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San Francisco General staffing shortfalls spotlighted; DPH and HR outline hiring reforms
Summary
Nurses and clinicians testified to unsafe staffing and closed beds at San Francisco General Hospital while DPH and its HR director described a 13.4% vacancy rate and an action plan to speed hiring, expand exam capacity and target a 90‑day hiring cycle.
San Francisco General Hospital staffing shortages and patient‑safety concerns dominated the Budget & Finance Committee’s hearing on May 7 as clinicians described closed beds, missed breaks and repeated reliance on registry staff while Department of Public Health leaders said the department has budgeted FTEs but fallen behind in hiring.
Sue Curran, CEO at San Francisco General, said the hospital has a 13.4 percent vacancy rate (about 90 full‑time equivalent RNs) and that the hospital is using registry and part‑time staff to cover shifts. "Currently, right now, we have a 13.4% vacancy rate," Curran said, adding the hospital has budgeted for positions but struggled with recruitment and onboarding delays.
Ron Weigelt, DPH’s human resources director, described systemic delays in the civil‑service hiring pipeline that created a backlog of classification exams and referrals. He said DPH has increased its exam team from one person to a planned six, is partnering with the city’s Department of Human Resources on a lean continuous‑improvement effort focused first on RN hiring, and aims to shorten the time‑to‑hire to about 90 days.
Weigelt said the backlog included classifications where exams were delayed by grievances and resource constraints, and presented concrete steps: more exam sessions, two operations managers to track vacancies and metrics for hiring performance. The department also proposed adding about 97 FTEs tied to the opening of the new San Francisco General building, phased through FY2015–16, at an estimated cost in the budget submission.
Nurses and other hospital staff gave extended testimony about day‑to‑day impacts on patient care. Emergency Department nurse Heather Bollinger said staffing shortfalls had persisted for years and that the ED had been operating with many beds closed on a near‑daily basis; "Our trauma center serves over a million people," she said, and staff have documented "shift after shift the staffing numbers that have been unsafe, placing the patients and the staff at risk." Several witnesses described delayed transports, patients waiting in the ED for many hours for inpatient beds and breaches of contractual staffing ratios.
DPH and hospital leaders acknowledged the operational pressures and said hiring and process reforms are the immediate priorities; the department also noted a shift in financing due to Affordable Care Act changes and a state realignment "clawback" that the department is budgeting to replace with earned patient revenue.
Supervisors agreed to continue Item 3 (staffing/patient safety) to the call of the chair for a status update and filed Item 2 (the budget hearing) during the meeting. The committee said it will monitor hiring metrics and HR progress as the city prepares for the new hospital opening expected in late 2015.
