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management methodology based on ac- curate forecasts greatly reduces the time and dollars spent in fi lling open shifts, and makes instances of last-minute chaos much less frequent. With a strategy involving predictive analytics, once initial schedules are cre- ated, any holes in the schedule (gaps between the anticipated/forecasted need and the number of staff scheduled) are automatically posted as open shifts for qualified staff members to pick up. Within some hospital organizations, these open shifts are attached to incen- tives. T e incentives are based on sever- ity of need and decrease in value as the day of the shift approaches, encouraging staff members to sign up sooner. One seven-hospital metropolitan system that utilizes this approach is able to fi ll 75 percent of open shifts at least two weeks in advance of the shift.

Technology automates best (and worst) practices

A lot of emphasis in healthcare today is put on tools: technology solutions a health system can buy and implement. However, technology without a founda- tion of sound, effi cient and accepted policies and practices will result in little good. Technology does not magically eliminate the variances between policy and practice that exist within all health systems, but it can automate an organi- zation’s business rules to create a more standardized and repeatable process. Essentially, your software is the tool that automates your plan. Good software and a bad plan only automate a bad plan.

Laying a foundation of best practices, gaining buy-in across the organization to implement the necessary changes to create consistency and then embedding those strategies into a customizable solu-

tion are the only ways of ensuring that the changes an organization makes will be permanent.

Change takes time, but the results are

worth the eff ort. T e previously men- tioned seven-hospital system undertook a massive transformation, going from a collection of individual hospitals oper- ating separately into a truly intercon- nected organization. T is change took fi ve years, but it has had tremendous, sustaining results. T e system’s progression to an en- terprise model of resource management and adoption of the forecasting and open shift-management strategies has helped staff members reduce their contingency usage from 33 percent of patient care hours to 12 percent over a fi ve-year pe- riod, resulting in a cumulative savings of $23,588,580. Staffi ng satisfaction had a remarkable improvement over this same time period, as well. Among registered nurses (RNs), satisfaction with staffi ng levels increased from the 18th percentile in 2006 to the 86th percentile in 2011.

Consolidation needs collaboration Organizations consolidate to con-

trol costs, optimize resources and take advantage of economies of scale. Ensuring that consolidation results in the savings and effi ciencies it is in- tended to provide requires a great deal of organizational communication and collaboration. No single area – HR, fi - nance, nursing or IT, for example – will be successful in the long term without the support and cooperation from the entire organization. Outcomes achieved were due as much to collaborative culture as to technologies and workforce strategies implemented. All three of these elements must work in tandem to result in sustainable improvements.


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