Staffing and Scheduling
Foundations for advanced labor management.
By Chris Fox, October 2013
“Technology is not a panacea.” We have all heard this expression, and it’s probably safe to say that most of us can see the logic in it. At the same time, in my experience, it’s also safe to say that while we have all heard it ad nauseam, it is hard to know how to put it into practice.
A variation of this idiom is “technology is a tool, not a solution.” Again, it sounds good – we can all buy into it – but what does it really mean? If technology is not a solution, then what is it? What is the solution?
The answer is not always the easiest thing to swallow. The truth is that the solution is education, change management, a cultural shift, process redesign, discipline and a lot of hard work – then technology.
This is hard to accept when you know you have a problem that needs fixing, you’ve spent the money on new technology to fix it and all you want to do is move on to the next issue. And it is more difficult when you realize that this (generally) means waiting to implement the technology until the foundation has been established. But the truth of the matter is that laying the foundation is the bulk of the solution, as well as the bulk of the work.
The answer to this depends on what you are solving for but, ultimately, it comes together in the shape of a “plan.” With labor management, the plan consists of an efficient, sustainable process that gets the right person to the right place at the right time, and at the right cost.
With this understanding, when you know what you are trying to fix, you can work backwards from there to develop your plan. First, who is the right person? In patient care, the right person a majority of the time is a core staff member. Core staff has an FTE (commitment to work a number of hours) and are paid benefits based on that commitment. A core staff member working at their FTE is in the best position to take care of a patient on their unit. Knowing this, you can dive into data to determine how many care staff you need on a unit-by-unit basis.
This process goes on to look at layering in other sources of staffing, but the point being illustrated is a simple one. The foundation of a solution lies in an organization’s plan – the people, the data, and the policies and processes it operates under.
Polices and processes, in order to create an efficient framework, must be:
- Tailored to the specific goals and culture of the organization;
- Standardized across the system; and
- Understood, accepted and followed – always and by everyone.
Very often when we engage with a new client, they express their belief that, within their organization, there is very little variance between how their policies are interpreted and how they are put into practice. What they often discover through our analysis is that the opposite is true: The variances here and there add up to a staggering number (and cost) when aggregated at the system level.
If a vendor implements a solution before the work of policy and process alignment is complete, what the software solution ends up doing is automating and exacerbating inefficiencies that exist within the current state. This will result in a tool that is not capable of producing the benefits that were promised. When this happens, the tool struggles with user adoption, the spirit of the project is lost and individuals slip back into doing things the way they have always done them. This leaves you with an expensive, unused tool – and employees who will be more resistant the next time they are asked to adopt a new solution.
It is difficult to have to wait to implement a technology that you think will solve the problem by itself. But it is even more difficult to get the resources, rebuild the excitement and go to the work of redesigning and reimplementing a technology because it failed.
While the work and analysis needed to right size staffing sources and align policies and procedures may not sound exciting, developing a roadmap to achieve your organization’s goals is about as thrilling and important as it gets. Seeing the path to achieving your desired future state as a series of steps is much more achievable and practical than thinking a technology implementation is going to get you there in one big leap.
Nothing in healthcare is simple. There are always a thousand moving parts. Part of the due diligence in a technology implementation is building the base on which you layer the technology. When the foundation involves changing the habits of people – getting them to understand and adopt new ways of doing things – having a solid plan is crucial.
About the author
Chris Fox is CEO of Avantas.
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Tags: Staffing and Scheduling