Axsium recently took a moment to interview Deb Moulton, senior consulting manager, on her experience with a recent staffing transformation initiative. She shares some key observations from this latest healthcare project.
You recently led a staffing office transformation project. Can you tell me more about that project?
The current staffing office was a one person shop that provided minimal benefit to the hospital. They wanted to change from a one person staffing office to a strategic staffing service for the hospital. The vision was that the staffing office would be transformed by taking on added responsibilities in the areas of scheduling, staffing, and timecards, and by expanding the scope of the units that the office supports.
Why did the hospital undertake this initiative?
The hospital was introducing clocks in order to better track the hours employees worked. As part of this initiative they needed to have accurate schedules in their timekeeping system that aligned with the clock punches. In the current state, schedules were not being updated which meant the data feeding to the timekeeping system would not be accurate, creating exceptions and inaccurate pay calculations. By expanding the responsibilities and hours of the staffing office they could ensure schedules were being updated in a timely fashion providing better data for the timekeeping system. By moving these tasks to the staffing office it allowed managers to spend time on patient care, better meeting the hospital needs.
What was going on in the staffing office before you got engaged with them?
The current staffing office was providing little benefit or support to the medical center prior to our engagement. There was little communication between the office and units therefore they did not have an overall sense of the staffing needs for the units they supported. Units were overstaffed and flexing off staff in some cases while other areas were calling staff in and paying overtime. They were basically seen as an office that provided daily staffing reports and prepared invoices for the agency. Processes were not documented and units did not rely on them to support, anticipate, or communicate staffing issues throughout the day.
Did the hospital have a vision for what they wanted the new staffing office to look like?
They had a partial vision – making it better in general, better data output – but with our guidance we were able to make this vision a reality. As an overall vision, they saw the staffing office taking on additional responsibilities related to scheduling, staffing, and timecards, and expanding the scope of the units that the office supported. However, managers that had worked with the staffing office to date rolled their eyes when this was announced. With our guidance we were able to work with them to develop new procedures that clearly outlined the roles of the new staffing office. As part of this initiative the staff in the office expanded from 1 to 5 employees. This included a Manager who was trained on the new policy and procedures.
What did it all look like when it was done?
When it was done they had documented policy and procedures that were clearly communicated to all units they supported. They had expanded their hours of operation so that they were taking the sick calls and filling the vacancies. They had grown from an office of 1 to 5 employees. They were handling the day to day staffing requests for shift trades or time off requests. They were participating in huddles throughout the day in order to have a better understanding of what was happening on the unit in order to assist with flexing staff or filling needed vacancies. They were communicating with the units when there were staffing changes. The scheduling system was being updated on a timely basis so that data fed accurately to the time and attendance system. Daily they were reviewing the timecards and working with managers to address any exceptions in order to pay employees accurately. They were the first point of contact when employees had questions about their pay. Most importantly, managers were able to spend time on strategic initiatives and patient care rather than administrative tasks.
Axsium’s traditional strength has been with workforce management systems. How much of your time and effort were spent focused solely on the scheduling system?
The scheduling system was just one component of what we changed. The majority of time was spent on working with the group to develop policy and procedures related to scheduling and the change management plan to implement these new procedures. The change management piece consisted of 2 components – training and a communication plan. Creation and execution of the change management piece was the most critical to the success of the staffing office transformation.
What was the one biggest challenge you had to overcome?
The biggest challenge was working with the former staffing office employee and managers to accept the change. The managers did not want to let go of the staffing responsibilities as they felt they are the only ones that know their employees, plus they had a lack of trust and respect in the ability of the former staffing office employee. The former staffer was challenged with taking on her new responsibilities as it felt overwhelming without support from leadership. Once the new leadership was in place in the staffing office, I was able to work with them to develop a rollout plan to get beyond this roadblock. As they began to participate in meetings, management became more receptive to the staffing office and the change in their responsibilities and roles.
What has been the most significant benefit to the hospital by going through this transformation?
They have now established a centralized service entity that exists to relieve nursing managers and schedulers from administrative duties that take them away from direct patient care. Managers can now spend time on more value added activities within their departments. This approach has improved communication between floor managers and support staff. There is reliable monitoring of expiring credentials, certifications and skills, as well as an overall consistent application of staffing practices across the medical center.
What advice would you have for other hospitals looking to make improvements in their staffing office?
I would suggest engaging Axsium to bring our experience and expertise to guide them through the process. With our assistance we can transform your staffing office to a service entity that brings value to the organization. Our guidance on developing detailed workflows coupled with a change management will be critical to the success of the initiative. A well-executed plan will ensure buy in at the various organization levels and mitigate the risk associated with the change. Effective change management will result in higher end user adoption, reduced end user support and a smoother transition to production.
