Access to real-time scheduling data helped one New York state health system cut overtime hours in half in just one year.
It happens at every hospital. A nurse at the end of her shift is asked to pick up the shift of a colleague, who has just called in sick. The nurse is tired, having worked three back-to-back 12 shifts, but agrees, eager for the overtime pay.
Unfortunately, the nurse manager has no way to quickly determine that four other nurses could have fit the additional shift into their schedules without pushing into overtime.
A hospital's labor force is the largest piece of its budget and improper management and scheduling can have a large impact on a hospital's bottom line.
Ellis Medicine, a 450-bed health system based in Schenectady, NY, empowered its managers with real-time scheduling information to effectively and efficiently staff their units. And by providing the same up-to-the-hour scheduling information to every employee, Ellis extended intelligence on staffing issues system-wide.
"Unscheduled absences are a challenge for all organizations. What's key is to know ahead of time what our schedule is, where people are, and when they will be here," said Joseph Giansante, vice president of human resources.
"By providing that information in real time, a manager can make immediate adjustments. With systems in the past you didn't have this data, and you find out you have issues in the pay period, two weeks beyond being able to do anything about it."
The scheduling system Ellis uses from an outside vendor allowed all departments and employees to have access to the same scheduling data through a coordination of its HR, IT, and finance departments. After running the pilot in the inpatient units, Ellis rolled the system into nonclinical areas, including food services and environmental care.
The three-hospital system and teaching facility was able to reduce compensation costs for its 3,300 employees by 40% without understaffing any units, all through managing, and reducing, unnecessary overtime costs over a six month period.
Over the first year of implementing the system, Ellis cut overtime hours in half. This resulted in a savings approaching $2 million for overtime compensation, not to mention unseen costs saved in the patient safety arena due to a fatigued workforce.
"We created an individual staffing dashboard. So for each unit, and this is real time, anybody can go on our intranet, pick a particular unit at a particular time of day and find out what was the staffing model that day and that unit," says Giasante. "They see any unscheduled absences, or what was the ratio of employees on the unit to the patient. Any employee, manager, can go on there and check that out. That's ultimate transparency."
Giasante says this leads to an improved sense of teamwork on the department level. Employees are less likely to take unscheduled absences when anyone in the hospital can look up why a particular floor was short-staffed, and data is updated to the hour.
Within two years, the scheduling module paid for itself, says Giasante. Retention has increased and turnover has gone down by almost 10%. Three years in, employees surveyed reported higher job satisfaction levels.
"So many scheduling issues for managers are managed just by having data. Without that, a manager, to his or her credit, [has] to run [his or her] departments, things come up and they have to use their people and if we don't give them the tools to manage these schedules, then shame on us," says Giasante.
Chelsea Rice is an associate editor for HealthLeaders Media.
