Always a key element of healthcare, appropriate nurse staffing is becoming even more important as the industry payment model shifts from reward for high volume toward one that emphasizes efficiency and quality of care.
"Now, nursing has a significant impact on revenue," said Susan Reese, chief nursing officer at Kronos, a workforce management software firm based in Chelmsford, Mass. "If nursing does a good job and the patient has a good outcome, potentially the revenue stream increases."
Long gone are the days of scheduling 25 nurses on a unit whether or not they were truly needed. Today, healthcare managers are turning to tools such as the Kronos for Healthcare suite and MedAssets' Workforce Solutions to better manage staffing, scheduling and labor analytics needs.
With the Kronos Opti-Link program, for example, staff on the floor enters patient data into the system, and within hours managers see how staff is matching up, both in terms of patient volume and care needs.
"The customer can really start refining their staffing techniques to find exactly the staff they need," Reese said. "They can better define their workload and match staff appropriately to really rein in labor costs."
Not to mention meet their regulatory obligations. Such staffing tools are critical in California, where state law requires hospitals to maintain a nurse-to-patient ratio of 1:5.
"We admit 78 percent of the people we see in the (emergency department). That's our front door," said Kathy Wojno, chief nursing officer at Hollywood Presbyterian Medical Center, a 434-bed facility in Los Angeles. "If I'm not within the ratio, I have to close the ED."
For the past seven years, HPMC has used MedAssets' Workforce Solutions to manage its combined staff and agency nursing pool of 600. MedAssets' WFX tool allows HPMC to match nurses to patients who most need specific nursing expertise. The tool simplifies both long-term scheduled needs, such as staff vacation, as well as rapid-response situations, such as covering for those who call in sick. In addition, Workforce Solutions provides support with vendor management, agency strategic sourcing and workforce optimization.
Not that there are any truly simple solutions. In retail or manufacturing, for example, managers can look back at data from a period that is traditionally busy or slow and staff accordingly. Hospitals rarely have that luxury.
"In a hospital setting, workforce management at the point of service is very chaotic," said Kathy Baker, the director of nursing management, emergency department and transport services at Virginia Commonwealth University Medical Center in Richmond. VCU's medical-surgical unit, for example, serves on average 595 patients on a given day. One recent day, Baker said, that number spiked to 655. "Kronos helps you get organized in a systematic way that improves the probability that you'll manage the real-time, day-to-day chaos appropriately."
The Kronos suite is also useful when making large-scale labor management improvements, said Kathye Habig Nippert, vice president of workforce management at Cincinnati-based Catholic Health Partners. CHP is Ohio's second-largest healthcare system with 29,000 employees and 24 acute-care facilities. Over the past four years, CHP has realized $13.5 million in savings using Kronos tools to standardize measures such tracking work hours and activities, refining vendor management and developing highly detailed reports.
"It's a journey, and it's not easy to get a handle on these issues," Habig Nippert said. The tools "provide more clarity to the data and help you organize it. It's key to getting your data refined and finding opportunities to address."