Focus on fill rates: The new approach to open shifts

Ken Bailey, Division Director, Staffing Operation and Productivity, CHI Health & Jackie Larson, President, Avantas -

Scheduling staff in patient-care facilities is anything but cut and dried.

Depending on the type of scheduling tools used (if any), planning staffing needs involves guesswork and multiple revisions before the schedule period begins. A time-consuming process for unit managers, once all staff is scheduled to their FTE, open shifts often remain. This is when contingency resources are tapped into – whether it’s core staff in extra or overtime, resource pool staff, or agency.

Filling vacant shifts is often a frustrating process that involves managers making desperate recruitment calls and bartering with staff to pick up shifts – leaving managers stuck in a reactive world instead of a proactive one. This approach supports or rewards staff to hold out until the last minute to pick up shifts in hopes of a higher incentive. This is a common approach to open shifts that results in negative staff morale and increased labor costs.

Having a clearer view of future staffing needs can alleviate a lot of stress that comes with the scheduling process and improve fill rates. Automated scheduling software exists that can better plan staffing needs for provider organizations.

Technological advancements in the scheduling and staffing of healthcare professionals has been driven by predictive analytics. Analyzing metrics such as an organization’s historical census data and staff behavior patterns, predictive analytics is able to forecast future patient demand within 97 percent accuracy 30 days in advance of the shift.

This technology-enabled solution sets the stage for an effective open shift program that rewards staff for picking up shifts weeks in advance. An automated and streamlined open shift program can be an effective scheduling practice to save an organization essentially wasted dollars on last-minute incentives.

With the right scheduling software, open shifts are automatically posted to staff in their competency areas once the manager has scheduled staff to their FTE. Open shifts are ideally posted 30 days in advance and updated in real-time as staff pick up shifts or needs change.

Understanding Staff Motivation
At the root of an effective open shift program is understanding what motivates staff to pick up open shifts.

Knowing what motivates an employee works in favor of both the staff member and the organization. Some people are motivated by money; others will be more apt to pick up shifts when they fit into their schedule.

What this means for a health system is the need for a scheduling module of decreasing financial incentives as shift dates approach. Monetary incentives well in advance of the shift that decrease as dates draw closer satisfy both staff motivators of money and flexibility; they pay well, yet also enable staff members to plan their lives around their schedule by exchanging flexibility for dollars.

Focusing on Fill Rates
Rethinking their approach to open shifts, in August 2016 CHI Health implemented a variable open shift incentive program. Previously using a static incentive model – offering the same incentive no matter the shift – the result was a struggle to consistently fill vacancies. With the new program, incentives are tied to fill rates, drawing staff to the areas of greatest need. A smaller incentive is offered for open shifts with a higher fill rate, while those with a lower fill rate have a greater incentive amount.

Since implementing the variable incentive model, CHI Health has seen consistent improvement of fill rates above the target of 95 percent each pay period.

CHI Health further strengthened their enterprise mentality by streamlining the program across all 14 of their hospitals in Nebraska and southwest Iowa. Standardizing the incentive model across all facilities has resulted in staff asking to be cross-trained at other sites, which allows them to pick up higher incentive shifts when the need is greater than what is available at their home facility. This aligns with the outlook that staff is a shareable resource across the enterprise.

In a constantly evolving industry like healthcare, provider organizations must continuously strategize about how to best optimize their resources. In a climate where there is increasing pressure to control costs while delivering excellent patient care, utilizing predictive analytics to schedule staff helps ensure hospitals have the appropriate workforce to keep up with the growing demand.

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