Avantas was excited to host individuals from six of our clients for a Concentrated Consulting session focused on float pools and centralized resource management. Engagement was high and the room was buzzing with inquisitive questions as teams participated in a dynamic dialogue and learning session over the span of three days. Here are a few key takeaways from our dynamic session:
Core vs. Contingency
“We’re backwards. We see our core like contingency and our contingency like core. We schedule PRN first. We’re all backwards. It will be a total restructure of our thinking.”
When scheduling your staff, it is critical to remember the difference between core and contingency staff. Core staff are those FTE’d folks who are hired to a specific unit – they’re your starting players. Contingency are the flexible resources that are used to fill any remaining gaps in staffing – PRN, site-based, and enterprise float resources.
When building your schedule, core staff should always be scheduled first, ensuring they are meeting their FTE and weekend/holiday commitments. Contingency, such as float resources (even if they carry a FTE) or PRN, are then scheduled to fill the holes. Additionally, they should be deployed to the areas of greatest need based on their competencies. Contingency resources should not dictate which units they will work on. The purpose of contingency is to fill in where they are needed the most.
Practices such as treating contingency as core and vice versa are a sure way to frustrate core staff and risk losing them.
“Every department has their own policy for filling shifts. Then it’s halfway through the day and the RMC is notified of staffing changes or shortages. We’re handcuffing ourselves.”
Provider organizations should have clear and standardized policies that are applied consistently in all situations. Adhering to consistent staffing and scheduling policies ensures uniformity in practices and has a positive impact on employee morale and patient satisfaction.
One of the best ways to ensure staffing policies and practices are being followed is through a centralized resource management center (RMC). An RMC can ensure staffing policies are being applied at the enterprise level when collaborating with clinical decision makers on staffing decisions.
Fear of Losing Control with an RMC
“There is a fear of units losing control with an RMC. But you can see they (nurse managers) still play an integral role in making staffing decisions, based on conversations with the RMC.”
We recognize that a propensity for being in control is an understandable attribute of nurse managers, so this fear of “losing control” is equally understandable. In general, individuals in the healthcare industry tend to lean on the side of caution when it comes to new practices – wanting to stick to the familiarity of the way things have been done before, sometimes even if it is ineffective and causes frustration.
Hospital leaders continue to drive all clinical staffing decisions on their unit, but they entrust an RMC to identify staffing needs weeks to months in advance and place resources in the areas of highest demand. An RMC simply takes over the administrative duties that so often bog down a nurse manager, keeping them from more fulfilling clinical responsibilities and staff development.
The success of an RMC is built on a framework of best practices, transparency, cultural acceptance, automated scheduling processes, and continual monitoring of metrics. A properly positioned and designed RMC is the conduit for all other workforce strategies to be enacted through.
Communicating the Why Statement
“Practice has made it permanent. It has not made it perfect.”
So many provider organizations get stuck in a hamster wheel when it comes to their staffing and scheduling practices because that’s simply the way it’s always been done. Implementing significant change and seeing successful outcomes doesn’t happen overnight. It’s a process that takes open communication of why a process is changing. Changing mindsets can be hard, but it’s not impossible. Making sure the why statement is communicated to all employees is vital and can be as simple as, “I want to help you have a better day.” This will help drive individuals to stay accountable for following new processes as they see what the benefit to them is.