Healthcare, like any other industry, is awash with terms, acronyms, and jargon. There are a lot of words that, for most of us, mean the same thing. For those individuals with a specialty relative to a particular term however there can be worlds of difference in the subtleties. Take the terms EMR and EHR, for instance. For most people, the terms are synonymous. For others there is a difference that goes from records of immunizations and procedures, etc., (EMR) to a comprehensive understanding and management of wellness (EHR).
The same can be said of the terms "workforce management" and "scheduling and staffing." To many these mean the same thing, more or less. To others, such as myself, scheduling and staffing is a component of workforce management, which is an end-to-end methodology rooted in science, best practices, and technology that is deployed across the enterprise and manifests in a proactive, repeatable, and sustainable process.
There are a number of elements necessary for an enterprise workforce management plan to take shape, but the cornerstones of an effective and efficient approach are:
- Standardizing Policies/Practices
- Forecasting Patient Demand
- Properly Sizing and Aligning Resources
- Centralizing Resource Management
Touching briefly on each will illustrate their importance both singularly and as a series of components that build upon one another.
Standardizing Policies/Practices
Misalignment of policies across a system and the variances between policies and practices create inefficiencies that are as damaging to the bottom line as they are to quality, continuity of care, and staff morale. Standardization of policies and practices creates a framework for predictable results. One example of standardization within a hospital is the establishment and execution of a cancelation order. A clear and defined order in which staff should be cancelled when need is less than the amount of staff scheduled will ensure the treatment of staff is fair and cost effective. For instance, more expensive staffing sources and/or staff without FTE commitments would be cancelled before a core staff member not in overtime. While this seems logical and obvious, variances often happen unit to unit and shift to shift. While these variances can seem insignificant at the time, when aggregated at the system level they result in considerable unnecessary expense to the organization and frustration for staff.
Forecasting Patient Demand
What will demand/volume be on any given department 120 to 90 days from now? Having a forecast of the need for staff at the time schedules are being built, i.e., scheduling to demand, will result in more accurate staffing plans. Once core staff are scheduled to demand, and at their FTE commitments, an updated forecast, 30 days out from the shift, can highlight remaining holes in the schedule which can be filled through the use of contingency staffing sources and open shift management protocols. This proactive, data-driven approach greatly reduces costs associated with overtime and staffing premiums as well as the time managers spend trying to fill holes in the schedule 48 to 24 hours before the shift.
Properly Sizing and Aligning Resources
Key to efficient, sustainable workforce management is determining the right size of core staff and the subsequent layering and sizing of contingency needed to respond to volume. Looking first at core staff, the point is to hire at a level that keeps them working to their FTE commitment with minimal need to float or have shifts cancelled. As mentioned above, core staff should be scheduled against forecasted patient flow, not level pattern. A contingency staff program is designed to provide ultimate flexibility and nimble expansion and contraction capacity. Hiring targets for contingency staff are based on demand elements and trended gaps as well as the need for expansion in times of need. The right layering of contingency staff varies by organization, and can include numerous layers of resources consisting of PRN and FTE'd staff, some of whom will be capable of working on multiple units and even different facilities to meet emerging demand.
Centralizing Resource Management
Core to the concept of enterprise labor management, a centralized resource management center (RMC) can be beneficial to virtually all organizations and is especially powerful at large, single-site hospitals and multiple-site systems, including those with extensive clinic and/or outpatient operations. In these types of organizations, the establishment of a RMC is one of the most effective ways of controlling costs through economies of scale and the consistent application of policies. With advanced workforce management tools at their fingertips an RMC can provide in-depth schedule analysis and reporting functions and manage the strategic deployment of resources against real-time demand across the system.
Worlds of Difference in the Subtleties
Scheduling and staffing is the part of workforce management that consists of developing schedules and the day-of activities of placing staff across a provider organization. Workforce management is the overall approach and all the intricacies inherent in managing the delivery of services and care proactively, in the moment, and then improving over time through the analysis of KPIs.
Terms are thrown around casually in every industry, and there is nothing wrong with that, but it's important to remember that there are often deep oceans teaming with nuance below the surface of every term.
Chris Fox is President at Avantas, a leading provider of strategic labor management technology, services, and strategies for the healthcare industry. He is an industry veteran and proven leader who has played a critical role in the company's rapid rise to leadership in healthcare enterprise labor management. Contact him at chris.fox@avantas.com