Nurses have always had an essential role in health care. Now more than ever, as the industry faces increased pressure to improve quality of care, reduce costs and enhance patient satisfaction, hospital and health systems recognize the importance of an engaged nursing workforce.
The ability of a hospital nursing staff to improve the care experience hinges on their work satisfaction. According to a study by Health Affairs, for every 10 percent of dissatisfied nurses, patient referrals decrease by 2 percent. With this in mind, it's critical that hospital leaders consider approaches to maintaining a satisfied, engaged nursing staff.
In a recent article published in Hospitals & Health Networks, the authors discussed approaches that should be top of mind for hospital leaders looking to increase patient outcomes, lower the cost of care, and offer an improved patient care experience. The authors also articulated the need for hospital leaders to reduce excessive overtime as a "tactic" to improve nurse satisfaction. In fact, a study conducted by Health Affairs found that compared to nurses who worked shifts of 8–9 hours, nurses who worked shifts of 10–11 hours had a greater likelihood of being burned out, being dissatisfied with the job, and intending to leave the job. Excessive overtime is not just a drain on staff morale; it also impacts the patient experience. Research has shown that overtime can increase the risk of patient falls and hospital-acquired infections as well as the likelihood of medication errors. And, when nurses work long hours, patient satisfaction and HCAHPS scores suffer, according to a study conducted by API Healthcare, a GE Healthcare company. In order to anticipate and prevent overtime usage, a nurse leader must have access to reliable, accessible, timely and actionable data.
Reducing unexpected and excessive overtime is not a small task and requires planning, excellent work processes, and a sophisticated monitoring system. There is a plethora of tools available to healthcare leaders. We believe that the best solution should offer a strong integration, ease of use and a robust set of actionable reports to better the organization. The ideal solution should be a fully integrated system that offers staffing and scheduling, time and attendance, acuity measurement, and a productivity measurement component.
Innovations in Data Analytics
In order to understand the allocation of resources, leaders must analyze multiple data points, for example: patient acuity, staff competency, skills mix, vacancy rate, and turnover. Focusing on one data point only can lead to the wrong conclusion. Innovations in data analytics have made that possible. Automated workforce management solutions—such as staffing and scheduling, patient classification, time and attendance, and human resources and payroll – can assist organization leaders to leverage predictive analytics. Such systems offer the ability to proactively identify and manage overtime before it happens. Furthermore, a fully integrated acuity measurement system allows nurse leaders to assign patients to a nurse based on the needs of the patient as well as the competency of the nurse. In our opinion, such alignment has the ability to support an engaged workforce.
An important added benefit of an automated workforce management solutions is the ability to empower nurses with self-scheduling. These solutions provide qualified staff with visibility to open shifts, enterprise-wide, giving nurses the convenience of managing their own schedules. An article published in The Journal of Nursing Administration found that when nurses self-scheduled their work, they had significant benefits for job satisfaction, work-life balance and team cohesion.
As organizations move into automated solutions, they may begin to realize the financial benefits while improving quality. We opine that the true value comes when organizations take an integrated approach. By integrating all of these solutions – like enterprise resource planning (ERP) or electronic health records (EHR) – health systems are able to truly optimize the technology and appropriately deploy the right resources, at the right time, to the right patient.
Looking Beyond the Technologies
While the advances in data analytics have created a new era for clinician scheduling, and perhaps offer a solution set for employee engagement, it's important not to forget that employee engagement starts with core values. We believe that the greatest assets of any healthcare organization are the employees, the clinicians.
By pairing innovations with a strong sense of values, hospitals and health systems have a better chance in creating a positive work environment, which in turns translates into a satisfied, engaged workforce.
About the Authors
Sylvain Trepanier, DNP, RN, CENP, is the system vice-president & chief nursing officer for Premier Health, a regional integrated healthcare system based in Southwest Ohio. Prior to joining Premier Health, he was a regional chief nursing officer for Tenet Healthcare. Dr. Trepanier is a seasoned nurse executive with healthcare system experience in executive leadership, quality improvement study, organizational transformation, system standardization, and leadership / management training. Dr. Trepanier is an active member of the American Organization of Nursing Executive (AONE). He obtained his Bachelor's and Master's degree in Nursing from the University of Montreal Canada and a Doctorate of Nursing Practice (DNP) from Texas Tech University Health Science Center (TTUHSC), Anita Thigpen Perry School of Nursing. He serves on multiple boards (journal editorial boards, nursing school advisory board, as a Director for a Board of Trustee, and Chairman of the Board for a Home Health Agency).
Karlene Kerfoot, PhD, RN, NEA-BC, FAAN, is chief nursing officer of workforce solutions for GE Healthcare. She has held a variety of positions in nursing, clinical practice and patient care administration in large healthcare systems, healthcare consulting and academic positions. Dr. Kerfoot earned a doctorate in nursing from the University of Illinois, Chicago, and a masters and BSN from the University of Iowa in Iowa City. She has published more than 300 articles in the areas of leadership, patient safety, data-driven staffing and workforce issues. She also writes a popular column on leadership for Nursing Economic$, serves on numerous editorial boards, speaks nationally and internationally, and is a board member of the DAISY Foundation.
The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.