Healthcare’s Symphony Orchestra

Barry Chaiken
Barry Chaiken

Guest post By Barry P. Chaiken, MD, FHIMSS, chief medical information officer at Infor.

In many ways healthcare is like a symphony orchestra. Although information technology can enhance care planning, assist in medication administration and reduce duplicative testing, it cannot replace the people required to deliver care services to patients. Nurses are needed to administer medications, therapists are needed to provide treatments, and physicians are needed to diagnose illnesses and provide treatment plans. On average, hospitals devote close to 70 percent of their budget to labor costs. Until robots replace humans in the delivery of patient care, selection of the proper skill mix and number of professionals remains a significant factor that determines cost in provider organizations.

Although information technology cannot replace the staff delivering care to patients, it can assist organizations in choosing the best talent available, help develop that talent and determine the best way to utilize the skills of these professionals.

To identify the best talent, information technology tools allow the extraction of an employee’s “behavioral DNA” – the measurement of behavioral, cognitive and cultural traits. Organizations then compare this prospective employee’s “DNA” to the “DNA” of existing high performing employees within the organization in an effort to identify individuals who possess a high probability of excelling within the organization.

These tools leverage the big data research of behavioral science PHDs in human traits that include ambition, discipline, energy, acceptance of authority, attention to detail, flexibility, conscientiousness and empathy. By combining the behavioral and performance, data organizations generate a performance profile for a specific position, providing a consistent structure and a common language for evaluation. Once organizations create and validate a unique position profile, prospective hiring managers compare a candidate’s a pre-employment assessment generated “DNA” to the “DNA” of an ideal candidate for the position. Reports include recommendation levels indicative of how well the candidate’s assessment score matches established parameters related to the open position.

Each report explains why a score was earned, and creates customized guidelines for each candidate covering best-fit scores, career path planning, interview questions, onboarding, coaching and feedback, allowing hiring managers to consider any potential disconnects, and evaluate a candidate before the first interview, resulting in better employee selection. By comparing specific traits of existing employees to their job-related performance data like safety records, healthcare organizations can create a custom blueprint for each open position, and assign employees to departments where their traits are best suited.

Staffing to Patient Needs

For more than a decade, the federal government required hospitals accepting Medicare funding to have adequate numbers of licensed registered nurses, licensed practical (vocational) nurses, and other personnel to provide nursing care to all patients as needed.

In 2004, California became the first and only state to date to require, by law, minimum nurse to patient ratios that must be maintained at all times by every care unit within a hospital. Seven other states require hospitals to maintain standing staffing committees responsible for plans and staffing policy (CT, IL, NV, OH, OR, TCX, WA), while five states require some form of disclosure and/or public reporting (IL, NJ, NY, RI, VT).

Although staffing to patient census provides a blunt instrument to identifying the nursing needs of patients, it ignores the availability of valuable evidence-based guidelines that link patient care delivery requirements with a patient’s diagnosis and related acuity. In addition, patient data, newly available from the HITECH act driven implementation of electronic health records (EHRs), allows for a refined evaluation of patient care delivery needs and the staffing skills required.

Although information technology tools will never replace patient care staff, it offers a means to intelligently recruit and retain skilled caregivers and deploy them in the most efficient way possible to help patients. Unlike other industries that may cut staffing in ways that negatively impact the consumer experience, healthcare providers must consistently deliver exceptional service to patients who rely upon them for care. Utilizing newly available information technology tools offers a way to honor patient needs while effectively managing the cost of care.

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