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Do Not Return-Clinical
Health care staffing services (HCSS) are contracted to fill vacancies
that health care organizations are unable to fill with currently employed staff.
Health care organizations requested coverage for 8,000 vacant positions each
day in 2003.1 A study of Medicare cost reports over a nine-year period found
that short-term acute care hospitals have increased their use of contract labor
from 1.3% of personnel expense in 1997 to more than 3% by the end of 2005.2
The Bureau of Labor Statistics, U.S. Department of Labor projects that the
temporary employment industry, comprised primarily of staffing services, will
grow at an average annual rate of 3.8% from 2004 to 2014, adding nearly 1.6
million new jobs.3 Coupled with the current health care staffing shortage of
nurses, physicians, and technologists, the demand for healthcare staffing
services is expected to continue to increase.
The Joint Commission’s 2007 Comprehensive Hospital Accreditation Manual
states in standard LD.3.50: “Services provided by consultation, contractual
arrangements, or other agreements are provided safely and effectively.”
Compliance of performance with this standard is demonstrated by:
The hospital or HCSS client evaluates the contracted care, treatment and services to determine whether they are being provided according to the contract and the level of safety and quality that the hospital expects.
The hospital or HCSS client retains overall responsibility and authority for services furnished under a contract.
In the health care environment, it is crucial that care givers maintain clinical
competence and the necessary skill level to provide quality of care and patient
safety. It is the responsibility of health care providers to address performance
issues as they occur. The responsibility for dealing with performance issues of
contracted staff reverts to the health care staffing service. In order to deal
effectively with performance issues, the healthcare staffing services firm must
have ongoing and open communication with the organizations that they contract
with, especially when dealing with a report of “Do Not Return.”
In a study of agency nursing in acute care settings, health care staffing services
indicated that they valued constructive and open communication with hospitals
with the ultimate aim of insuring quality practice. The importance of hospitals
acknowledging their responsibilities in the whole process was highlighted.
Targeting problems so they are addressed and corrected when valid, could
significantly enhance the working relationships between organizations and
improve quality of care.
2004 Market Analysis and Executive Summary: Temporary Healthcare Staffing, Nov. 2004 - White Paper. Staff Care, Inc., November 30, 2004.
Shoemaker P, Schuhmann TM. Trends in hospitals’ use of contract labor. Healthcare Financial Management. April 2007.
American Staffing Association. Annual Economic Analysis. Alexandria, VA: Author. 2007.
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