Breaking free from silos: The journey to centralized healthcare staffing

Many hospital units are so used to functioning in staffing and scheduling silos that a centralized approach seems unfathomable – a mythical utopia just beyond their grasp of reality.

When managers and staff have become conditioned to following staffing practices because it has “always been done this way,” it narrows their horizons and they become more resistant to change.

But we know that working in silos prevents transparency, increases an organization’s labor spend, and damages staff morale – an inefficient practice with costly repercussions. Healthcare is constantly evolving and as health systems continue to grow and expand, the effects of a silo staffing mentality are magnified.

Rather than viewing each department or unit as their own entity, healthcare organizations are encouraged to adopt an enterprise mentality – a more cost effective and efficient approach to staffing. This approach requires shared vision and organizational cooperation extending to all applicable service lines, sharing resources and aligning policies and operational practices. Working together as one cohesive team across the enterprise reduces redundancies and delivers economies of scale.

Core to the concept of enterprise labor management, a centralized resource management center (RMC) is one of the most effective ways of controlling costs through economies of scale, consistent application of policies, and proactive identification of needs and improved coordination of resources against real-time demand across the system.

Serving as a communication hub, resource analysts in the RMC collaborate with clinical leaders to manage employee throughput against patient throughput. The resource analysts take on administrative support tasks, freeing clinical managers to focus on patient care and staff development. With a thirty-thousand-foot view of what is happening within the enterprise, the RMC strives to place the right person at the right place at the right time.

A properly positioned and designed RMC is a conduit through which all other strategies can be enacted. But the journey toward a new staffing approach isn’t met without hurdles. Breaking out of silos is often a difficult task and requires a culture shift when put into practice. To help ensure a smooth transition, there are several areas that should be nurtured.

One of the most critical elements needed for any significant change is strong organizational alignment. Organizational alignment enables change to occur due to a culture of personal accountability and the commitment everyone shares in achieving organizational goals and quality patient care. Strong organizational alignment commands buy-in, leaving no other option than to be onboard with strategic initiatives.

Strong organizational alignment is supported by clear communication extending from leadership to all employees. Being transparent about initiatives and communicating action plans keeps staff aligned with organizational goals and earns their trust.

For unit managers and directors who have spent years learning the ins and outs of their departments and know their staff, it’s a significant change in mindset to view staffing with an enterprise mentality. Cross-collaboration between leadership and department managers is necessary for a centralized staffing approach to be successful. The organization must work together across all facilities and departments to align their strategies and review outcomes. Leaders should know just as much about other departments as they do their own, as they regularly share ideas and successes with one another.

An academic client of Avantas in the southeast region of the country operates an 819 bed medical center and utilizes a centralized resource management center to staff approximately 50 inpatient units. They began their RMC journey in October 2016, as they recognized the advantage of having an enterprise-wide view and the benefits that could result. A year after going live with their RMC, they have already recognized significant reduction in labor costs and overtime. One of the biggest takeaways from implementing an RMC, as is true for any significant change initiative, is that collaboration and buy-in is key to success.

Shifting how staff is viewed as a resource and adopting an enterprise labor management mentality does not happen overnight. It takes clear and consistent communication from leadership to explain the reason for the change and the benefits of its expected outcomes. Success with centralized staffing is a result of a foundation of best practices, cultural acceptance, transparency, schedule automation, and continual monitoring of metrics and refinement.

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