By Jill Bayless, CHC SVP Clinical Services
Improving a hospital’s financial performance seems relatively simple – it’s driven by decreasing costs and increasing revenue. In reality it’s quite complicated to optimize these factors while keeping quality care top of mind. One of the biggest challenges for hospitals is managing staff productivity, which means maintaining the right number and mix of clinical staff based on patient diagnoses and volume. Optimizing productivity is critically important because the cost of labor is the greatest expense for a hospital.
In our experience, almost every hospital has some room to improve staffing productivity. Here are some top-line recommendations to help a hospital department run more like a successful business.
- First of all, take a look at the numbers. Compare staffing levels to patient census information for the hospital as a whole and for each specific department. Reviewing staffing data over time will help identify trends and opportunities for improvement.
- Next, investigate the reasons for any discrepancies. Bring key players to the table – department managers, administrators and others - to discuss possible alternatives. Would shifting and flexing based on time of year or physician activity be advisable? Invite questions from everyone engaged in the process.
- Set an acceptable productivity target standard. Use the data review, input from personnel and national benchmarks to establish a standard staffing ratio for the hospital overall and for each department.
- Establish ongoing tracking system. A plan to maintain this productivity standard is critical for success. Successful hospitals make department managers responsible for meeting staffing benchmarks and for implementing flexible staffing based on patient census figures.
- Review the standard. On an ongoing basis, set up a regular time for managers and leaders to review departmental staffing guidelines and make necessary changes.
Some additional tips on staffing and productivity:
- Look at total hours paid vs. hours worked, which excludes PTO and holiday time. Hours worked is the best benchmark to use for the purpose of improving staff productivity. Each department will have a unique work standard; for example, the number of procedures in the OR, or patient census on an inpatient unit.
- Consider work process redesign. The best department managers and CNOs manage staffing levels from shift to shift and cross-train personnel across departments, especially in smaller facilities.
- Rethink span of control. It may be possible for one director to manage several departments.
- Analyze compensation practices across the organization for standardization and consistency.
- Always monitor quality of care – HCAHPS, patient perception, and employee and physician satisfaction. Examine readmissions and other quality of care metrics regularly to ensure quality of care.
- From an operational perspective, consider the potential impact of external factors. For example, if one surgeon is leaving the hospital staff, how might that affect OR staffing requirements until a new surgeon comes on board?
- Help to educate hospital board members on the potential impact that managing productivity will have on the hospital’s financial performance. In many cases, where there is marginal financial performance, a focus on productivity will allow the facility to maintain viability.
CHC offers a comprehensive assessment to help clients take an in-depth look at productivity and staffing concerns. Learn more about CHC Operational Assessment Services.