You can feel it in the air – a crisp cool breeze rustling through burnt-orange leaves and the warm smell of pumpkin spice everything. Fall is near and it is a welcomed season for many.
It’s particularly received with open arms by Husker Nation. With football season brings tailgating and time to spend with friends and family cheering on your favorite team. It also brings a yearly event that creates staffing chaos in hospitals and health systems across the country – flu season.
Across the continuum of care, the several month cycle of infectious disease frequently turns the most well-conceived plan into a nightmare of staffing chaos.
Despite the widely available predictions by the CDC and other organizations of when, where, and how influenza will strike, staffing problems persist. This is because even the most accurate prediction of when the flu will strike your region is of little value unless you have solved the staffing supply side of the equation.
To further illustrate this issue, let’s look at it from another angle. What event impacts staffing on the same day every year but creates staffing uncertainty? Halloween. October 31 comes around every year and yet staffing problems persist with little to no change in patient census. Halloween and other “non-holiday holidays” are notoriously difficult staffing days. Why? The supply of available staff decreases on these days (with little or no increase in patient demand), thus creating a staffing shortage.
In the Midwest, where football reigns supreme on Saturdays during the fall, the bigger games of the year have also been known to sabotage staffing plans, and different events may impact other states in similar ways.
Fall shouldn’t make even the most experienced workforce planners shudder. To wrap your head around the supply/demand equation, the first course of action is to understand and solve issues that diminish the available supply of your most valuable resource – core staff.
Core Staff Availability
Core staff is defined as full- and part-time employees who are assigned to a single department and are working within their designated FTE.
Initial improvement steps may include:
ANALYZE factors that are impacting the supply of available core staff.
INVESTIGATE further to gain a full understanding of trends especially damaging to staffing outcomes. The following are two examples of issues you may uncover:
- FTE leakage is particularly harmful. Hours dedicated within your budget for core staff FTEs but are not schedule or worked have “leaked” from your available staff resources.
- Same-day or near-time absences can derail any staffing plan. Carefully analyze past events by day of the week, shift, department, and individual to plan the depth of replacement staff that will be needed.
PLAN improvements to address each issue discovered. Set goals and timelines and report results. Once initial goals are met, take actions to hold the gain and move on to your next set of improvements.
Improving core staff availability is a great first step, but it is not the full remedy to every staffing woe. Once these improvements are underway, it’s time to consider contingency staff availability.
Contingency Staff Availability
Contingency staff is defined as all those except full- and part-time employees who are assigned to a single department and are working within their designated FTE. This would include core staff members working above their FTE, including overtime.
Initial improvement steps may include:
ANALYZE demand for contingency staff to fully understand the minimum and maximum required depth to right-size expansion and contraction capacity.
DEFINE the purpose of each segment of contingency staff, assigning highest value and depth to layers with the greatest float attitude and aptitude. Seek adaptability.
- Limit unit-based PRN to extreme cases of clinical competency such as burn unit or high risk OB.
- Dedicate the highest volume of hours to an internal float pool tiered according to the needs of the enterprise.
- Include meaningful use of external agencies who have proven ability to supplement with high-quality staff in times of high need.
- Prevent burnout by reserving core staff working above the FTE, including overtime, to times of most extreme need.
PLAN infrastructure needs, including selection and competency models, similar to other proven and successful models. Give contingency pools a distinct identity including leadership separate from core staff.
Begin to drive uncertainty out of your staffing plan by using these strategies and continue on the road to success by adapting more advanced methods. It’s a worthwhile journey out of chaos.