a patient who was afraid to ask for his medication because he could see how much stress the mental health technician was under.

This compromised the quality of care that patients could receive from exhausted care providers. It harmed morale and disrupted families. And it was costing taxpayers $1 million each month in increased overtime costs.

Workers who were exhausted and stressed out by unplanned, mandatory overtime were getting sick or calling in sick, thus exacerbating the problem. Tired workers missed the warning signs in patients who were escalating their disruptive behavior, thus making an unsafe situation worse. Workers in short-staffing situations are more at risk of on-the-job injury, again making staffing problems worse.

A number of passionate and compassionate allies in the legislature raised a stink, advocated for workers and patients, hauled management in front of committees, and fought for quality public services. But year after year management reverted back to horrible hiring, retention, training, and staffing practices that harmed patients.

Care providers at OSH stuck with it over the years, continuing to raise safety and patient care concerns. Finally, they found a willing partner in Superintendent Greg Roberts. The Superintendent came forward with a novel approach to address this problem: 13 hour and 20 minute shifts. Three long shifts per week allow workers to plan ahead, get rested and put in the time. This staffing pattern has made it easier for management to avoid short-staffing, which in turn reduces absenteeism.

Front-line workers who are leaders of our Union worked hard on this. Randy Davis, Dan Smith, Kerry Rechiro, and Jeff Hodson led their co-workers on this fight for patient safety, quality services and worker rights. Superintendent Roberts also demonstrated leadership in breaking a culture within management at the hospital. Superintendent Roberts deserves tremendous credit for breaking the “we-have-always-done-it-this-way” mentality that hampered the state hospital for years.

The new staffing pattern became fully implemented on May 20. Already mandatory overtime is down 75%. We believe that the quality of patient care will improve, too. The new facility at OSH is a big step forward in terms of quality of care but, without adequate staffing, it was starting to feel like a missed opportunity. The new staffing pattern complements the new facility and hopefully will allow care providers to achieve their goal of providing top-notch care to vulnerable Oregonians with mental illness.

We still have work to do to reduce injuries and violence at OSH, but the potential to succeed is now much greater.

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