Guest post by Jenny Korth, CMPE, director of Project Management and Support, Avantas.
As more patients are entering the healthcare system and organizations will need to be equipped with the right processes to ensure that care is delivered by the right person at the right time to prepare for this patient influx. Effective resource management in healthcare is trickier than in a lot of 24/7/365 industries. What makes it so is that there is not one specific blueprint to managing each hospital, or even each unit within a hospital.
Fluctuating volumes in addition to geographic location, patient and staff demographics, and differences in culture, both of the area and in the organization all play factors in making resource management in healthcare far from cut and dry. This being said, there are strategies that can be universally applied to all types of healthcare organizations (single-site hospitals, academic medical centers, multi-hospital metropolitan systems, large regional systems, and systems with extensive clinics operations) to ensure they have the staff they need to care for their patients, and are able to do so in a cost effective manner.
Key to the strategies I’ll outline below is the customization needed to meet an organization’s specific needs.
Proper Staff Size
This is the basic idea of having the right number, types and layers of staff to meet patient demand. It starts with a right-sized core staff. The “right size” will vary from unit to unit, but essentially it is the number that keeps staff working to their FTE without the need for excessive overtime, floating, or cancellations.
Relative to types and layers of staff, this is where contingency staffing sources (e.g., float pools) come into play. Depending on the size of the organization it could have as many as seven different types of contingency layering to fill in when staff are not available to take an assignment or when volume spikes. These layers can include an enterprise float pool, site-based scheduled float pool, site-based PRN pool, unit-based PRN Pool, core staff in extra shifts and overtime (although this should be used sparingly), agency, and travelers. While agency and travel staff can sometimes have a negative connotation, the fact is that by maintaining relationships with the highest quality staffing organizations in your city, you will experience reduced costs, improved coordination of resources, and, with the proper contractual stipulations, prevention of agency recruitment of your core staff members.
How then does an organization determine the numbers, types and layers of staff it needs? The answer lies in data. Key optimization statistics like workload, FMLA, “FTE leakage,” incidental worked time, as well as demographic and generational trends must be analyzed in order to set these numbers.
It’s essential to harness BI tools day-to-day at the frontlines of care to be able to spot and correct emerging negative trends, like an uptick in overtime. Unit managers need the tools and training to be able to leverage the data that is around them, but has traditionally been held by finance groups. Organizations that effectively use data to improve patient care are those organizations that have a high degree of cross-departmental camaraderie.
In addition to the day-to-day examining of analytics, those at the executive level need to be provided with snapshots into some of the most important metrics relative to goals. For instance, if an organization has a goal of decreasing incidental worked time (time on the clock before or after a shift or during a scheduled break) leadership must be periodically updated so they can adjust their level of attention and interaction with the issue.
Centralizing Resource Management
One of the most effective ways of controlling costs, coordinating care, and ensuring consistent practices across a health system is through the implementation of a centralized Resource Management Center (RMC).
One challenge many healthcare organizations struggle with is a silo approach to labor management. This typically involves a director or manager controlling the unit’s scheduling, deployment and administrative duties. At first glance, allowing managers to administer those functions may seem like a good idea because they are familiar with the work performed and the skills of staff members on each shift. However, in the end, managers find themselves spending too much time planning and handling the day-of-shift chaos that results from last-minute call-ins, scheduling errors, etc.
The purpose of a resource management center (RMC) is to serve as a communication hub, collaborating with clinical leaders to manage employee throughput against patient throughput. Essentially, the RMC takes on the administrative support tasks, freeing managers to focus on patient care and staff mentoring.
The RMC is an integral part of an enterprise approach to managing labor. This strategy allows for in-depth schedule analysis and reporting functions while coordinating and carrying out a system’s workforce management, deployment and alignment strategies. With the right scheduling tool, a RMC has incredible transparency across the organization, visualizing supply and demand and consulting house supervisors and other leadership on potential real-time adjustments to deploy staff across the system to meet demand as it unfolds, all while following protocols that keep costs in line.
Touching briefly on the topic of “the right scheduling tool,” it’s important to remember that with whatever scheduling tool an organization utilizes it is critical that there be ongoing efforts to achieve high-engagement and adoption with end-users. While some software solutions are better than others, none are effective if they are not utilized. This is the role the system administrator(s) plays within the organization. The system administrator should be the key driver of recommendations, configuration changes, and strategy implementation needed to achieve organizational goals. This requires the individual or individuals in that role to have a good working relationship with the software vendor. This also means that the vendor must be committed to the long-term success of the tool within the organization, not just having a successful implementation.
Establishing a Center of Excellence
These things taken together – leveraging BI, right-sizing staffing sources, float pool development, agency management, centralizing resource management and effective system administration – can enable an organization to establish a true, single site, center of excellence that facilitates the strategic deployment of resources and provides oversight to effectively manage the workforce plan, resulting in standardization of policy and practice, facilitation of fair and just scheduling practices, optimization of core and contingency resources, elimination of costly redundant infrastructure and improved outcomes.
Not lost in all these strategies and concepts is the fact that the culture of the organization is perhaps the biggest single ingredient to bringing about this huge, but incredibly positive shift. Many of the principles I discussed here involve empowering staff, improving work-life balance, and reducing the in-the-moment chaos that too often happens in the hours and minutes leading up to a shift. These are all things that staff will be able to get behind if the communication strategy leading up to the roll out of these strategies is effective, and then ongoing, and there is an understanding that this sort of improvement is a process. It takes time, but it’s time well spent with many victories to look forward to along the way.