Staffing Excellence is and has always been hard to define. Still, we have made progress. We now know that applying the word staffing to the end-to-end cycle of labor management that is necessary within the acute care setting may encourage a far too narrow approach. It wrongly suggests efforts taken during the space in time most difficult to control – the few hours and minutes leading up to a shift start time – will result in significant improvement to staffing levels, clinical outcomes, and financial performance.
Avantas has proven that more than 98% of actions to map and execute an effective workforce plan can and should occur 48 or more hours ahead of the actual time care is delivered. The failure to conduct the strategic due diligence that is an organization’s labor management plan results in what is referred to as “staffing chaos” in the time leading up to the shift. This chaos includes last minute recruitment calls, floating or cancellations, reliance on agency staff, and pleas to staff to extend their shifts, typically with a let’s make a deal approach and a lose-lose outcome. All of these are temporary solutions that are as culturally carcinogenic as they are financially crippling.
Historical perception also works against us when we apply the term “staffing” to what is ultimately one of the most crucial clinical and operational activities within healthcare. Any who have been privileged to regularly attend Executive Leadership meetings within hospitals can attest to the wonderment that spreads across the room when a harried colleague arrives well after the session is underway with the words, “Sorry I am late; I was staffing,” falling from their lips. Hearing this, other executives wonder, “You mean you have a key operational process that requires a high-level leader’s intervention, yet you leave it to the last minute each and every day?”
The first step to ending this madness is to call it what it is. It is not staffing. It is Resource Management, Workforce Planning or – better yet – what we at Avantas call our propriety HELMTM methodology (healthcare enterprise labor management). The second step is an outcropping of the first and is best described as a cycle of iterative improvements. The good news is that when you begin this cycle and are strategically and proactively managing resources, you’ll be doing far less in the hours and minutes leading up to the shift. Your efforts will shift to doing more in the years, months and weeks before the care is delivered.
Here are three initial steps to achieve this seemingly lofty, but very attainable goal.
Standardize policies and practices across the system
An organization’s staffing polices and how they are applied can vary widely across a system, whether that is a large, multiple hospital system or a stand alone, 200-bed facility. These variances can happen unit to unit and shift to shift. They can even vary minute to minute depending on the circumstance and the individuals involved. The first step in standardization is to review what policies exist. Next, compare those policies with best practices. The critical part comes with the implementation of new policies, the elimination of unnecessary or flawed policies, and the enforcement of existing best practices.
Properly size core and contingency staff
By analyzing core staff behaviors and trends, historical census levels and predicted future census, staffing levels, payroll data, and various HR information an organization can determine how to align core staff size to the point that keeps them working without the need for excessive floating or cancellation. Then, by developing a right-sized and nimble supply of internal contingency staff, an organization can adjust to fluxes in patient demand without relying on agency and overtime.
Centralize resource management
Also, but inaccurately referred to as centralized staffing, centralizing resource management can be beneficial to virtually all organizations, however, it is especially powerful at large, single-site hospitals or regional, multiple-site systems. In these types of organizations, the establishment of a centralized resource management center is one of the most effective ways of controlling costs, coordinating care and ensuring consistent practices (leading to predictable and sustainable results) across a health system. With advanced workforce management tools at their fingertips, a resource management center can provide in-depth schedule analysis and reporting functions and manage the strategic deployment of flexible resources against real-time patient throughput across the system.
These three strategies are just the tip of the iceberg, but they are crucial if your organization is going to migrate from a “staffing culture” to one that truly manages its resources to deliver superior clinical care at the right cost.
Other strategies to consider are demand forecasting, enterprise pool development, automation with a scheduling and productivity solution, and leveraging real-time business intelligence to put actionable data in the hands of clinicians. To learn more about these strategies, visit Avantas.com.