Effective workforce compensation management is a principal challenge for hospitals and physician practices as they look for ways to control costs and reduce waste in a post-reform healthcare era. Scheduling challenges generally underlie compensation management issues.
Many administrators have come to realize that traditional systems of scheduling physicians, nurses, technicians and other support staff — particularly in the operating room — are inefficient and often lead to waste. For instance, administrators might inadvertently schedule a non-full-time equivalent employee to work overtime when there is another non-FTE worker who has not yet worked a full week's worth of hours, explained Rich Miller, founder and chief strategy officer at OpenTempo, at Becker's ASC Review's 14th Annual Spine, Orthopedic & Pain Management meeting in Chicago. Mr. Miller founded OpenTempo, a cloud-based software provider for staff scheduling, in 2006.
By implementing certain best practices, it is possible to increase efficiency across the board, give employees more choice and satisfaction when it comes to scheduling and reduce the burden of manual scheduling processes.
Scheduling best practices
There are four scheduling best practices administrators could consider to improve efficiency, reduce waste and improve employee satisfaction, according to Mr. Miller and Dr. Beck.
1. Understand demand. The first step to creating an effective scheduling system is to use historical data — which can be gleaned from the EMR — to measure and evaluate a department's employee demand history and project necessary staffing levels.
"It's not just enough to look at the patient schedule," said Mr. Miller. "You need to understand demand across the day and look at it on a year-to-year timeframe." For example, the day after Thanksgiving is typically a low-volume day, and it is also a day many staff would appreciate having off so they can spend time with friends and family. With this insight, administrators can plan accordingly and have fewer staff.
Jeffrey Beck, MD, an anesthesiologist with Fairfax Anesthesiology Associates and Falls Church, Va.-based Inova Fairfax Hospital, added that it is also important to identify the factors related to staffing that contribute to inefficiencies. This includes evaluating the efficacy of case scheduling practices, imposing stricter rules for case start and end times, and improving consistency of care strategies.
2. Implement a 'single source of truth,' or one place where all staff can view the updated the schedule in real time.In the past, printed paper schedules or a whiteboard were standard methods of keeping track of an OR schedule. However, these systems were inefficient and often resulted in confusion among staff because schedule changes couldn't be instantly communicated. Dr. Beck said his team began moving away from paper scheduling in 1999.
"We were trying to get rid of paper so that there could be one current view of the schedule," said Dr. Beck. "We went from printing out a schedule and handing it out to everyone to a web-based system."
3. Empower staff with self-scheduling. Allowing staff to schedule themselves and solve their own scheduling conflicts with one another makes the process more transparent, fair and less "personal," according to Mr. Miller.
With Dr. Beck's system, employees have the ability to contribute to building the OR schedules, so long as they do so in a way that completely fits within the hospital's requirements and policies. "We wanted to put the power into people's hands — those who are being scheduled," said Dr. Beck. "We implemented a request mechanism where we flushed out the framework of our schedule, so people could indicate if they are working or not, if they are going away on vacation. I can remember being out of the country and putting in my own request. It gives everyone a lot of flexibility."
4. Manage and track staff requests and swaps. While lending more power to employees through self scheduling can improve satisfaction and morale, it is still important to oversee the scheduling changes that occur to ensure there is always enough staff on hand and ensuring a swap is compatible with your clinical needs.