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Getting on Schedule

December 1, 2007
by David Raths
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Hospitals are dumping manual scheduling for automated systems that tie into other HR software

Jared peterson

Jared Peterson

At many hospitals, the complex task of scheduling the right mix of nurses for each shift involves drawing up plans on a large erasable whiteboard. But with healthcare executives pushing for greater productivity, those whiteboards are rapidly being replaced by scheduling software that ties into time-and-attendance and payroll systems.

“It's always been a difficult task in nursing to make sure you have the right mix of staff for every shift,” explains William Ware, director of decision support services at Henry Medical Center, a 215-bed community hospital in Stockbridge, Ga. Scheduling software is appealing because it promises to automate the process of calculating optimal staffing for all departments by shift, while also cutting down on the time managers spend developing schedules.

A few years ago, executives at Henry Medical Center decided they wanted to treat the hospital's systems that involve labor management as a connected suite of products. Previously the hospital had used Kronos Inc. (Chelmsford, Mass.) software for time and attendance and Siemens Medical Solutions (Malvern, Pa.) for payroll. For scheduling purposes, hospital IT employees would download data from those systems into a Microsoft Access database, but “it wasn't an elegant solution,” Ware says.

In 2006 Henry replaced those systems with products from API Software Inc. (Hartford, Wis.) and added API's ActiveStaffer scheduling module. “It was important that all three feed data smoothly to each other, so getting all three from API made sense,” Ware says. The software includes a self-scheduling feature, which allows employees to choose which shifts they'd prefer. Ware is working on feeding patient census counts from the hospital's Siemens system into the staff scheduling software so that nursing administrators can do real-time needs analysis.

Like Henry Medical Center, many hospitals are looking for workforce management suites of software, says Jared Peterson, vice president of research operations at healthcare technology research firm KLAS Enterprises LLC (Provo, Utah). He estimates that only 30 to 40 percent of hospitals have already adopted some form of labor-scheduling software.

Peterson adds that some of the vendors in the scheduling software niche are coming at it from a financial background while others have experience in clinical areas. “If the vendor is coming at it from the clinical side, the product might have lots of features that appeal to the chief nursing officer,” he says, “but if that person makes a purchase decision independently, it may fall to people in IT to grapple with integration issues with HR and payroll systems, so you have to be sure nursing and IT are on the same page.”

Robert Blake is convinced his enterprise couldn't exist without automated staffing software. The system executive of Memorial Hermann Premier Staffing in Houston manages a large internal float pool for a 10-hospital system with 3,500 licensed beds.

Developed seven years ago to cut down on the use of contract labor, the internal agency has grown to 1,300 staff members who handle 90 percent of the variable labor in the system. “It would be impossible to do this without the software,” says Blake, who has been using RES-Q Labor Resource Management, a Windows-based program from RES-Q Healthcare Systems (Calabasas, Calif.) since the agency's creation. “All the nursing units throughout the Memorial Hermann system use it and can access it 24/7,” he says.

Blake notes that the software speeds up communications. “It offers the ability to grant access to two people in different locations,” he says, “so both can go in and look together at a staffing situation and make decisions together.”

Blake gives RES-Q high marks for interoperability with other HR systems, a feature he called essential. Information from a customized central HR system and its time-and-attendance module is downloaded automatically into RES-Q every day, so he can see, for instance, if someone was tardy. Blake also likes that the software can act as something of a backstop. For instance, the system will not allow the administrator to schedule a person whose license isn't active or whose CPR card isn't updated.

Blake would like to add a self-scheduling feature. He also is interested in products that offer predictive analysis. “All of the products used for scheduling do the same basic things,” he says. “It's become something of a commodity at this point.” He'd like vendors to offer a product that takes data from various points in the hospital and feeds it into an algorithm that would help predict needs going forward. “For instance, data about the diagnoses of people in the emergency room, intensive-care unit and operating rooms would give us a better idea of what our staffing resources in the medical-surgical unit is going to be in the next two to three days,” he says. “That would be really valuable.”

Blake's advice to other large hospital systems starting such an implementation is to push to make all departments adopt the software concurrently. “Don't allow one department not to participate,” he suggests. “Afterwards, they'll ask themselves why they put up resistance. The benefits are mammoth, from my experience.”