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Goal: To study the relationship between work organization, recruitment, retention of nursing staff, and injuries in four acute care hospitals in the South Fraser Health Region.
Additional Funders: CHSRF
Main Partners: OHSAH; University of British Columbia; the former South Fraser Health Region; BC Nurses' Union; Hospital Employees Union; Health Sciences Association; Health Employers Association of BC

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This project examined how the organization of care for Alternate Level Care* (ALC) patients impacts on a number of patient handling-staff factors. The study focused in particular on injury rates, job satisfaction, emotional exhaustion, and nurse recruitment and retention.

The study, conducted in 2001-2002, identified five care models for ALC patients within four acute care study facilities located in the former South Fraser Health Region.

Some Findings:

• Dedicated ALC wards result in less injury to healthcare staff.
• Greater attention needs to be paid to improving the prevention of injury in Geriatric Assessment Units.
• Licensed Practical Nurses/Care aides were three times more likely to be injured than Registered Nurses; training, work assignments, and other factors to prevent injuries to LPN/CAs should be reviewed.
• Increased worker participation and management attention to health and safety could improve perceived management supportiveness, increase satisfaction with the hospital, and decrease emotional exhaustion.
• The ALC model alone was not a significant influence on termination or recruitment. Staff who had not been told that they would be working with ALC patients when they were hired, yet spent over 50% of their time working with ALC patients, were at greater risk of emotional exhaustion, dissatisfaction, and lower self-rated health. It is therefore important to inform staff, upon recruitment, whether they will be working with ALC patients, and efforts should be made to not place staff that do not like working with ALC patients in units that have high ALC loads.

* (ALC = a patient who is considered a non-acute treatment patient but occupies an acute care bed. This patient is awaiting placement in a chronic unit, home for the aged, nursing home, rehabilitation facility, other continuing care institution, or home care program etc. The patient is classified as ALC when the patient's physician gives an order to change the level of care from acute care and requests a transfer to another facility- Canadian Institute for Health Information, 2001.)

Related Resources
Final Report:	Caring for the Caregivers of "Alternate Level Care" (ALC) Patients: The Impact of Healthcare Organizational Factors in Nurse Health, Well Being, Recruitment and Retention in the South Fraser Region of BC (424 kb, 125 pgs)	Download
Fact Sheet :	Improving Care for Caregivers of Alternate Level Care (ALC) Patients (19 kb, 1 pg)	Download
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