3 staffing metrics every hospital should monitor

Labor has a key role to play as hospitals work to provide quality patient care at less cost.

According to Omaha, Neb.-based Avantas, a provider of strategic labor management technology, services and strategies for the healthcare industry, labor makes up between 50 and 60 percent of a hospital's operating budget. Therefore, it is important that organizations evaluate how these monies are allocated and how they are utilized for patient care.

Here, Jackie Larson, president of Avantas, shares three staffing metrics every hospital executive should be monitoring to effectively manage their medical facility and provide quality patient care.

1. FTE leakage: This term refers to the hours a staff member has not worked but should have based on their full-time equivalent commitment. Avantas found there is FTE leakage equivalent to about one or two FTEs per hospital department per year, when all workers' leakage is combined. For various reasons, such as managers granting paid time off without having a replacement or simply not scheduling staff to their FTE commitments, the staff member does not work those hours and other staff members or agency workers fill inMs. Larson says these sources of staffing are more expensive than a core staff member working within their FTE. "So it's a double whammy… the staff that are brought in could be used elsewhere (probably) and they are more expensive — all because the person that was supposed to be scheduled for those 12 hours was not," she adds.

2. Incidental worked time: Incidental worked time is any instance where staff members clock in before their scheduled shift or clock out late beyond their scheduled shift time. Avantas' research suggests that only 40 percent of IWT is clinically necessary, such as staying late to ensure a complete report off of a patient with high acuity, according to Ms. Larson. The remaining 60 percent of time can be avoided through various training or education initiatives, such as teaching strategies to stay current with charting during the shift. Avantas also found there's about $40,000 per hospital department per year spent on unnecessary incidental worked time. "You aggregate that up to a single hospital and then up to a large system, that impacts their ability in terms of how they can hire additional resources that truly care for the patient," Ms. Larson says. "Anytime there's dollars being spent that don't directly impact caring for the patient, those are metrics [hospitals] need to evaluate."

3. Core as contingency: Avantas defines "contingency" as any source of staffing that is not a core, or permanent, staff member, and core staff members who are working above their FTE. So core as contingency would mean asking a core staff member to pick up extra shifts. While that may be clinically necessary, there is a tipping point at which some of these tasks for core staff start impacting turnover, according to Avantas' evaluation. With overtime, Avantas found that threshold to be very low — below what is average in the hospital data it analyzed for 38 hospitals across six health systems. The average of overtime on a hospital department is 4.6 percent of a staff member's work hours, Avantas found. However, Avantas research also shows at 3.1 percent is where turnover starts escalating. "The message here is don't overuse core staff as contingency. You have to have other forms of true contingency staff that you can draw on to backfill when core staff can't take a patient," Ms. Larson says.


More articles on workforce and labor management:

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Huron Valley-Sinai Hospital nurses vote to unionize



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