Four ideas to improve staff management
The chasm between fi nance and nursing can be addressed with features and functions that safeguard the quality of patient care by optimizing appropriate and effective staffi ng.
By Michael Meisel
inance and nursing have different perspectives and priorities for hospital-information technol- ogy. This is particularly evident in the evaluation of enterprise work-force-management systems
for staffi ng and scheduling. In fact, when it comes to staffi ng and scheduling, there is a chasm between fi nance and nursing. When fi nance and nursing try to get together on a work-force-management solution, why is there such a deep divide between them? Are there features and func- tions for staffi ng and scheduling, which if understood by both, might bridge the divide?
What you see, and how you see things, depends on where you stand. Finance is back in the hospital’s offi ces.
By maximizing the scheduling of its own nurses, hospitals promote continuity of care by staffi ng open shifts with the nurses who have the most knowledge of their policies, standards and procedures.
Nurses are out on the fl oors. Finance looks at numbers and is focused on the bottom line. Nurses see patients and are focused on patient care. So when staffi ng and scheduling are considered, fi - nance is primarily concerned about the data that results from the application of work-force-management systems. Finance wants accurate labor cost data from the system – and, of course, the best possible price for the system. Nurse managers and nurses use these systems and are directly affected by the application of the software day by day, shift by shift. How the data gets into a work- force-management system is not of particular concern to fi nance, as long as the data coming out is accurate for back-end analysis of labor costs.
The data results from nurses and nurse managers using the system for staffi ng and scheduling, so they do care. They demand usability, solid functionality and clinically
10 April 2010
meaningful features that support quality care. How can fi nance and nursing get together on a solution
for staffi ng and scheduling? They should look for features and functions that safeguard the quality of patient care by optimizing appropriate and effective staffi ng, improve the quality of life for nurses, and protect the hospital’s bottom line. Four examples illustrate such features and functions.
Open-shift management: Managers use open-shift management to post unfi lled shifts. Nurses sign on and access a list of open shifts specifi c to their own depart- ments and those for which they are cross-trained. They can then offer to work any open shift they choose. The software applies a hospital’s staffi ng and scheduling rules, such as preventing overtime.
Open-shift management gives nurses the opportunity to pick up additional shifts and increase their income. Filling open shifts with full-time, part-time or fl oat pool staff reduces overtime. It also decreases the need for the staffi ng offi ce to call in nurses from a staffi ng agency, every hospital’s most costly nursing option. Controlling overtime and agency staffi ng protects the hospital’s operating margin. In addition, by maximizing the scheduling of its own nurses, hospitals promote continuity of care by staffi ng open shifts with the nurses who have the most knowledge of their policies, standards and procedures. Self-scheduling: Some systems enable nurses to access units’ overall schedules so that they can request shifts and swap shifts with their colleagues. This helps them better balance the demands of work and home life, and improves job satisfaction and decreases turnover. Self-scheduling also encourages nurses to share responsibility with unit managers and their colleagues for ensuring that all shifts are covered and adequately staffed. Unit managers end up making fewer requests for nurses to stay a few more hours after completing their scheduled shifts. Such requests are a source of friction on nursing fl oors and increase costly overtime. Hospitals that use self-scheduling fi nd they can reduce overtime and the need to bring in agency nurses.
HEALTH MANAGEMENT TECHNOLOGY