Rethinking labor management for medical groups

What you did yesterday for scheduling and staffing may not be good enough for today or tomorrow.

Jackie Larson, senior vice president of client services at Avantas, a scheduling software and healthcare consulting firm, and Sherri Luchs, chief administrative officer of Penn State Hershey Medical Group, discussed how the optimization of labor management can improve the quality and cost of healthcare in a session at the Becker's Hospital Review 6th Annual Meeting in Chicago May 8.

To address shifting quality and cost expectations, the Penn State Hershey Medical Group decided to move their organization from a traditional fixed model to a variable staff model, Ms. Luchs said. Penn State Hershey Medical Center was embarking on a similar project in its inpatient facilties, she said, but nothing like this had ever been done with a medical group before.

The fixed staff model provided the same amount of staff everyday at a FTE-to-staff ratio of 3:1, regardless of patient volume. In the variable model, staff members would be deployed based on predicted volume and a staffing plain that aimed to put the right staff with the right skills in the right place at the right time.

The idea was to set up layers of contingency so physicians and other staff could take paid time off, or go to a meeting and so that practices wouldn't be left unstaffed if someone called in sick. It essentially aimed to build a pool of resources that could flow across multiple practice sites and reduce variability in operation practices related to staffing and scheduling.

The shift to a variable model required huge amounts of communication and change management Ms. Luchs said. "We had to go through some disruption, because not every manager said 'Sign me up!'" It was the same story with the providers. The medical group received mixed reviews — some supported the new model, while others wanted to wait and see what would happen before diving in.

The group began to provide educational resources to increase the level of comfort for managers and staff on the new process and what to expect. They still use it today, according to Ms. Larson. "As you have turnover and churn in staff, it's that commitment to education and vision that will help you maintain the new processes," she said.

The project proved successful in improving efficiency and lowering costs. In FY 2014, the clinical fill rate was 85 percent and the non-clinical fill rate was 88 percent. The clinical fill rate to date in FY 2015 is 99 percent and the non-clinical fill rate is 97 percent. The hours worked per patient visit are down to 1.56 from 1.71 in 2014. Penn State Hershey was able to save $1.3 million in fiscal years 2012 and 2013 from the project, according to Ms. Luchs.

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