title: Identifying Strategies to Decrease Overtime, Absenteeism and Agency Use: Insights from Healthcare Leaders.
abstract: BACKGROUND
  Working overtime, absenteeism and agency use can negatively impact working environments, the health of staff and patient outcomes, and increase healthcare costs. The purpose of this study was to explore how healthcare leaders in Ontario hospitals implement and sustain best practices that advance workforce stability within their organization.
  
  
  METHODS
  Qualitative study design using semi-structured interviews and thematic analysis.
  
  
  RESULTS
  Participants included 23 healthcare leaders from 16 hospital sites. Two main themes emerged: (1) enacting proactive human resource practices and (2) having strong, caring and strategic leaders that create learning and supportive work environments. A number of sub-themes identified were reported through narratives stratified according to size (small/large) and performance (low/high) of each site.
  
  
  CONCLUSIONS
  Insights gained from this study may offer healthcare leaders strategies to maximize the nursing workforce and minimize overtime, absenteeism and agency use to ensure safe, efficient and quality healthcare.
authors.affiliation: Scientific Director, Nursing Health Services Research Unit Knowledge Translation and Exchange Program, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto St. Michael's Hospital Volunteer Association Chair in Nursing Research Scientist, Keenan Research Centre of the Li Ka Shing Knowledge Institute St. Michael's Hospital Toronto, ON.
authors.forename: Lianne
authors.initials: L
authors.lastname: Jeffs
authors.affiliation: Chief Executive Officer, Registered Nurses' Association of Ontario (RNAO) Founder, RNAO Best Practice Guidelines Program Co-Chair, Nursing Workforce Stability and Continuity of Care Working Group of the Joint Provincial Nursing Committee Toronto, ON.
authors.forename: Doris
authors.initials: D
authors.lastname: Grinspun
authors.affiliation: Co-Chair, Nursing Workforce Stability and Continuity of Care Working Group of the Joint Provincial Nursing Committee Toronto, ON.
authors.forename: Tom
authors.initials: T
authors.lastname: Closson
authors.affiliation: Lawrence S. Bloomberg Faculty of Nursing, University of Toronto Research Coordinator, St. Michael's Hospital Toronto, ON.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Mainville
mesh_terms: D000041:Absenteeism; D017048:Health Care Costs; D006801:Humans; D007588:Job Satisfaction; D007857:Leadership; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D009864:Ontario; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D012931:Social Environment; D012944:Social Support; D013192:Staff Development / Q000458:organization & administration; D016526:Workload