Managing a workforce to peak efficiency

Balancing the myriad concerns of a hospital's workforce is no easy task. Challenges aside, however, it's a balance worth achieving not only for quality patient care and staff happiness, but because a well-managed workforce is critical to survival in a time of rapid change in U.S. healthcare.
Healthcare executives, HR directors and department managers must ask and answer many essential questions: How many people do we need, and in what capacity? When and where do we need them? Are they maximizing their skills and experience? Do they feel fulfilled in their work?
To position your organization properly to answer such questions, experts recommend beginning with these four steps:
• Gather accurate data
• Recognize personal benefits
• Reconsider your staffing model
• Achieve staff buy-in to changes

COLLECTING DATA
In 2009, Stamford Hospital got serious about tightening labor costs. The 305-bed community hospital in southwestern Connecticut, with a 2,700-person staff, turned to OptiLink, a management and acuity solution from Kronos, to collect and better comprehend employee expenditure data and to guide adjustments.
The result was a dramatic drop in hours and labor costs, as well as a reduction in volume-adjusted full-time employees from negative 29 to less than negative one. In the first quarter alone, the hospital saw labor savings of $487,617.
"You have to be as efficient as you can," said Harold Jacobson, Stamford's business operations manager for client services. "In staffing you have to match patient-care needs with very closely monitored staffing levels. You need the right tools to be able to do that."
Jacobson cited three advantages to using a data-driven tool like OptiLink:
• Utilization of patient data for more appropriate staffing;
• Increased staffing oversight and accountability;
• Use of real-time data to improve staffing decisions.

IN PERSONAL TERMS
Staff scheduling efficiency need not be at the expense of employee satisfaction, said Scott Wooten, senior vice president and CFO of Alegent Creighton Health, a system of 11 acute care hospitals based in Omaha, Neb. Alegent Creighton has more than 100 sites of service, with over 1,300 physicians and roughly 9,000 employees.
Wooten credits the Avantas Smart Square solution for helping to best optimize the scheduling of Alegent personnel, which has led to the system's nationally recognized levels of worker satisfaction.
"The tool set saved us millions of dollars early on," Wooten said. "And it allows us to continue to manage effectively our most important resource, our human resource."
With scheduling more effectively managed, Wooten said, employees "feel they have more purpose, which is caring for people. When you have engaged employees, they're going to be happier, and you're going to have better outcomes, and happier patients."

STAFFING MIX
A quest for heightened efficiency doesn't end with simply having the right people on the floor. It extends to how hospitals adapt to shifting staffing needs. A growing number of facilities are embracing the idea of "flexible staffing," or employing health professionals who are vetted and hired by an agency and deployed to a facility.
"(Hospital clients) are more willing to outsource their staffing needs than they were five to ten years ago," said Susan Salka, president of AMN Healthcare Services, a San Diego-based hiring agency with national reach. "They're eager to find the right mix of core staff and flexible staff. They're realizing the use of temporary staff often upgrades the overall clinical competency of the staff."
Areas where flexible staffing can help include:
Finding the right mix of clinicians. Every clinician needs to work to the maximum potential of their education and experience. In the process, responsibilities are being pushed down from physicians to physician assistants, and from PAs to nurse practitioners, and so on.
Overcoming shortages. Attrition is starting to resurface as the economy recovers, Salka said. Firms such as AMN "can bring supply into a market. Otherwise, local hospitals are recruiting from each other, and that's a zero-sum game."
Providing strategic support. More hospitals consider firms like AMN to be strategic partners, helping administrators set baselines for labor costs and set targets aided by the permanent/flexible staffing mix, and helping make decisions to hit those targets.

EMBRACING CHANGE
In the push to tighten budgets and improve efficiency at healthcare organizations, it's crucial to communicate to staff the reasons for changes, explaining clearly how they will improve the financial health of the organization.
"It's all about engagement," said Stephanie Drake, executive director of the American Society for Healthcare Human Resources Administration, which has more than 3,400 members and 44 chapters throughout the United States. "With all the changes hospitals and healthcare are facing, it can be daunting to the average employee. So it's imperative to keep them engaged and understanding why we're all here: We're here to deliver quality care."
Drake suggests organizations be as transparent as possible about the reasons behind a change in technology, or why fulltime staff is being replaced by flexible staffing.
"Use any and all methods," she said. "Town halls, not just from HR, but also from unit leadership, the board, and the C-suite. Be consistent with your message and communicate frequently."