2/20/14 MSH Meeting Minutes

Michelle Chalin, Colleen Ryan, Jennifer Frew, Amanda Mathiowetz, Shannon Pech, Chuck Carlson, Tim Headlee, Scott Grefe, John Knobbe, Molly Kennedy, Ryan Cates, Eric Hesse, Mike Homer, Rita Olsen, Carol Olson, Connie Anderson, Tom Christensen, Gregg Frey, Tom Kolstad, Melissa Gresczyk, Meghan Goodrich


1. Vocational Schedule Changes a. Management was asked by clinical leadership if there are hours available later in the day in the vocational department. Staff will begin working 7:30am – 4pm beginning March 26th with spring quarter starting the following week. The memo came out February 19th. This will create consistency across the program. The time difference will give staff an additional 15 minutes to make sure security measures have been met and timesheets are recorded. b. A concern about this interfering with canteen hours was expressed. Patients will need to make the choice with their schedule. Management is trying to balance this because patients value their work hours. How the schedule is affected will be paid attention to. c. AFSCME received a concern about the extra half hour running into security tasks done in the East Shop. Management responded that when the schedule is implemented, we can get a better idea of how this is affected. d. Management is looking into patients working with the city to create some weekend hours. This will be starting May 15th. e. It is encouraged to bring any concerns to management.

2. Safety and Overtime Statistics a. According to the Overtime Report, there was an increase in Overtime for the month of January. Some of this was created by Holiday Overtime and the events of January 22nd. b. OSHA’s Log of Work-Related Injuries and Illnesses were very minimal with 3 items.

3. Patient Death Update a. There is an active police investigation. Also, a letter was received from the Minnesota Disability Law Center that they will be conducting an investigation. An outside resource has been hired to conduct an analysis that will start February 26th and last two days. This is required by the Joint Commission. b. A number of staff has been approved to use leave. Todd Cole has been meeting with staff. He has left his contact information and will make himself available to anyone who would like to utilize his services.

4. Crisis or Admission Unit Ideas a. A lot of interest has come up because of the death. Management has sent out some ideas to staff and have asked staff for ideas. Carol Olson has received some ideas. The next step will be to meet and get a better idea of what is realistic budget wise and programmatically. This will be a set progression.

5. Nursing Home Consultant Project Update a. Reports are completed and there are two different options being looked at. One option will require more nursing staff while the other option focuses more on hiring other positions like General Maintenance Workers allowing nursing staff to focus more on nursing duties. Becky Kern is currently trying to put together a budget for the two different suggestions and how many fulltime positions they require. The outcome will most likely be a combination of the two suggestions. Management is looking at a deadline of February 28th for some decisions to be made. b. Carol Olson proposed that the issue of vacation and the Nursing Home be talked about with a smaller meeting involving Management and AFSCME. 1 vacation slot is allotted still because of budget issues. They are trying to accommodate for a consistent 5-6 extended medical leaves at a time. With these medical leaves there are 32-56 shifts not covered. Also, acuity of patients (i.e. hospital coverage, medical trips, etc.) continues to go up. Those filling temporary positions often leave for a permanent spot. It is being looked into if a temporary solution could be pulling from, for example, the Transport Team. John Knobbe presented a temporary plan to get staff a 2nd spot of vacation. Management is looking into this.

6. Shift Change Expectations a. For the most part, staff will be expected to stay until 10pm but this will be looked at case by case. More information is now going into shift changes. There were some concerns with night staff with getting a proper shift change but per research done by Kevin Graves this has gone up 22%. OD’s are being flexible with granting vacation at the end of the shift. Vacation will depend on if all end of shift duties have been fulfilled.

7. Chuck’s Farewell


1. The use of protective shields during room entry’s or other needs and the use/approval of the scoops a. The Scoop should now be referred to a Transport Device. This is how it is worded in the procedure. Training on the Transport Device went out to TTS’s and Unit Leads who were to train Security Counselors on their unit’s. Meghan Goodrich will get an updated report on the number of staff who have completed training. b. The use of the shield was never added to the restrain procedure. Per Carol Olson this is a valuable tool and she is following up with licensing on how to get it in the procedure. The shields will not be taken away. We are looking to get a clear communication on this because some staff have been told to not use the shield. Carol Olson will be talking to Dr. Pratt and will then get a clear message out to all staff.

2. Concerns in regards to the Avatar system bogging down because multiple users at one time. The IT department made staff aware of this and how it can become a problem. The Internet cannot support the mass/multiple use. a. Bandwidth on campus has been research and a graph of usage was received. The bandwidth on campus has not yet spiked up to the maximum. We are not even coming close to the max. Issues with Avatar are being looked into. The same issues have been throughout DHS for the past 3 years. If you have experienced the blue circle continually circling, your computer has disconnected from the DHS system for some reason and it is unknown why. When you log onto Avatar it goes through multiple servers which will provide a license. There is a problem with one of the servers and the appropriate people have been contacted. Avatar slows down because of the server, not the bandwidth. There are plans for engineers from Avatar to meet with IT on campus. When the state decided to go with Avatar, it was decided that our own IT would support it. There is a contract now being put into place with Netsmart (developer of Avatar) to take over support. b. There is not a new Avatar coming. There is an upgrade called My Avatar. This upgrade will include enhancements to the screens, it will be easier to get to where you want to go, and some different terminology. This will happen around July. c. The question was raised if a draft on Avatar can be changed by anyone. This is being looked into.

3. Vocational 1 area, Patient/Staff ratio are causing safety and security concerns. 1 staff per 10/15 patients. Also concerns about patients leaving the area before informing staff. a.There are different ratios for different areas. Vocational can hold up to about 50 patients an hour. The highest they get is 40-45. They have been stretched and busy for the past 3 months. Management is paying attention and is tracking this. Spreading it out to lower the ratios is being looked into. Management is not aware of staff being left alone with patients. If this does happen, please get the help of staff in an office. b. The only patients with the 1 staff to 10-15 patients are the level 5 shop patients who have grounds privileges and are able to walk to and from work without staff. This should be more than adequate staffing.

4. Progress/ Completion of the MSH lead list a.The list is done. Meghan Goodrich will be contacting everyone to let them know where they are on the list. There will be a copy given to union leadership. Staff can also contact them to get their number of the list also.

5. MSH staff bathrooms being changed/utilized by the patients


a.This began with a vulnerable adult engaging in sexual activity in the ATS Bathroom. There is a 2nd bathroom in the ATS labeled “Staff Only.” Rita Olson called the RT’s and units to see if it would be an issue to make this a patient bathroom. All answers came back unanimously that it would be ok because there are an adequate amount of bathrooms for staff. b.Question was raised why add a second bathroom to the problem. Management responded that that is why the locks are on the bathroom doors. A concern was then mentioned that the patient let in can invite other patients in. Management responded that staff must monitor these doors. 6. Communication/information concerns with EMAR/Omni cell and fulltime positions for LPN’s a. Per Melissa Lemke when nurses go on to do med removal, EMAR and Omnicell will not line up. This will not happen and with many systems this does not occur. Nurses should not scroll through the list of med’s but instead search by the brand/generic name as instructed to do in training. b. The reason that med pass is taking longer is because prior to EMAR & Omnicell, nurses spent time prepping medications for patients before their arrival. Now that there is no prep time, it is taking more time patient to patient so the time has been shifted. c. The connectivity is the big issue, not the product. Once that is fixed it should be more time efficient. Note- please remember to log off. d. When it comes to the issues with Omnicell and the door jamming, it seems to be user error. If the lid is put back on quickly, it may not be on all of the way and will cause a jam. This occurs rarely but when it does happen, it has been advised to use a yard stick or a thin object. These machines are leased so putting a foreign object in the product may be a liability. Management is waiting to hear back from Omnicell on this. Please remember to close the drawer completely. It was suggested to offer refreshers to staff. e. Full time positions for LPN’s have been brought up to Anne Barry. 1 fulltime position has been added and management has asked for more and are pushing for it but this is a budget issue. f. RN’s do not get a $100 bonus if they are inversed on a Friday night or weekend. Must be volunteer overtime Friday nights or the weekend. *Clarification on January’s Minutes for snow removal- Changes have been made to the notes on snow removal in January’s meeting minutes. The supervisor will go to a list of capable and qualified employees in a designated work area. The list will be written in seniority order. The offer of overtime will rotate through the list to ensure equal offering of overtime.