Rostering is a leading concern for nurses and midwives, and it impacts the ability to maintain ratios, staff wellbeing and retention. Staff shortages are one of the greatest challenges in our health system. Current rostering practices and principles are based on historical customs that are not meeting the needs of our contemporary workforce. This leads to decreased workforce availability, absenteeism, and casualisation.
Rosters are a key component in staff satisfaction and retention, and rostering staff is one of the most complex and important management functions. Rosters need to ensure sufficient and suitably skilled personnel are allocated to deliver high quality and safe patient care and appropriately meet anticipated service demands. They must also comply with relevant regulatory frameworks, including industrial agreements and legislation relating to fatigue management, fairness and equity.
Western Health has undertaken a project with Safer Care Victoria, the Department of Health, and the Australian Nursing and Midwifery Federation and 2 other health services to explore, identify and understand the rostering preferences of nurses, midwives, unit and roster managers. This was based on their experiences, perceptions and satisfaction with current rostering principles, which allowed us to develop acceptable and feasible employee-centred rostering principles.
The Nursing & Midwifery Directorate extended this co-design process to include all nurses and midwives working at Western Health to ensure that any guidelines that may be developed met the needs of all areas.
At all stages of the co-design process the responses to the questions were validated by our Professor of Nursing and her team, and only the results that were statistically significant were incorporated into the guidelines.
The project was driven by a commitment to understand the challenges posed by current rostering custom and practice and to inform development of a suite of employee-centred rostering principles which focuses on the importance of the Four Fs:
- Foundations,
- Flexibility,
- Fairness, and
- Fatigue Management.
Western Health joined with the other project participants to develop a set of state-wide nursing and midwifery roster guidelines using a co-design approach. The Victorian Rostering Toolkit was published by Safer Care Victoria in December 2023. This project has been supported by the Western Health-Deakin University Nursing Research team who have provided statistical analysis of the results of each phase of the co-design project.
The Nursing & Midwifery Directorate have developed the Western Health guidelines using both the internal co-design process and the Safer Care Victoria guidelines to ensure that they meet our local requirements.
The new guidelines are planned to be implemented across Western Health in 2024.