3 thoughts on establishing budget-friendly staffing strategies

Appropriate and cost-effective staffing is key for healthcare systems that aim to ensure the delivery of high-quality care as well as achieve financial success.

At the Becker's Hospital Review Health IT + Clinical Leadership 2018 conference, May 10 to May 11 in Chicago, a team from Chicago-based Rush University Medical Center discussed the challenges they have faced with regards to keeping staffing models budget-friendly as well as the tools they are using to overcome these challenges. The team included: Connie Weissman, IS senior analyst; Shonda Morrow, RN, assistant vice president, nursing, finance and resource management; and Andrew Soltys, BSN, RN, assistant unit director, clinical staffing office.

Ms. Morrow gave an overview of the medical center as well as its division of nursing.

"The division of nursing includes more than 3,000 nurses. If you think about the magnitude of the DON with so many different roles, you want to be able to attribute staffing and hours to particular roles. It's important to understand your job classes and, then when building your system, you can attribute the types of hours to job class…The whole concept of technology optimization is empowering your charge nurses. They know what is happening on the floor, and so, they need the tools to make the decisions regarding staffing up or down. Our plan was to optimize our current technologies [including] a tool from Change Healthcare."

Ms. Weissman noted the medical center was not using the Change Healthcare as effectively as it could be.

"We had a Rolls Royce, but we were driving it like a VW bug…We had to optimize the system. We were already using it for scheduling, and we needed to update the system configuration. Optimizing it required us to look at what data we are putting in the system — we needed budget numbers in [the system,] staff grids so it's useful for charge nurses and census data so it can calculate our hours per patient day. We have identified some opportunities for improvement."

Mr. Soltys discussed the changes that have taken place with the charge nurses' role in the facility as a result of the implementation of the system.

"We're starting to get [charge nurses] thinking more proactively. The role has changed in our faculty and we are getting them thinking about what it would mean to take on a new staff member, what would it to the productivity. We have different levels of charge nurses, and we are going through the process of getting everyone up to speed on documentation. Our unit leaders are empowered to make whatever changes they need to their unit, but when there is a review of finances, there needs to be a story behind the decisions of adding or removing nurses from units. Charge nurses, in the best case scenario, are taking part in the nursing unit leadership team."

Editor's note: Quotes have been lightly edited for length and clarity.

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