--0000000000006dc07c064dd9951e Content-Type: multipart/alternative; boundary="0000000000006dc07b064dd9951d" --0000000000006dc07b064dd9951d Content-Type: text/plain; charset="UTF-8" Content-Transfer-Encoding: quoted-printable Hi Tim It is a few things that make these referral cluster shifts difficult to manage: 1. Staffing: We need registered staff who have their own vehicles. 2. Billing Complexity: Clusters often involve up to 10 clients, each with a specific Paris ID. VCH requires billing to be broken down by these IDs and specific hours. 3. Clinical Oversight: Each client has their own HSO. We have to review these individually to identify lifts or complex risks to prepare the caregiver. Currently, neither the Case Managers nor I have the capacity to sustain this level of review. 4. Delegation of Tasks (DOT): Many clients require medication management, colostomy bag care, or compression stockings, all of which require a DOT. VCH schedulers aren't authorized to send these; they must come from a supervisor in a different unit. If I don't catch the requirement in the HSO and wait for the DOT, the caregiver cannot perform the tasks. It is a very inefficient system for last-minute staffing. 5. Logistics: We often don't receive entry notes for buildings. This results in caregivers calling on-call managers who then have to hunt through files. I am currently trying to create a daily synopsis for each cluster so caregivers have visibility on timing, DOTs, and noteworthy details at a glance. I could hire an administrative person specifically for this workload, but I am concerned about the volume drying up. There are still many unknowns. While I'm not sure if VCH will discuss clusters separately, it may be a conversation worth having if they remain short-staffed and need our assistance. Best regards, Sharon Sharon, Speirs General Manager Vancouver, BC Office: 778.279.3634 sspeirs@thekey.com TheKey.ca [image: TheKey] On Wed, Mar 25, 2026 at 6:40=E2=80=AFAM Timothy Thomas wrot= e: > So apart from the scheduling system what are the constraints? Is it staff > availability? Timing? > > I will work on a scheduling solution for you. > > Are we allowed to sub contract in our agreement? > > On Wed, Mar 25, 2026 at 9:20=E2=80=AFAM Sharon Speirs wrote: > >> Morning! Hope all went well last night and it was a rockstar event! >> Wanted you aware as I had to turn down this opportunity as it was 8 >> cluster shifts all for today but came in last evening / I took one as I = was >> working on Squamish so worked on it but refused the rest . >> I literally don=E2=80=99t know how to make these work last minute as the= y are >> really complex. I don=E2=80=99t have the bandwidth nor the scheduling pl= atform for >> this and it=E2=80=99s getting too much. >> It was 8 clusters all of them at least 5- 7 clients so I turned down ove= r >> 40 hours of revenue . Literally makes me sick to my stomach. >> I looped in Jay and Sheila for transparency . The hours went to another >> agency