How Mission Health saved $500K by eliminating early clock-ins

As hospitals seek new ways to reduce spending without affecting patient care, facilities may overlook one key way to improve their bottom line: managing labor practices.

During a June 11 webinar sponsored by workforce management and human capital management cloud solutions company Kronos and hosted by Becker's Hospital Review, Susanne Mowry, RN, administrative supervisor and team leader of nursing administration at Asheville, N.C.-based Mission Health, discussed how the health system saved more than $500,000 in labor costs by standardizing workforce management policies and processes.

During a review of its workforce management policies, Mission Health identified 23 different policies related to timekeeping and payroll, some of which contradicted one another. The health system established a collaborative group between human resources, finance and nursing leadership to consolidate these policies across the enterprise.

The collaborative effort resulted in three systemwide policies related to timekeeping, paid time off and attendance. The policies outlined expected behaviors and consequences for not meeting these expectations. For example, the systemwide policy on timekeeping defined a "tardy" as a staff member arriving more than seven minutes after his or her established start time.

To evaluate how workforce practices affected labor costs, the group pulled "clock-in" and "clock-out" data from the Kronos timekeeping system, focusing on those who punched in early and those who punched out late. Visibility into this data gave the health system better insight into workforce behaviors — and a new way to control labor costs.

"We partnered with finance to determine the magnitude and cost associated with early, very early, late, very late 'in' and 'out,'" Ms. Mowry said during the webinar. "We discovered early and very early clock-in was costing nursing $133,000 a month, which equals $1.5 million a year."

With this information in mind, the group established a new goal: zero early clock-ins among nursing staff. To achieve this goal, leadership managed nursing staff schedules via the Kronos timekeeping and scheduling system, creating a centralized platform for unit directors to identify early clock-ins and late clock-outs.

In a push by the health system's CNO to "optimize Kronos" in 2015, nursing leadership kicked off a set of initiatives to drive adoption of the workforce management solution among staff. Here are three key steps Mission Health took:

1. Interview nurses about their perception of the solution. The resounding response Ms. Mowry's team heard when interviewing nurses in 2015 was, "we don't trust the software." She stressed it was important for her team to listen to, and validate, their concerns.

Moving forward, nursing leadership committed to improving communication regarding any technical issues nurses identified.

"We built trust … by really going back to the nursing leaders and listening to them," Ms. Mowry said. "They had every right not to [trust the software]. We had issues that were related to the software set-up, but with the help of the Kronos team, we were able to identify and correct those issues."

2. Train staff on the solution's functions. During interviews with nursing staff, Ms. Mowry's team identified a few areas where education efforts could improve staff use of the workforce management solution. For example, many nurses were unsure how to do online self-scheduling, shift swapping or requesting time off.

The team realized the nursing staff had undergone only limited training on the software when Kronos' scheduling solutions were first implemented at the health system. To address the issue, the team provided unit directors with in-person, one-on-one training for various features of the Kronos solution and provided all nursing staff with access to online training modules.

3. Educate staff on the importance of managing labor costs. The team also shared data on timekeeping with the nursing staff to raise awareness among employees about the amount of money the health system spent on incidental overtime, and thus how important it was for them to clock-in according to their schedule.

Staff education on the importance of managing labor costs was critical to the initiative's success, according to Ms. Mowry, because it allowed leadership to convey their expectations to staff. "It's letting your employee know: 'This is the reason the hospital is focusing on this, because we want to save money,'" Ms. Mowry said.

"By doing these few simple changes, we were able to save $500,000 for the nursing division at our main facility," she continued. "And, as a result, we saved jobs."

Listen to the webinar recording here. View the webinar slides here.

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