Why Is Health Care Staffing Such a Guessing Game?

Dear Guesstimates:

Your query didn’t specify what part of the health care arena you’re operating in, so it’s a bit difficult to be specific with guidance. That said, here are a few thoughts:

Workforce staffing and scheduling is an almost alchemic process that relies on forecasts of demand and availability, constrained by a host of realities. Those of us who travel regularly see it play out every day as airlines flex their system form and schedules to best match passenger demand, within the constraints imposed by equipment, weather, oil prices, union contracts and the law. Though it’s easy to poke fun at other aspects of their operation, most commercial airlines do a remarkably good job of putting crews, equipment and passengers together in the right space at the right time.

It hasn’t always been that way. Over the years, forged largely by the hard lessons of repeated bankruptcies, they have become much more data-centric and realistic, particularly with respect to crew and resource scheduling.

The health care space is not appreciably different in that you are just as labor- (and capital-) dependent as any airline, and you, too operate with demand factors that can be difficult to predict, let alone control. While traveling is important, delivering high-quality health care reliably and efficiently is essential.

I would venture that the health care space generally lags the major commercial airlines in sophistication of staff and resource scheduling. Witness the almost unconstrained use of contingent staffing in many parts of the health care arena, and the fact that much of your expensive equipment sits idle at night and on weekends. As evidenced by your question, the good news is, your industry is catching up, and needn’t undergo bankruptcy to get there. Three specific suggestions:

1. Get serious about predictive analytics. Much is being written and said of late about big data, and the use of predictive analytics to better understand your operation, forecast demand, and aid in staffing and scheduling. Routine staffing levels for many hospital functions (radiology, pathology and maternity, for example) are reasonably predictable around local, societal and historical norms. And, just as airlines have learned to flex their system form on a daily basis, using different schedules and equipment on different days, hospitals, labs, and other medical practices can staff adaptively as well. One of the biggest requirements is to get a little smarter each day about how you do it.

2. Ask your people. Usually, the people actually doing the work know more than anyone about the demand factors and how they play out relative to staff schedules. Just this afternoon, I overheard a bartender (don’t ask) telling his manager about a scheduling change that would improve guest service and employee morale AND lower cost. You can institutionalize this approach by discussing regularly with your staff about workflow, patient care expectations and schedules.

3. Be willing to challenge the status quo. Take a serious look, for example, at your use of core vs. contingent staffing, not just when you deploy each, but how you treat them as well. Where possible, adjust pay and incentive practices to permit individual workers or entire departments to go home (with pay) when their work is done. As individual and organizational objectives become better aligned, the organization gets more efficient and scheduling takes on a whole new look.

Source: Bill Catlette, Contented Cow Partners, Memphis, Tennessee.