For more than ten years we have been promoting centralized resource management as one of the keys to optimizing labor for hospitals and health systems. But, setting up a Resource Management Center (RMC) does not ensure success and it does not automatically result in savings or improved placement of resources.
The RMC, if developed to its full potential, allows for in-depth schedule analysis and reporting functions while coordinating and carrying out a system’s workforce management, deployment, and alignment strategies – not to mention freeing managers from the majority of administrative tasks that keep them from actually managing their units. All of this results in:
Improved coordination of resources
Proactive identification of needs
Reduced labor costs
Economies of scale
So, what if you have centralized your resource management and are not seeing the results you expected? It could be a number of things. Below I’ll run through a couple of the possible issues and provide some solutions.
Issue: Multiple / frequent critical staffing shortages.
Indicator: Frequent staff shortages.
Possible Causes: Scheduling is inadequate, indicated by high FTE leakage (staff not working up to their FTE) and poor balance of shifts to patient need; Proactive scheduling review was not completed or was ineffective; Significant patient census spikes; High number of staff call in absent; Unit manager granted time off to staff that were needed for patient care.
Solution: The Resource Management Center can impact the quality of schedules through monitoring the schedule submission window and consulting with schedulers before schedule finalization. It is important to implement a review process of future schedules with adequate time to warn leadership and attempt to correct any potential shortages. Improvements of 40-60% in FTE leakage have been seen by consulting with schedulers to improve balance, properly code shifts, and identify challenging shifts well in advance. A consistently applied incentive program can also assist with meeting staffing needs.
Issue: Excessive recruiting calls (staff burnout, nonresponsive).
Indicator: Low shift pickup results.
Possible Causes: Proactive scheduling review was not completed or was ineffective; Low user adoption of open shift functionality (if applicable).
Solution: Related to the first issue, very often excessive recruitment calls are the result of imbalanced schedules, schedules that do not reflect demand, and staff not being scheduled to their FTE. Implementing the solutions above can alleviate the frequency of recruitment calls and thereby increase the effectiveness of future recruitment calls. If the need for excessive recruitment calls stems from a lack of use of your open shift management tools there are undoubtedly awareness issues. Often when we engage with a new client and perform reviews of policies and procedures we routinely find a lack of awareness of staff of open shift protocols. In order to be effective, open shift tools must be understood, available, proactive, and be in line with staff motivations. Avantas has conducted research into what motivates staff to pick up open shifts. That research is available here, “Open Shift Management: Understanding Staff Motivations is Key to Filling Shifts.”
Issue: Significant variance in deployment to demand (some unit schedules are balanced while others are short).
Indicator: Extreme balance swings within a facility.
Possible Causes: Inadequate contingency staff to meet demand or lack of alternate unit orientation to facilitate core floating.
Solution: The most common problem associated with these symptoms is an inadequate skill mix or insufficient contingency resources. In previous articles we have discussed having the proper mix of core and contingency staff sources. This is key, as is the facilitation of multiple-unit orientation for core staff, allowing them to effectively float from unit to unit in the event of significant shortages. While floating can be a staff dissatisfier, this can be greatly diminished with the right on-boarding program and cultural commitments. A recent article in HealthLeaders profiles the efforts CHI Health Mercy Council Bluffs (formerly Alegent Creighton Health) undertook to decrease the stigma of floating and touches on a number of other initiatives that have resulted in increased staff satisfaction and savings.
Centralizing resource management is an advanced labor management strategy. Success relies on a solid foundation of best practices and the right technology tools. It is not a “plug and play” initiative; it requires continual attention to refine processes to ensure it is providing all the benefits it can.
Feel free to email me at firstname.lastname@example.org to learn more.