Optimizing electronic health records (EHRs) can improve clinical efficiency and many organizations rely on outsourced medical transcription services to achieve this goal. However, clinical workflow optimization also depends on efficient staff scheduling and workforce management. This is even more important as the nation is facing a provider shortage. Diligent workforce management is crucial to cutting hospital/practice operating expenses and improving care delivery.
Efficient workforce management is a priority for all industries and healthcare is no different. A joint survey from the Healthcare Financial Management Association and Navigant reported that healthcare executives predict labor budget increases and continued shortages of physicians, nurses and mental health providers. Among other things, diligent labor management was named a top priority area. The Healthcare Finance report on the survey cites Danielle Dyer, managing director of Navigant, as saying, “The need to more effectively manage labor by staffing to demand will only intensify as operating margins continue to diminish, and as the pressure to enhance care quality and efficiency increases. These results magnify the need for provider leadership to objectively analyze their current practices to better staff departments and meet dynamic patient volumes”.
According to Patient Engagement HIT, organizations can better manage provider shortages by focusing on a better staff scheduling strategy, creating incentives for new hires, and utilizing non-physician clinicians. One widely recommended solution is collaborative staffing. Under this model, hospital staff can view open shifts that they are qualified to work across multiple units and facilities. It empowers employees by allowing them to work with managers to fill open shifts based on their skills and preferences, and the patient’s best interests. The collaborative care model allows healthcare organizations to leverage underutilized resources, prevent use of more costly resources, improve staff engagement and satisfaction, and optimize staff scheduling.
Healthcare Internet of Medical Things (IoMT) or digital health solutions can optimize staffing and workflow. A www.healthcare-informatics.com article points out that even a basic IoMT solution can collect and collate data on staff location and expertise, patient acuity and location, and availability and location of critical diagnostic and therapeutic equipment. Using analytics, managers can leverage the data to improve workflow and make better staffing and scheduling decisions so that the right people are assigned to the right places, improving care, patient satisfaction and staff morale.
In a www.outpatientsurgery.net article published December 2018, Leslie Mattson, RN, BSHM, a nurse consultant with ALM Surgical Solutions in Atlanta, GA offers 8 tips to ease staff scheduling in these surgical centers:
- Assign routine late days in advance for unexpected late days when cases exceed scheduled times, or for a late add-on case
- Provide differential pay to acknowledge extra time
- Flex time in and out based on volume, role, and patient arrival and discharge times
- Pay PRN staff incentives for extra work and better availability during holidays, when staff shortages can occur
- Have a plan for a month or 3 months to overcome challenges that can occur due to scheduled outs or increased staffing needs
- Schedule staff meetings to review staffing challenges and discuss solutions.
- Arrange lunch on busy days.
- Mentor and train the right person to support the future staffing leadership needs
Other tips to improve staff scheduling:
- Use shift templates to create a schedule once and only fill in missing shifts as they occur
- Allow staff to make their availability known so that the best person available can be selected for each shift based on their skills
- Let staff to swap shifts
- Inform staff of schedules in advance using multiple means, including scheduling software
The Institute of Healthcare Improvement (IHI) recommends organizations identify trends in patient traffic and reorganize their provider schedules by reviewing their provider supply and patient demand for both in-office appointments and phone call or secure message consultation. According to the IHI, patient traffic should be tracked on a daily or weekly basis, as well as on a seasonal basis as flu season, allergy season, snow-bird season, and school physicals when there is an increase in demand for appointments.
In a report published in 2017, Cerner Corporation provided several instances of how providers implemented commendable staffing solutions, “putting the right care giver, in the right place, at the right time”. At Banner Thunderbird Medical Center (BTMC) in Glendale, Arizona, better EHR documentation has led to data-driven business decisions. BTMC used Cerner’s Clairvia, an integrated patient-centric and outcomes-driven software suite, to adjust BTMC’s staffing based on the needs of individual patients.
Nurse management at Children’s Hospital Los Angeles (CHLA), the first and largest pediatric hospital in Southern California, implemented a workforce management tool that could calculate a patient’s acuity based on information captured in the EHR. The solution provided nursing staff of changes in patients’ statuses, allowing nurse managers to remodel staffing to meet the needs of individual units.
The more data available, the more proactive hospitals and health systems can become. In the above instances, clinical documentation within EHR systems allowed nurses to classify patients. Medical transcription outsourcing plays a key role in getting the care patients need documented accurately and in a timely manner in the EHR.
