Hiring, credentialing and scheduling shifts are notoriously challenging for so many mid-size and smaller hospitals because of the diligence required. There are things that need to be completed by law, including an application that can run from 30 to 50 pages long. Throw in licensures, background checks, health status and peer references, and that takes a lot of time.
Largely, this is still a manual process. But it's also more than just another case of healthcare lagging behind other industries. Today's artisan-style approach to these operations also presents hospitals with the opportunity to automate credentialing, hiring and scheduling in ways that can save both time and money.
Two classes of vendors, one targeting credentialing and hiring the other focused on automation, are bringing offerings particular to healthcare organizations to market.
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Predictive analytics improve scheduling
Automation can make lives easier for managers, some of whom can spend up to 60 or 70 percent of their time trying to fill vacant shifts as opposed to rounding with patients or mentoring new staff.
Avantas, AMN Healthcare and Shiftboard are among the players trying to change the rules to that particular game. Avantas touts its use of predictive analytics, using embedded forecasting to create a shift in how managers are thinking about staff.
In a manual process, they rely largely on intuition to know what the volumes are and how to craft the staff schedules. But two hours before the start of a shift they're often scrambling because something's changed, or someone has been called off the unit.
An automated approach using predictive analytics can often project 120 days in advance of a shift what the demands are going to be, what the availability of the staff will be and how that aligns with workforce demands.
Avantas President Jackie Larson said the team collects historical data that managers can tap into to predict 96 percent of the time what the staff targets will be 60 days out.
"They're creating anywhere from 1,000 to 2,000 different models based on time series modeling. They're creating exploratory models validated before and after," Larson said.
Avantas then refines those models based on what actually happened to adjust projections going forward, which Larons described as the continual refinement of the algorithms.
"The model is able to essentially digest the new information and assess whether that's a legitimate trend," she said. "Or the model can also say, 'This looks like it's an anomaly, but we're going to continue to watch it in case there's enough validation on it that will warrant a change.'"
With clinician shortages in the workforce these days, the number of time hospitals are spending on administrative details can be wasteful. It's time that would be better spent taking care of patients, and and that's what automation does: free up time so clinicians can focus on what's going to drive patient care and quality, and improve both patient and staff satisfaction.
Larson estimated that automating scheduling can result in an organization saving 4 to 7 percent annually on their labor spend. Managers at University of Kansas Hospital, one of Avantas' clients, used to spend 13 hours creating a schedule; that's now down to 6.
"Healthcare is fairly conservative," said Larson. "Sometimes it's really hard to think about a different way of doing things. We need to have a good support network -- knowing what to do, how to do it, and when it gets hard, knowing they have a network of individuals they can reach out to so they don't revert to old practices. It gets hectic. That's what clinical life is."
But even before scheduling becomes an issue, hospitals need to hire and onboard those clinicians in the first place.
Automating hiring and credentialing
The Greeley Company, Newport Credentialing and SkillSurvey are helping healthcare providers to start automating hiring and credentialing to streamline and ultimately accelerate the processes.
SkillSurvey CEO Ray Bixler, for instance, said that once his company built its first peer referencing application, it reduced clients' peer referencing processes from several weeks to just three days.
If a doctor is filling out a potential employer's application, they need to fork over some personal information, work history, degrees, where they graduated, what they'd like to accomplish once hired. They need to divulge their licenses, their certifications. It's a lot of information, and the credentialing team needs to sift through all of it.
"Once that's done, the person's still not credentialed," said Bixler. "Hospitals have these department chairs and committees that meet, and they generally don't meet more than once a month. So if the credentialing process isn't complete, it could be another 30 days. That is how the market has been served, and how it's been doing this job for decades."
With a more automated approach, the process becomes akin to using TurboTax in that software guides the credentialing team along.
"A doctor that can't get credentialed isn't going to service anybody," said Bixler. "Patients aren't getting serviced when positions aren't getting filled. And of course, the hospital feels the impact because now they're not generating revenue."