The Forgotten Users: What Hospitals Really Want

I’ve had several conversations in the past few weeks with hospitals that all have the same underlying theme. It goes something along the lines of:

“We are frustrated with our current scheduling system from vendor XYZ and are thinking about replacing it. What are other hospitals using that works for them?”

Have you ever thought that? You wouldn’t be alone!

These are very interesting conversations to have because there is much more underneath the covers that leads a hospital to get to the point of asking that question. For me, the conversation typically goes one of two ways (and often times we talk about both).

1. The grass is not greener on the other side of the fence. If you read this blog regularly (and we thank you!), you’ve heard me say that there is no perfect scheduling system. Every scheduling solution on the market today has strengths and weaknesses and those who are happy with their systems are those who are leveraging the strengths and working around the weaknesses.

2. What is the current pain point that is causing this frustration? In my experience, there are three common themes that bubble up into frustration.

• Poor design and usage of the system itself.

• Lack of training and/or clear process flows on how the system should be used by the end users.

• General cultural resistance to change, where the end users simply reject the system in favor of some legacy practice.

All three of these of problems commonplace and I have good news for you about them: They are all solvable. That’s what we at Axsium do: Help hospitals overcome these types of problems and start getting the most of out of your chosen scheduling system.

But now I’m hearing about a new twist, a new pain point that hospitals who are established in their use of their chosen scheduling system are experiencing. It’s subtle and was not immediately obviously. It took a little bit of discussion to uncover: The Forgotten User.

Vendors for scheduling systems typically have two primary users that they think about:

1. Managers/schedulers. These are the people who build schedules and manage them. Scheduling and staffing. The build a schedule and post it (“scheduling”). Then they maintain it through shift-to-shift changes (“staffing”).

2. Employees. Just about every software system has some version of Employee Self Service. Staff can make requests, sign up for shifts, and/or whatever else is designed for them via configuration and workflows.

So who is forgotten? It’s the Centralized Staffing Office. These are the folks whose job it is to perform coordinated staffing changes for groups of departments within a hospital (or even between hospitals). They have to manage multiple units, large numbers of staff, temporary staff (agency), nurses with different skill sets, and a host of other tasks. The staffing office lives in the scheduling system. They need specific targeted data and they need it NOW!

The problem that bubbles up to frustration is that centralized staffing offices use the manager/scheduler views, access, and tools. None of them are designed for the unique needs of this group. The views may not scale across multiple units, or they may not have the specialized functionality that they need to manage something unique to them, like agency staff or multiple skills across multiple units and nurses.

This creates inefficiencies and annoyances. That bubbles up to frustration which causes hospitals to ask questions like “What are other hospitals using for their staffing office?” At its worst, it can lead to outright rejection of the scheduling system.

Staffing offices spend a lot of time looking a gaps in coverage and plugging in the right nurse to fill that role. The “right nurse” can mean any number of things: Is available? Needs more hours? Appropriately skilled? Worked in that unit before? Been called in recently? Senior? Junior? High hourly rate? Already working on another unit that has excess coverage? The list goes on and on. And staffing offices have to do all of these things, whether the scheduling system helps them with it or not. And even when a scheduling system has been designed to take advantage of it strengths and fit the needs of a manager/scheduler beautifully, the staffing office is still trying to shoehorn in their needs to something that doesn’t fit them and getting frustrated.

How do we solve this problem? The high level answer is easy: Scheduling systems need to account for the centralized staffing office as a third user group, with their own unique needs. They don’t need to use an iPad to approve a time off request. They do need to see coverage for multiple units simultaneously. They don’t need build and post a schedule from scratch. They do need to see all nurses across the hospital with their availability and skills.

It’s not my intention to call out any scheduling system vendor and beat them about the head with this gap in their system. Far from it! Instead, it is my intention to highlight this need, this gap and say:

“Software vendors – Please! Fill this gap! Don’t forget about the staffing office. Your customers will love you and you’ll have a competitive edge. And do it intentionally!”

One final thought: Despite my “call to action” here, don’t read too much into this. Software solutions are part of the problem, but not all of it. And they are only part of the solution, but not all of it. Accurate and timely execution of the process built around staffing are essential to making any system valuable. In other words: Fixing the software is good. Fixing the user behavior is essential!