6 common challenges of a centralized workforce management strategy

The idea of centralization typically has a lot of traction in organizations that want to reduce redundancies, create efficiencies and ensure standardized processes.

Within healthcare, centralizing workforce management, both day-of staffing and deployment responsibilities as well as strategic staffing plan initiatives and analytics, has grown in popularity as provider organizations are faced with incredible pressure to find savings without sacrificing quality.

The extent to which organizations choose to utilize this strategy is a continuum. Some organizations choose to use this as a defacto call center with data entry functions for specific departments while others task their resource management center (RMC) with in-depth schedule analysis and reporting functions while coordinating and carrying out their workforce management, deployment, and alignment strategies. Organizations that take the latter approach can experience cost savings and increased effectiveness with staff coordination and placement, freeing managers from the majority of administrative tasks that keep them from managing their units.

Centralizing resource management is not a panacea, however. Nor is it a plug-and-play solution. Success with this strategy requires a firm foundation of operational best practices, organizational understanding and acceptance of the RMC's role. It also necessitates dedicated and intelligent staffing strategists who understand the sensitivities of their role and their relationships with departments throughout the system.
Following are solutions to the six most common challenges organizations that have centralized resource management have in their administration of this transformational strategy.

1. Multiple / frequent critical staffing shortages

Possible Causes

- Scheduling is inadequate, indicated by high FTE leakage (staff not working up to their FTE commitment) and poor balance of shifts to patient need
- Proactive scheduling review is not completed or is ineffective; Significant patient census spikes
- High number of staff call in absent
- Unit manager grants time off to staff who are needed for patient care.


The RMC can impact the quality of schedules through monitoring the schedule posting window and consulting with schedulers before schedule finalization. It is important to implement a review process of future schedules with adequate time to warn leadership and attempt to correct any potential shortages. Improvements of 40-60% in FTE leakage have been seen by consulting with schedulers to improve balance, properly code shifts, and identify challenging shifts well in advance. Best practice is to maintain a consistent two-week forward-looking process for scheduling review. A consistently applied incentive program that rewards staff for scheduling in advance (proactive) versus incentives for next-day or same day pick-ups (reactive) also assist with meeting staffing needs.

2. Excessive recruiting calls with low pickup results (staff burnout, nonresponsive)

Possible Causes

- Proactive scheduling review is not completed or is ineffective
- Low user adoption of open shift functionality (if applicable)


Related to the first issue, excessive recruitment calls are often the result of imbalanced schedules, schedules that do not reflect demand, and staff not being scheduled to their FTE commitment. Correcting these issues can alleviate the frequency of recruitment calls and thereby increase the effectiveness of future recruitment calls. If the need for excessive recruitment calls stems from a lack of use of open shift management tools there are undoubtedly awareness and/or engagement issues. In order to be effective, open shift tools must be understood, available, proactive, and be in line with staff motivations.

3. Extreme balance swings within a facility, i.e., some unit schedules are balanced while others are short.

Possible Causes

- Inadequate contingency staff to meet demand
- Lack of alternate unit orientation to facilitate core floating


The most common cause associated with this is an inadequate skill mix or insufficient contingency resources. Having the appropriate mix of core and contingency staff sources is key to effective enterprise workforce management. Also important is the facilitation of multiple-unit orientation for core staff, allowing them to effectively float from like unit to like unit in the event of significant shortages. While floating can be a staff dissatisfier, this can be greatly diminished with the right on-boarding program and cultural commitments.

4. Inability to establish a comprehensive picture of scheduling due to unsubmitted schedules.

Possible Causes

- Schedule period or policy misalignment
- Poor accountability around schedule posting dates


Hospitals across the country utilize a mix of four, six, and eight week schedule periods. It is not uncommon that within an organization there will be different schedule periods department to department. This can create a multitude of negative results including problems with KPI and financial reporting in addition to the misalignment of schedules. The first step to counter this is to standardize schedule length and schedule due date timing. Scheduling will become a shared event between units and the organization's focus will become engaged on a normalized cycle. Additionally, an escalation process should be developed for schedulers who do not adhere to the timeline. When followed, an escalation process will help establish shared vision and accountability.

5. Late shift / unit finalization with contingency / float pool staff and core staff floating


- Poor RMC timeline adherence
- Poor engagement / communication with facility partners


Shifts should be finalized at least one hour prior to the shift start time. If an organization is unable to do this consistently there are most likely a number of overriding issues. First, timelines might not be established or adhered to across the facility. Second, an organization might not be utilizing a staffing tool that allows for real-time census data combined with enterprise transparency. The union of real-time data and transparency will enable the accurate identification of supply and demand, i.e., areas of over and under staffing and associated possible movement of staff. If there is a need to float in or out of a department or cancel a shift, the float/cancel logic should be determined at the time shifts are finalized to enable timely communication and minimize disruption.

6. Frequent call and staffing escalations causing staff aggravation


- Frustrated clinical staff / leadership
- Over-worked / dissatisfied staff (procedural misalignment).


Have a call recording solution in place for RMC management to access to review calls for de-escalation and employee training purposes. Assess the escalated call(s) with the complainant or their leadership objectively. Search for an opportunity to adjust your procedures to alleviate the frustration without sacrificing either party's functional needs. Understand that sometimes short-term pain can lead to long-term gain if you are in pursuit of the correct solution(s).

Jackie Larson is a senior vice president at Avantas, a leading provider of strategic labor management technology, services and strategies for the healthcare industry. With more than ten years of experience spanning research and development, strategic planning, and technology solutions, Jackie has become a healthcare industry leader in developing and delivering tailored, best-practice strategies.

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.

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