Operations at One Hospital Mends the Workforce as Well as Patients

By Gail Schuetz, Jackie Larson

Jun. 13, 2017

In health care, rules and regulations come with the territory.

Those who enter the health care arena must be able to flourish under the guidance of federal and administrative protocols. When thinking of patient care, policies and practices are standardized to ensure safe and effective delivery.

However, when it comes to standardizing staffing and scheduling practices and procedures within their organization, some providers struggle to maintain consistency.

The University of Kansas Hospital in 2015 conducted an operational assessment to identify variances between practice and policy in an effort to optimize labor.

It became clear that resource management practices varied from unit to unit and even shift to shift, which could have adverse effects on the organization at the enterprise level.

In order to remedy this type of situation, an in-depth examination of operational components of an organization’s workforce management strategy is often the first step to developing a consistent, repeatable and fair resource management strategy.

By gathering information from sources such as current HR policies and a cross-sampling of unit managers and team member interviews, the operational assessment identifies and establishes the elements that allow providers to achieve operational goals and implement best practice work strategies. The measures taken as a result of this analysis lays the groundwork for virtually any initiative that will follow.

What initiatives an organization should take on first depends on a number of factors, as certain initiatives might be necessary to complete before others. For example, defining and standardizing workflows and staff-float policies would need to be tackled before an organization should develop a centralized resource management center.

Core to leading any significant change effort is organizational alignment. No amount of tactical change management training will substitute for having an entire organization that has a clear vision of goals, shared responsibility and personal accountability to achieve results.

An operational assessment makes a point to show the degree of strategic alignment needed within the organization. Strong organizational alignment commands buy-in; there is no option not to be on board with strategic initiatives.

To promote strong organizational alignment for change, an organization should elect a driven and passionate executive champion with decision-making authority to represent staff at all levels of the enterprise. This individual must be willing and able to sway the majority in the right direction.

Having leaders on the ground floor paves the way for change by encouraging staff members to do their part to see the positive outcome of the initiative. This coaching mentality and results-driven response to change inspires a culture of personal accountability and fosters the commitment needed to achieve organizational goals.

Organizational policies and practices are not the most gripping topics, but they are vitally important for standardization, realizing predictable and sustainable outcomes and promoting fairness through their uniform application.

When the University of Kansas Hospital conducted its operational assessment, the data collected revealed eight areas for recommended change. The necessity of this analysis quickly became clear, as employee surveys showed that only 48 percent of the staff thought the staffing and scheduling of written guidelines were easily accessible and only 55 percent agreed that these written guidelines were followed by staff. This highlighted a need for standardized and consistent practices, and communication of them across the hospital.

The energy and focus that followed this analysis enabled the hospital to achieve remarkable improvements, including a 63 percent reduction in core staff floating, a 65 percent reduction in last-minute work requests, as well as an improvement in core staff fill rate from below 70 percent to above 95 percent. This gave managers time back in their day to focus on patient care and improved the work-life balance for staff, evidenced by the lowest turnover rate in the organization’s history.

An operational assessment can add immense value to an organization when it comes to nailing down the action items necessary to optimize their workforce and leverage best practices. It is a blueprint for organizations to use to put the wheels in motion to enact significant changes. To ensure the success of any initiative, a strong emphasis should be placed on communication of work processes across all levels of the organization, and employees should have a clear view of the “why” behind the initiative and how they fit into the picture. Significant change doesn’t happen with just the flip of a switch. It takes effort to gain people’s buy-in, but solid change leadership education tools and framework can provide essential support to create a strong culture of alignment and a smooth transition.

Gail Schuetz is the director of nursing at the University of Kansas Hospital.
 Jackie Larson is president of health care industry staffing analytics company Avantas, which is based in Omaha, Nebraska.

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