Policy and Implementation Package

The implementation package is the main tool for health employers to make ratios a reality across settings, once definitions are landed and defined. The implementation package includes:

1. Ministry of Health Policy Directive
2. mNPR Implementation Instruction Manual
3. mNPR Implementation Planning Template
4. Joint Regional Implementation Committee Terms of Reference 

Five Things You Need to Know About:

The Ministry of Health Policy Direction

1. The policy directive was developed jointly by the BCNU, the NBA, the HEABC and the Provincial Government.
2. It formalizes the agreement outlined in the April 2023 memorandum of understanding between BCNU and the Province of BC.
3. It focuses on implementing and evaluating minimum nurse-to-patient ratios to improve care (drawing on evidence from other jurisdictions where similar ratios have led to improved patient outcomes and nurse job satisfaction).
4. It contains measures to improve supervision by promoting safer and more effective nursing practices. This includes expanding the role of charge nurses to ensure better oversight and support for nursing staff.
5. The policy outlines the necessary actions, expected benefits, and goals for rolling out minimum nurse-to-patient ratios and provides a clear roadmap for improving care quality and nursing practice.

Link to the Policy Directive (PDF, 262.5KB).

The mNPR Implementation Instruction Manual

1. This manual is directly linked to the policy directive and serves as a crucial tool for its successful implementation.
2. It provides a step-by-step guide to health employers for rolling out the policy, including detailed instructions on planning, evaluation, and communication, ensuring that all aspects of the implementation are covered.
3. It covers how to manage labour relations and financial considerations during implementation, including strategies for addressing staffing gaps and operational risks.
4. The manual explains how to submit the implementation plan, detailing the specific requirements and processes for gaining Ministry of Health approval.
5. It connects minimum nurse-to-patient ratios implementation to broader goals such as improving care quality and leadership, emphasizing the importance of aligning ratios with the overall objectives of the health-care system.

Link to the Implementation Instruction Manual (PDF, 795.4KB).

The mNPR Implementation Planning Template

1. This template is tied to both the policy directive and the instruction manual and serves as a practical tool for translating policy into actionable steps.
2. It includes details on staffing analyses, quality practice environments, and communications.
3. Health employers must submit this template to the Ministry of Health for approval and funding. The template is a required submission to ensure the plan aligns with Provincial guidelines.
4. The health employer completes this template in collaboration with their Joint Regional and Implementation Committee (JRIC) to ensure all regional and organizational considerations are accounted for.
5. It must include everything outlined in the instruction manual, as it is crucial for the template to be comprehensive and in full compliance with the manual’s guidelines.

Link to the Implementation Template (PDF, 199.4KB).

The Joint Regional Implementation Committee Terms of Reference

1. The Joint Regional Implementation Committee (JRIC) terms of reference outlines committee responsibilities and clearly defines the roles and responsibilities of each member.
2. It lists the JRIC members ensuring that all key stakeholders are involved in the decision-making process.
3. The terms of reference ensures all JRIC members have access to necessary materials and data which will help facilitate informed decision-making and effective collaboration.
4. It includes a process for solving any problems that arise, with an escalation process for unresolved issues. This will ensure that challenges are addressed promptly and effectively.
5. It allows for subject matter experts to be brought in when needed. This will provide the JRIC with additional expertise as required to support the implementation process.

Link to the Joint Regional Implementation Committee Terms of Reference (PDF, 292.4KB).