Scheduling Hospital Staff Is Simple, Right?!

by | Aug 11, 2011

It’s funny dealing with employee scheduling in healthcare. There is a perception about scheduling that is pretty common and yet fundamentally flawed. And that perception is tha—well, hold on. Before we hit that, first what comes to your mind when you hear the term “scheduling”?

A lot of hospital leadership – and probably a lot of you – think about things like: ”You tell employees when to come to work” and…you’re done. That’s it. Because you’re scheduling employees. To work. At their job.

How hard can it be?!

Managers have been scheduling employees since the beginning of time. “Don’t forget to be here tomorrow at sunrise – and try to be ON TIME for once!” Verbal scheduling is the simplest, most basic form of WFM.

With the advent of paper and the ability to read & write, scheduling got a new medium for communication. And for a lot of employers (and hospital departments!), that’s where scheduling is at today. Manager writes it down and posts it on a bulletin board. Employees know where to look to see when they are working. Couldn’t be simpler.

Of course, in today’s world, computer systems have become the new medium of choice for employee scheduling. But even using computers can take a lot of forms. For many, it is just the paper method gone electronic. Instead of writing out a schedule, the manager will key into a spreadsheet, print that out, and post it on a bulletin board.

But we all know it can be better than that and there is a lot of talk about scheduling systems – utilizing computer-based applications to build schedules and delivering them to the employees. (We even talk about scheduling systems on this blog!) Most recently, smart phones are the latest trend to hit WFM, with apps being developed for accessing and updating schedules.

No matter what medium is used, though, when you boil it down, scheduling is just telling employees when to work, right? As I said before:

How hard can it be?!

THAT is the perception that I started off this post talking about. It’s pretty common. And, it is fundamentally flawed.

Do you remember the posts from a few weeks ago about productivity? (See Part 1 & Part 2.) We talked about how the labor productivity part of the business of healthcare is balancing quality patient care with the cost of the workforce.

Well, the cost of your workforce is how much you pay them to work. And in healthcare, that’s not just their base wage rate but also things like OT, shift differentials, bonuses, premiums, and external agency costs. Depending on the systems you have and use, those costs are controlled reactively by looking at metrics like “hours per patient day” or “labor dollars per adjusted admissions”, which comes from timekeeping and payroll data. Or they may be attacked more proactively by scheduling within the budget and so OT is not incurred and updating the schedule to flex off staff when census drops, to contain those costs.

And all of the sudden we’re back to scheduling.

It’s not just “Don’t forget to be here tomorrow at sunrise” any more. It’s the place you go and the system you use to proactively contain labor costs. (Good luck doing that on a bulletin board!)

The scheduling system is (or at least it should be) the heartbeat of your hospital operations. It’s what tells your staff to come to work, and it also should tell them where to be and what to be doing. And it should be telling you if you have the right number of people helping the patients who need it most and how much it is costing you and if that’s okay or not. It should be helping you be compliant with mandated ratios and assist with achieving Magnet status or producing data for Joint Commission inquiries/reports.

So, if you had such a heartbeat in your hospital or you were getting ready to put one in, would you think of it like an electronic version of a bulletin board posting? Or would you treat it like a system that has as much impact to how your hospital operates as a new EHR system? Because although scheduling may or may not be as important as EHR to a hospital, it is at least important enough to warrant the discussion, which is a far cry from being just an electronic way to tell employees when to show up to work.

As we talk about productivity in this blog, and we’re going to talk about it quite a bit, we’re also going to talk about scheduling. To me, scheduling is the core of WFM in healthcare. As I already said, it’s the operational heartbeat of the hospital. And you can’t talk about productivity or labor costs or patient care or any WFM subject in healthcare without talking about scheduling.

What I hope you take away from this back to your hospital or health system is an understanding that scheduling systems in today’s world are bigger than just, well, scheduling. And scheduling systems have the potential to affect a hospital just as significantly as any clinical system. Therefore, when we talk about the importance and the impact of scheduling processes and change management, we’re not just talking about a better way to post a sheet of paper on a bulletin board, we’re talking about the heartbeat of the hospital. That’s pretty simple, right?!

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