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Do Not Return-Professional
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 2003.4 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 2005.5
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.6 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.
According to the National Student Nurses'Association Code of Professional
Conduct, student nurses should maintain the highest standard of personal and
professional conduct. Nurses, as do other health care professionals, have strong
responsibilities to demonstrate behavior that is ethically and legally appropriate at
all times. It is the responsibility of HCSS firms to address employee events of
professional misconduct as they occur. In order to deal effectively with
professional conduct issues, the HCSS 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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