But meeting those levels isn't easy, particularly when qualified nurses are in short supply. The American Hospital Association reports that 126,000 nursing positions are unfilled in the United States, which is experiencing a tight market for nursing nationally with no letup in sight, according to the American Association of Colleges of Nursing. Government agencies and trade groups are forecasting chronic nurse shortages that could seriously affect patient care over the next two decades.
Hospitals routinely rely on nurses supplied by temporary staffing agencies to supplement their regular ranks. The practice can have drawbacks, however. Nurses who aren't regularly employed at a particular hospital may be less familiar with the institution's procedures, which can affect patient care. And while temporary nurses generally don't earn benefits, the cost differential is narrowed by the fees charged by staffing agencies.
Pittsburgh Mercy Hospital has hit on an idea that its administration finds a better solution to the supplemental staffing issue than relying wholly on agency-supplied nurses. It is using RN Bids, a Web-based application that allows its own nurses and qualified non-Mercy nurses to bid competitively for available nursing shifts.
"First and foremost, we wanted our nurses taking care of our patients," says Barbara Allwes, director of supplemental staffing.
Nurses who are not Mercy employees can qualify to bid on available shifts by applying on the site.
The system, launched last May and rolled out through the hospital two units at a time, has allowed Mercy to reduce its reliance on staffing agency nurses by more than half.
The software for RN Bids was purchased from a hospital in Catholic Health East, a group of health systems in which Mercy is a member. Mercy tweaked the package to offer additional features, including one that allows bidding nurses to view the lowest bid submitted for a shift.
The system can be accessed from any computer with Internet capability or by telephone. Nurses use a pass code to enter the site, view available shifts and bid on them. They are assigned shifts based on their skill level, whether the shift coincides with their existing schedule (nurses can work a maximum of 16 hours in any 24-hour period) and on the basis of their bid for a particular pay rate. Nurses can customize the bid by selecting among hourly rates in 25-cent increments.
A nurse with specialized skills and experience, for instance, might bid for a shift at a higher salary level because she knows that the pool of qualified nurses for a particular unit assignment is limited. A nurse bidding on a shift for which the skill level is not as specialized or for which there may be a large potential pool of nurses available to fill it may choose to bid at the low end of the compensation scale.
Winning bidders are notified via e-mail and telephone, and those who submit bids that are rejected are notified by e-mail. All bids are accepted or rejected 24 hours prior to the beginning of the shift.
The system has had an additional benefit for Mercy. Allwes says that some nurses who were certified as qualified to bid on shifts but were not regular Mercy employees have since been hired by the hospital.