Domain #2: Scheduling
Having enough of the right kind of staff working to meet volumes is critical to fostering labor efficiently. Far too often, hospitals are "surprised" by variations in volumes and acuity. Being able to accurately predict volume variability and ensuring that rosters reflect the appropriate levels of full-time and flexible staff are key to reducing labor expense (labor waste).
Another factor consistently discovered to "require" expensive staffing alternatives is an organizations inability to accurately "gross up" staff rosters to accommodate all the areas of non-productive load that burden healthcare. Healthcare is unique: it is the only industry where highly clinically-educated-staff have direct personal access to physicians. The net result of this is higher than standard utilization of leaves, PTO, sick time and the education/orientation requirements of regulatory bodies. A failure to recognize ALL the causes of non-productive time can result in managers being "forced" to use overtime, agency and other "cost-plus" staffing to fill anticipatable gaps.
This section allows an organization to assess the level of performance is has achieved in understanding and overcoming the variables that impact "effective staff scheduling".
Components of the Scheduling Self Assessment are listed below.
Staff schedules modeled against historical volumes
Each department has modeled a minimum of two years of historical volumes.
Staff schedules modeled against non-productive load
Each department has modeled its annual non-productive load including: PTO, vacations, education time, orientation time, sick time & leaves (both long term and intermittent).
New grids developed
Staffing grids have been developed that reflect historical volumes and are "grossed up" for non-productive load.
Variances by shift & day of the week identified
Historical modeling includes calculating variances by shift and day of the week for each month of the year (so you know what an evening shift in January looks like up to 12 months in advance).
Roster gaps identified
Modeled volumes are compared to current staff roster to identify over or under staffing.
FT/PT roster gaps provided to recruiting
Identified gaps in staffing (both FT and PT) have been provided to the recruiting team.
Reporting & Performance
Reduced number of "surprises" in volume variability
Modeling of historical volumes has resulted in measurably clearer anticipation of changes in volume.
Reduced occurrences of "calling & canceling" staff
Better anticipation of volume variances has resulted in measurably fewer incidents of last minute "calling" and "canceling" of staff.
Improved match between volume variability and roster makeup
Modeling of historical volumes and inter-day volume variability has allowed the organization to gain a clearer understanding of the level of part-time & flexible workforce each department needs.
Labor Competency Domains
- #1) Staffing / Recruiting
- #2) Scheduling
- #3) Avoidable Days
- #4) Productivity
- #5) Process
- #6) Policy & Governance