Management Matters

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In today’s complex healthcare environment, including one of the largest nurse shortages in history, labor often presents the greatest challenges. An aging population, coupled with higher overall usage of healthcare services, will continue to escalate the need for qualified medical professionals.

According to the U.S. Bureau of Labor Statistics, the demand for registered nurses is expected to expand 14 to 16 percent between 2015 and 2021. Yet about 55 percent of today’s nursing workforce is 50 or older and approaching retirement age. While there are 2.7 million RNs working in the United States, another 500,000 unfilled nursing positions are being advertised at any given time—making nursing one of the hardest to fill and most frequently posted job openings in the nation.

“Labor is often the single largest expense for healthcare organizations,” says Tony Pentangelo, executive vice president of managed clinical services, HealthTrust Workforce Solutions. Hospital operators are already stretched thin with responsibilities to enhance patient care, boost workforce satisfaction and lower overall costs. Add to that list: grappling with the nursing shortage and limited visibility into scheduling, as well as staffing and productivity levels, and managing contingent labor overall.

Combating Workforce Challenges

Healthcare leaders need proven strategies to help them manage and overcome their workforce-related challenges. The HealthTrust Workforce Solutions team offers a data-rich approach to improving employee and patient satisfaction, and workforce efficiencies, including:

inSight Advisory Services.

Management and nursing professionals serving with Workforce Solutions’ inSight Advisory Services team are knowledgeable about staffing ratios and how to best utilize staff based on the level of care a unit requires.

“Our professionals consult with hospital leaders about their patient volume, scheduling processes and overall workforce planning,” says Rich Lopez, vice president and business unit leader, inSight Advisory Services, HealthTrust Workforce Solutions.

The team starts by analyzing a hospital’s current scheduling practices, staffing levels and labor productivity metrics. “We measure that information against departmental benchmarking data from high-performing hospitals around the country of all types and sizes,” Lopez explains.

After analyzing the data, the inSight Advisory Services team makes recommendations designed to improve productivity, beginning with workforce planning and scheduling processes, including:

  • Labor productivity and optimization programs
  • Scheduling and productivity technology
  • Best practices for scheduling effectiveness
  • Design and management of a more efficient float pool to fill staffing shortages
  • A management engineering department to provide on-site monitoring, education and assistance with workflow improvement
  • Potential adjustments to recruitment practices

Many solutions are enhanced by HealthTrust’s web-based labor management technology, which builds schedules around forecasted patient volumes and aligns with approved staffing grids to meet labor budgets and productivity targets. The final piece of the puzzle is a daily productivity monitoring system that allows managers to make timely adjustments if staffing levels are not in line with goals.

Managed Services Programs and Contingent Labor Management. 

Sourcing and managing today’s healthcare workforce is also challenging because of the scarcity of nurses with specialty skill experience. These external market forces all heighten hospitals’ need to engage contract labor. Critical clinical vacancies can lead to an increase in the utilization of premium labor, nurse dissatisfaction and turnover. Productivity challenges can also easily trickle down into decreased patient satisfaction scores.

Some facilities have a hard time even determining how many contract labor employees are on-site at any one time and how these employees were sourced, hired and onboarded. As the industry’s largest healthcare managed services program (MSP) provider, HealthTrust can help hospitals and other healthcare organizations improve visibility to contingent workforce utilization and optimization so they can improve their labor processes.
More strategically managing contract labor can help address clinician shortages, says Jim Davis, senior vice president of MSP and strategic accounts, HealthTrust Workforce Solutions.

“Using this and other best practices that have been refined within the walls of leading hospitals, we assist healthcare organizations in first understanding and then implementing solutions to address their workforce issues—whether it be clinician shortages, scheduling problems or productivity lags.”

When it comes to filling short-term positions, HealthTrust’s MSP serves as an extension of existing supply chain management and talent acquisition teams, featuring a web-based platform that helps engage contingent labor. Because the MSP is funded by suppliers, hospitals can fulfill staffing needs without incurring additional costs.

Partnering for a Better Positioned Workforce

HealthTrust Workforce Solutions recently partnered with St. Luke’s University Health Network, a 972-bed nonprofit health system in Pennsylvania, to meet its staffing goals while elevating some of the economic pressures caused by rising costs and diminishing payments and reimbursements.

St. Luke’s managers spent a considerable amount of time on a daily basis addressing the staffing needs of their units for the next 12 to 36 hours. A positive attitude and teamwork spirit existed within the system, with departments routinely sharing staff across the six-hospital network. But there was little process or discipline applied across the staffing and scheduling continuum, resulting in overstaffing one day and understaffing the next. This policy had the potential to damage morale and loyalty, create inefficiencies and threaten the health system’s commitment to effective operations and excellent patient care.

Workforce Solutions identified a need to produce a smoother and more predictable work life for St. Luke’s staff that was less wasteful and better supported the organization’s goals. HealthTrust’s inSight Advisory Services team started by conducting a labor productivity assessment that included interviews with more than 100 managers across the six hospitals, an analysis of scheduling processes and systems, and a study of productivity benchmarks at the department level.

Among inSight Advisory Services’ recommendations was for St. Luke’s to develop a volume forecasting process, and to determine core, average and peak staffing requirements for each department that would become the basis for hiring plans. The team also suggested the development of a central staffing center and nursing PRN pool. Finally, to increase labor productivity performance, HealthTrust proposed that daily productivity monitoring systems and tools be employed in all departments to support improvement initiatives.

After implementing inSight Advisory Services’ recommendations, St. Luke’s was able to reduce its staff productivity challenges across the network by 20 percent. It accomplished this without cutting any positions; instead, St. Luke’s adjusted the way it managed staffing levels in every department to better target the workforce to the workload.

Ultimately, St. Luke’s was able to strengthen a daily productivity infrastructure and implement an automated productivity system, leveraging technology and improving manager knowledge on best practices for scheduling. St. Luke’s department managers now have a timely, accurate snapshot of their real-time daily needs, allowing them to match staffing to patients to ensure optimal care.

“With good systems and tools in place to educate our managers, HealthTrust made us a better organization,” says Ed Nawrocki, president, St. Luke’s Hospital, Anderson Campus. “The process helped us understand that staffing management is both an art and a science.

“Our managers now have the labor productivity strategies and knowledge to manage staffing in a disciplined, unified way,” he adds. “We no longer spend time debating our data; we simply take action. HealthTrust rates 5 out of 5 for staffing management and approach.”

HealthTrust Workforce Solutions also offers contract staffing and recruiting services such as travel and per diem staffing, local contracts, interim leadership, permanent placement, locum tenens, physician search and international nursing. For more information on any of these solutions, contact Cheryl Rhody at cheryl.rhody@healthtrustws.com or visit healthtrustpg.com/workforce. 

“With good systems and tools in place to educate our managers, HealthTrust made us a better organization. The process helped us understand that staffing management is both an art and a science.”

Ed Nawrocki, president, St. Luke’s Hospital, Anderson Campus

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