Administrative expenses are an ongoing burden for the healthcare industry. The reason, many experts note, is that too many dollars are still tied up in healthcare's largest cost center: staffing. The good news, however, is that many hospitals are learning how to maximize resource utilization and reduce expenses by eliminating manual, time-consuming workforce management processes.
For decades, workforce management was the domain of paper charts and file cabinets. Clinical managers — who ideally should devote the vast majority their time to patient care — often would spend hours performing manual administrative tasks, including staff scheduling. These paper-based activities not only hindered productivity, they also had the potential to introduce costly under-staffing or over-staffing errors that could go undetected for long periods of time.
Workforce management solutions became only slightly more efficient once hospitals began to use computer spreadsheets to track employee schedules and time-off requests. This fairly basic automation allows schedulers to view and manipulate data more easily than with paper records, yet is still labor intensive. In fact, it is estimated that manually creating a single schedule via paper or Excel spreadsheet can take anywhere from 12 to 20 hours per schedule period for a senior-level clinician in a 50-physician practice.
While many progressive hospitals have gravitated toward multiple automated administrative systems, it is important to understand that disparate scheduling, time tracking and payroll solutions often operate in their own silos. Because these systems are unable to seamlessly exchange important human resources information, staff within various hospital departments end up duplicating data entry efforts. Siloed data also makes it difficult to proactively balance workloads, monitor clinician hours and ensure that employees are paid in an accurate and timely manner.
Even with administrative systems in place, for example, most hospitals still struggle to prevent short-staffing, which can lead to additional costs for temporary personnel. Similarly, the inability to view both scheduling and time data simultaneously often creates situations in which some staff are underutilized while others are working overtime. This so-called "lopsided scheduling" again results in significant impact to the bottom line. It is essential, therefore, for hospitals to consider how integrated automation can be used to streamline workforce management, lower costs and respond quickly to changing demands.
A fresh perspective on workforce management
Hospitals looking for clinical and financial efficiencies should start the process by evaluating technologies that help build schedules faster, reduce time spent processing staffing requests and assign resources more accurately — despite the many complex requirements of the facility and/or clinical specialties. For example, schedulers can verify whether or not a physician's specialty impacts clinical availability through integrated workforce management software.
Customized for a particular hospital or practice, the technology can be used to affirm that each department, specialty or subspecialty is appropriately staffed, providing patients with the highest quality and most timely care. It also can help make certain that other critical parameters are met, ensuring that:
- All schedule preferences and vacation requests are accounted for;
- Staff members are clocking the right number of hours;
- Enough personnel are available to accommodate varied daily patient loads; and
- The right mix of staff with the right skills, training, credentials and specialties is scheduled.
Fletcher Allen Health Care in Burlington, Vt., offers one example of workforce management benefits. With an OR nursing staff of 160, schedulers at the Vermont university hospital and medical center were spending 80 hours per scheduling period manually building schedules. After deploying integrated workforce management technology, however, Fletcher Allen was able to reduce the time it takes to create a schedule to eight hours each period — effectively lowering its build-time tenfold. As a result of the increased efficiency, the organization was able to trim the number of FTEs dedicated only to scheduling from 1.5 to 0.25.
Through a series of work patterns and automations that run in the background, integrated workforce management solutions help staff verify the accuracy and fairness of each schedule that is created. Rules-based scheduling features allow hospitals to apply predetermined rules, policies and regulations to both schedules and general requests to help reduce the chance of human errors that could prove costly to the organization or detrimental to patient care.
Furthermore, online request tools that automatically verify details such as accrued vacation credits give practices the ability to steer individuals to choose vacation times that are more likely to be approved. The benefits of these features include fast turnaround on all requests, which is likely to enhance employee satisfaction while also providing administrators with timely staffing intelligence.
Workforce automation tools that integrate with other administrative systems also enable schedulers to identify disparities in real time. When configured to share information with patient scheduling systems, for example, the software can provide staff with a more accurate assessment of case loads, allowing them to better forecast demand and more accurately assign personnel resources according to specialty.
Administrators can place staff forecasted for under-time into additional cases and relieve staff who are forecasted for overtime. In the end, staff work closer to their scheduled hours, thus reducing personnel-related expenses for the hospital while ensuring that all patient needs are still met at the highest levels.
Analytics prove indispensable
Scheduling is not the only benefit of a workforce management strategy. Time-based cost accounting can assist hospital leadership with information about how effectively resources are being utilized, while cost-analysis capabilities aid in activities such as overtime forecasting. In short: analytics capabilities can provide a clearer picture of minimum staffing requirements throughout the facility.
Better workforce data and analytics provides the intelligence administrators need to identify current and future staff budgeting needs, as well as quickly pinpoint factors such as extra personnel in the schedule who are not needed on a given day. This kind of proactive information not only helps facilities avoid paying for unutilized resources, it also lets practices better align future staffing assets through additional hires, reallocations or reductions through attrition.
Perhaps most importantly, optimizing staffing resources through workforce management technology allows organizations to transition scheduling from a task performed by clinicians to one that can be efficiently handled by administrative personnel. Hospitals gain cost-saving efficiencies, and physicians gain more time to spend with their patients as a result.
Improving staff utilization, decreasing costs
Hospital executives must continually look for ways to help their organizations become more efficient. Automated, integrated workforce management technologies offer a new way to streamline human resource allocation and utilization across the entire workforce, from administration to clinical services. Efficiencies created by applying software to scheduling enhancements translates into a positive return on investment and a healthier revenue cycle.
With the right tools, hospitals can eliminate staffing imbalances — including non-worked or overtime hours — and the labor expenses associated with manual scheduling processes. In addition to assisting hospitals with achieving financial stability, these tools also ensure hospitals offer the right staffing mix to meet patients' pressing medical needs.
The upward trend in overall healthcare costs will likely continue into the near future, driven by factors such as an aging population and new medical technologies. While hospital executives cannot control these trends, they can take advantage of tools and technologies that enhance operational efficiency, lower staffing costs, improve staffing levels — and as a result, positively impact patient care.
Rich Miller is CEO of OpenTempo, a premier provider of integrated workforce management software for healthcare.