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Streamlined Staffing: Taking the Guesswork Out of Labor Allocation

January 27, 2015
by John DeGaspari
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In an industry where staffing is crucial to patient care, better agency management and automated scheduling provide the best match
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At a time of continual change in the healthcare industry driven by an evolution in regulations, care delivery, and payment models amid rising demand for healthcare services, human resources professionals will be expected to do more with less.

That’s one conclusion of a survey on healthcare HR initiatives released last year by the American Society for Healthcare Human Resources Administration and HealthcareSource, a talent management solutions vendor. According to that survey, which polled over 500 HR professionals at healthcare organizations across the U.S., nearly three-quarters of respondents named streamlining HR processes as their top initiative for reducing costs. Furthermore, inefficient systems and inadequate technology were cited as among biggest barriers to achieving their HR goals.

Almost by definition, automating HR processes can help relieve some of these pain points. Implementing technology can make a difference not just in the bottom line, but also in standardizing processes within a provider organization, increasing efficiencies and providing transparency for employees. To be sure, those changes can’t be expected to happen overnight, and sometimes require difficult cultural changes.

Is the effort worth it? What follows is the experience of two major health systems—one to standardize its dealings with contingency staffing agencies, and the other that is in the early implementation scheduling software, with the ability to predict staffing requirements. 

Bon Secours Simplifies Contingency Staffing

Bon Secours Hampton Roads operates three acute-care hospitals, two long-term care facilities and two assisted living facilities in Virginia. It is part of the $3.3 billion Bon Secours Health System that encompasses facilities in six states. Overall, the Bon Secours Health System makes use of more than 50 staffing agencies to fill both per diem and long-term shifts, including both clinical and non-clinical positions.

Several years ago, Bon Secours Health System decided to address concerns of its local health systems around contingency staffing and working with outside agencies.  In 2008, it decided to implement a vendor management system (supplied by ShiftWise, Portland, Ore.), and piloted the program at the Hampton Roads health system.

Helen Anderson, administrative director of HR at Bon Secours Hampton Roads, explains that, at the time, chief nurse executives struggled to track agency hours, and often were not certain which agencies the hospital had contracts with. “It was not a well-oiled machine. It was dysfunctional, paper-intensive and time-intensive. We were frustrated, the agencies were frustrated, and it was not a feel-good for anyone,” she says.

Initially, the solution was implemented for the contingency nursing staff, which accounted for 77 percent of the labor job type usage, according to Anderson, who coordinated the rollout there. Since its initial rollout, the vendor management system has been expanded to other areas, including allied clinical areas such as radiology.

Anderson says that using an automated vendor management system has streamlined the organization’s dealing with agencies by standardizing its processes and providing transparency for both the hospitals and the agencies.

For example, Anderson’s team identified an orientation packet that it uploaded into the vendor management system, which outlined the organization’s code of conduct, expectations and requirements. These so-called prerequisites, as well as a background check, are taken care of before the agency person is approved, Anderson says. She adds that the agency is aware of hospital’s expectations and takes the responsibility of ensuring that the person meets those expectations before being placed on a shift.

She notes that this gives a level of comfort to the nursing executives, as well as human resources executives, that the contingency person hired has met the same expectations as regular hospital employees. It has also streamlined the auditing process when the hospital is visited by regulatory agencies. Pulling the profile on a contingency employee is simple and can be done in minutes on the computer, she says.

One of the most significant advantages of the vendor management system is that contracting has been standardized, Anderson says. The hospital now hires contingency labor only through contracted agencies that are entered into the system.

Three Migrations Of Vendor Management

According to Anderson, implementing the vendor management system has been an iterative process. She explains that the Hampton Roads health system has gone through three “migrations,” by which it has streamlined its process of working with agencies. During the first phase, it uploaded 14 agencies into the system, all of which had signed contracts. “We tried to minimize the number of agencies we worked with to have better relationships and build better rapport with them and vice-versa,” she says. This put the agencies on a level playing field: all had to meet the same expectations to place an employee.

In the next migration, it identified the three top agencies that gave Hampton Roads the most personnel and met certain quality measures, such as fill rates, time to fill and staff performance. Those three agencies were designated “first tier” agencies, and were offered a deal that they would be given first preference to fill a position, at a slightly reduced hourly rate, which would be made up for in volume. “That was beneficial, because they continued to give us quality people, the relationships with those folks increased, and we knew the types of people we were getting. It was a great win-win,” Anderson says.