Standardization of staffing practices and operational policies are not exactly edge-of-your-seat topics. But don’t underestimate their importance in achieving organizational goals, and improving employee morale and patient satisfaction.
When doing an assessment of a hospital or health system’s staffing policies and practices it’s not uncommon to find some managers who feel those guidelines are not easily accessible or understood and followed by staff. Managers report feeling frustrated with the lack of consistent policy enforcement.
Policies such as utilization of contingency staff, floating and cancellation order, and weekend and holiday commitments should be clearly defined and easily accessible by staff. Further, managers should be consistent with their application.
For units and facilities to share resources seamlessly and efficiently, staffing and scheduling practices should be aligned. When aggregated at the system level, variances between units and shifts – even if they seem insignificant at the time – result in unnecessary expense, inefficiencies, and frustration for staff.
For provider organizations with multiple facilities in the same metro area, policy consistency nurtures an enterprise mentality that allows for resources to be shared among units and locations.
CHI Health has embraced an enterprise staffing mentality and continues to strategize about how to best optimize their workforce. Headquartered in Omaha, Nebraska, CHI Health has 14 hospitals serving Nebraska and southwest Iowa. With several facilities within the same metro area, adopting an enterprise mentality has allowed CHI Health to efficiently share resources between campuses.
To further expand their enterprise mentality and support of sharing resources, CHI Health made the decision to standardize shift start times for nursing inpatient units across the system. In addition, nearly all campuses have transitioned to a four-week schedule. These changes have been instrumental in expanding their enterprise float resources.
CHI Health rolled out the change in three waves across the system. Spread over several months in the latter half of 2017, multiple campuses transitioned to their new start time on a set date in each wave. Instances of incidental worked time (IWT) were expected to decrease once start times were standardized across the system and help contribute to building their base of enterprise resources.
Incidental worked time is the amount of time staff members spend on the clock before or after a scheduled shift. While there is clinical justification for many of these occurrences, nearly 60 percent are deemed unnecessary and preventable. While extra time on the clock may seem harmless, it can cost an organization tens and even hundreds of thousands of dollars annually when aggregated at a facility level.
Since the new standardized start times were implemented, several CHI Health campuses have seen a reduction in IWT. These facilities have adhered to the operational policy change and have managers who are holding staff accountable to the new shift times. This strengthens organizational alignment and reaffirms that all employees must be bought into an organization’s initiatives to see successful outcomes.
Altering start times across the system is a significant change effort and must be preceded with clear communication to all staff members. Staff who have a clear understanding of how standardized staffing and scheduling policies benefit the entire organization are valuable stewards for upholding policies. Having employees who are bought into the organization’s vision are instrumental in helping drive the company toward its goals. An entire organization that has a clear vision of goals, shared responsibility, and personal accountability to achieve results is core to leading any significant initiative to a successful outcome.
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