Healthcare staffing is a more complicated process than one might suspect. With workload being primarily driven by patient volume, staffing needs to ebb and flow with demand. Because labor spending accounts for over half of a provider organization’s budget, effective staffing and scheduling can have a significant impact on the company’s bottom-line.
When health systems feel like their staffing practices are not up to par – maybe some units are constantly running short-staffed while others are floating people off or cancelling resources – it may seem difficult to nail down the root of the issue. Where to start? Do you need to hire more core staff? Are you adequately staffed with contingency resources?
The resolution to staffing issues is more accessible than you might expect. Data that hospital leadership has available at their fingertips is able to provide valuable insights that highlights areas of opportunity and trackable metrics.
Analyzing payroll data and department metrics can reveal a lot about what is happening on a particular unit. One metric to focus on that often gets overlooked is “FTE leakage” – a term coined by Avantas referring to the amount of hours lost due to core staff not being scheduled to their FTE commitment.
For example, Nurse Jane carries a .9 FTE commitment, so is expected to work 72 hours in a two-week period. Jane works 36 hours in one week, then submits a request for 12 hours PTO in week two but does not work any hours. The FTE leakage cause by Jane’s failure to either work or submit benefit time is 24 hours.
FTE leakage increases a unit’s labor costs and wastes overhead benefit expenses. A staff member who is not working to their FTE commitment results in more expensive contingency resources – either core staff in extra or overtime, or agency – being utilized to cover the shift. Further, the organization continues to cover the financial weight of the employee’s full-time benefits, even though they are not receiving the employee’s committed hours.
Using contingency resources to cover the shifts caused by FTE leakage also diminishes the strategic purpose of contingency resources – to supplement for other patient assignments or demands such as staff absences, high patient census or acuity.
Focusing attention on employee FTE commitments and ensuring they are met each schedule period can help a unit more appropriately utilize their staff to meet patient demand, relieving the feeling that they are constantly running short staffed.
FTE leakage is just one cause as to why a department would feel like they do not have enough core staff. There are likely other factors impacting staffing concerns. A monthly refresh of workforce metrics through the use of an online analytics dashboard allows leadership to track improvement toward their goals. Delivering metrics and schedule outcomes on a consistent timeline tells the story of an organization’s performance and illustrates opportunities to maximize existing staff.