AMN Healthcare Services Inc · NYSE:AMN
AMN Healthcare Services — Investor Presentation (December 2007)
35 slides from AMN Healthcare Services's investor presentation, December 2007
Slide 1: Partnering with Travel Nurses on the Magnet Journey
Partnering with Travel Nurses on the Magnet Journey Featured Panelists: Debi Boyle, RN, MSN, AOCN, FAAN Banner Good Samaritan Health Center, Phoenix, AZ Joan Forte, RN, MSN, CNAA-BC Stanford University Hospitals and Clinics, Stanford, CA Tammi Erving-Mengel, RN, MSN, CNAA-BC High Point Regional Heal
Slide 2: Focus On: Integration & Assimilation
Focus On: Integration & Assimilation A Specialized Orientation Exemplar Debi Boyle Banner Good Samaritan Health Center, Phoenix, AZ
Slide 3: Employed Registered Nurses: Best Resident-to-Nurse Ratio
Employed Registered Nurses Top 6 States With Best Resident-to-Nurse Ratio 1 District of Columbia 2 South Dakota 3 North Dakota 4 Massachusetts 5 Maine 6 Iowa Source: 2004 National Survey of the RN Workforce. DHHS. Accessed 3/16/07.
Slide 4: Employed Registered Nurses: Worst Resident-to-Nurse Ratio
Employed Registered Nurses Top 6 States With Worst Resident-to-Nurse Ratio 45 Arizona 46 Utah 47 Texas 48 Idaho 49 Nevada 50 California Source: 2004 National Survey of the RN Workforce. DHHS. Accessed 3/16/07.
Slide 5: Arizona Ratios
Arizona Ratios Arizona has One of the Worst Nurse-to- Patient Ratios in the United States
Slide 6: Vulnerability to Nursing Shortage
Vulnerability to Nursing Shortage Fastest growing state in the U.S. Phoenix = 5th-largest city in the U.S. Projected continued population growth Influx R/T winter visitors: Overall volume Aged Insufficient number undergraduate RN programs Competition for labor with growing high-tech industries
Slide 7: BGSMC Travel Nurse Orientation Program
BGSMC Travel Nurse Orientation Program Began in 2001 Coordinated by clinical care operations department responsible for orientation of: Travelers: RN Allied Health (i.e., RT, PT, OT, OR and rad techs, case managers) BH Registry Resource Team (i.e., float pool RNs, CNAs, HUSs) Transporters Staff supp
Slide 8: BGSMC Travel Nurse Orientation Program
BGSMC Travel Nurse Orientation Program Currently 4 days, 32 hours Didactic (12 hours): Abbreviated General ‘0’ RN JD Customer satisfaction, patient identification, fall prevention Hospital resources Credentialing Medical equipment, tubes, IV access Laboratory (12 hours): Cerner Computerized Clinical
Slide 9: BGSMC Travel Nurse Orientation Program
BGSMC Travel Nurse Orientation Program Attitude ‘DNR’ to BGSMC Clinical error ‘DNR’ to Banner Health Intra-system communication network
Slide 10: BGSMC Travel Nurse Orientation Program: Outcomes
BGSMC Travel Nurse Orientation Program Outcomes: Investment Use by specialty area Terminations and returnees Sequential modifications
Slide 11: BGSMC Traveler Investment
BGSMC Traveler Investment Category 2005 2006 2007* Total # travelers oriented 498 612 486 Total hours of orientation 27, 640 17, 951** 13, 350*** provided Average hrs. orientation per 55 29 27 traveler Cost/traveler $2,008 $1,545 $2,138 Total cost $1,000, 010 $945,767 $1,039,258 * January through mi
Slide 12: Total & High-Volume Specialty Area Traveler Use
Total & High-Volume Specialty Area Traveler Use (2005-Mid-September 2007) Category 2005 2006 2007 Overall # RN travelers 498 612 486* # Medical/Surgical 161 148 105 # ICU 143 153 122 # Telemetry 113 81 91 # Rehab Institute 21 41 11 *An additional 29 did not begin orientation due to failing the EKG o
Slide 13: RN Traveler Terminations
RN Traveler Terminations Reasons Major Specialty Year Clinical Unprof. Attendance Drug Personal $$ Total # % Hires M/S ICU Tele Rehab WIS Underperf. Conduct Diversion FamIssues Lost 2005 81 16.2 46 18 8 2 7 56 25 $162,648 2006 57 9.3 24 8 13 1 11 13 15 10 7 3 $88,065 2007 31 6.4 22 9 3 6 9 3 6 $66,2
Slide 14: Percent of Traveler Returnees
Percent of Traveler Returnees % RN Traveler 2005 2006 2007 Returnees* 2.4% 4.9% 7.8% * Returnees have reduced orientations depending upon how long they have been gone from the system, hence orientation costs are less
Slide 15: Traveler Orientation Modifications 2005-Present
Traveler Orientation Modifications 2005-Present 2005 2006 2007 • 12 hours General ‘O’ • 12 hours General ‘O’ • 12 hours Traveler Orientation • 12 hours Traveler Orientation • 12 hours Traveler Orientation • Medication , EKG Tests • General Assessment Test (GAT) • Medication Test (basic or ICU) • TAV
Slide 16: Lessons Learned and Future Initiatives
BGSMC Travel Nurse Orientation Program Lessons Learned: Continued refinement necessary Decreased negativity noted from core staff over past 3 years Positive reaction from Magnet appraisers regarding work environment, creative approach, subjective responses from traveler RNs whom appraisers requested
Slide 17: Focus On: Stability and Participation
Focus On: Stability and Participation Fostering Staff Nurse Engagement Tammi Erving-Mengel High Point Regional Health System, High Point, NC
Slide 18: Focus on Stability and Participation: The Unit
Focus on Stability and Participation: The Unit: 6 South 36 Beds (12 Telemetry) Neurology, vascular, general medical/surgical, ICU transfers RN and NA staff with Unit Secretary support
Slide 19: The Unit: In 2001, the Year of the Magnet Site Visit
Focus on Stability and Participation: The Unit: 6 South In 2001, the year of the Magnet Site Visit: Budgeted for 29.4 RN FTEs Had 9.4 vacant FTEs (32% vacancy!)
Slide 20: The Unit: 2007, No Agency Nurses
Focus on Stability and Participation: The Unit: 6 South Contracted with 7.0 agency staff (13-week contracts) x 1 year After one year, reduced to 3.0 agency staff 2007: No agency nurses, fully staffed, waiting list for hire
Slide 21: The Contribution of the Contract
Focus on Stability and Participation: The Contribution of the Contract Allowed for RN staff participation on clinical teams (Practice, Research, Magnet) Brought experience to the bedside Improved morale (Ahh, relief!)
Slide 22: Impact on Recruitment
Focus on Stability and Participation: Impact on Recruitment Able to stabilize staffing, improve morale — create a positive, desirable work environment Four of the contract staff accepted permanent positions
Slide 23: Cost
Focus on Stability and Participation: Cost “Priceless” $655,000 the first year $280,800 the second year Total: $935,800 Have not had a contract since early 2004
Slide 24: Innovative Practice
Focus on Stability and Participation: Innovative Practice Experience from other hospitals brought new ideas to our practice Experience from other hospitals brought encouragement and a desire to “reach for the stars”
Slide 25: Focus On: Innovation and Creativity
Focus On: Innovation and Creativity Responding to the Changing Healthcare Environment Joan Forte Stanford University Hospitals & Clinics, Stanford, CA
Slide 26: Stanford Hospital & Clinics
Stanford Hospital & Clinics “Reflections of Excellence” “To Care, To Educate, To Discover” Medical Staff = 1846 + 617 housestaff 1,600 nursing staff More than 20,000 annual admissions More than 26,000 outpatients served in hospital Clinic visits = 471,728 ER visits = 38,323
Slide 27: Reflections of Excellence
“Reflections of Excellence” 21 Main ORs 12 Ambulatory suites 16 Inpatient units 30 Psych beds 66 Intensive care beds 17 Rehab beds BMT/transplant Oncology
Slide 28: Changes in Healthcare
Changes in Healthcare Length of stay Increasing occupancy New specialties Rising acuity/CMI Changes in reimbursement Mandated staffing ratios Nursing shortage Fiscal pressures Business orientation
Slide 29: B1 - The Before Picture
B1 - The “Before Picture” Outpatient Patient mix Occupancy HPPD Competencies Staffing needs/FTEs
Slide 30: B1 - After the Makeover
B1 - After the “Makeover” Ortho specialty Inpatient Occupancy HPPD Competencies Staffing needs/FTEs
Slide 31: G2 - The Before Picture
G2 - The “Before” Picture Medical psychiatry Pain patients Occupancy Ratios HPPD Competencies Staffing needs/FTEs
Slide 32: G2S - After the Makeover
G2S - After the “Makeover” Step-down, monitored unit Admits from OR Occupancy Ratios HPPD Competencies Staffing needs/FTEs
Slide 33: Other Contributions to the Forces
Other Contributions to the Forces Responsivity Innovative practice Evidence-based Recruitment Retention Cost effectiveness Productivity
Slide 34: Thanks to Our Panelists
Thanks to Our Panelists Debi Boyle, RN, MSN, AOCN, FAAN Banner Good Samaritan Medical Center, Phoenix, AZ Deborah.boyle@bannerhealth.com Delona.woody@bannerhealth.com Joan Forte, BSN, MBA, CNA-BC Stanford University Hospitals and Clinics, Stanford, CA jforte@stanfordmed.org Tammi Erving-Mengel, RN,
Slide 35: This Webcast is posted at www.amnhealthcare.com
This Webcast is posted at www.amnhealthcare.com Check out all our other Webcasts available in our archive!
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