Back in November, Becker’s Hospital Review published an article highlighting the “no layoff” philosophies of the CEOs of ThedaCare and Scripps Health (both are five-hospital systems).
What these two CEOs demonstrate with this philosophy, besides compassion, prudence, and long-term vision, is the understanding that labor is an asset, not an expense.
A health system’s workforce accounts for around 60% of its operating expense. In other words, 60% of a hospital’s budget is invested in the skill, passion, and tacit knowledge of its workforce. Properly leveraging this asset can reap huge rewards both in terms of quality care and the bottom line.
The first step to leveraging your organization’s caregivers is understanding where they will be most effective and determining if you have the appropriate numbers.
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White Paper: Open Shift Management: Understanding Staff Motivations is Key to Filling Shifts.
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Care staff fall into two categories: Core and Contingency. Knowing who best fits into these categories and how many individuals are needed in each is crucial to the success of the organization and the wellbeing of its patients.
Core and Contingency staff members are different
Placing a person into a role not suited for them isn’t good for the person or the organization. It creates unnecessary stress and leads to low morale, poor quality, and eventually burnout.
HR must take an active role in matching an applicant’s traits with the organization’s open positions. This is easier said than done as it must take into account actual vs. perceived motivations of staff members. In a recent study Avantas conducted we found that Individual’s perceptions of what motivates them and how those motives manifest in reality are often contradictory. (Click here to read more about this study, “Open Shift Management: Understanding Staff Motivations is Key to Filling Shifts.”)
Filling a role with a person who is not adequately suited is a short-term solution with long-term negative consequences, including the eventual cost of turnover, estimated at one to two times the salary of the position.
Core staff, in general, enjoy the predictable nature of their schedules and find comfort knowing they will work on the unit they are familiar with alongside the co-workers with whom they have a relationship.
Contingency staff typically prefers flexibility and variation, and therefore enjoy working on a variety of units. They can be motivated by a higher wage or by a schedule that works around their lives.
These descriptions are just the basic nuances and represent only the tip of the iceberg relative to what each group of staff need. Under the umbrella of “contingency staff,” the traits individuals should have and their expectations of their role will vary greatly depending on what layer they occupy. In fact, the variances in this group of staff can be so great the strategies for managing them may be drastically different from one layer to the next.
Properly layering contingency staff
To effectively meet the ebb and flow of patient demand healthcare organizations must have the right size and layering of staff. How many layers you need and the size of those layers will vary depending on your organization’s size and what its unique challenges are, but the process for determining size and layering involves analysis of core staff behaviors and trends (expected and unexpected time off, etc.), historical census levels and acuity spikes, predicted future census, staffing levels, payroll, and various HR information.
Depending on the size of the system we recommend as many as seven different layers of internal contingency, in addition to the right size of core staff.
Determining the “right size” of core staff
Despite what a number of organizations believe, there is no fixed ratio of core staff that will work best for every heath system. A fair amount of census analysis is required to discover the right size for each organization. The point is to hire the number of core staff needed to keep them working without the need for excessive floating or overtime (staff dissatisfiers that will lead to turnover).
Labor management is a long-term strategy
Properly sizing core staff and leveraging contingency staff in the most effective way possible is not an easy task, nor is it a “one and done” solution. To be effective and remain efficient these issues should be analyzed every six months.
To learn more about this process and discover how our clients have succeeded with these strategies please email me directly at jackie.larson@avantas.com.