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2 Question: What are some of the biggest issues hospitals/health systems face regarding workforce management and staffi ng? Wendie Carlson: Attracting and retaining experienced nurses re- mains a critical challenge. Retention issues are most signifi cant in the fi rst three years of employment. The younger generations are focused on quality of life and don't want to work evenings, holi- days and weekends. Mandatory overtime is often a deal-break- er. Additionally, they are looking for more rapid career progres- sion, development opportunities and upward mobility than their baby boomer counterparts did. New graduates coming out of nursing schools are increasingly less prepared to take on fast-paced, high-stress and high-acuity clinical challenges. Consequently, greater investment in orienta- tion, education and training is needed for new graduates, placing additional fi nancial burden on healthcare institutions. The fact that healthcare is an industry that lacks change agility is a signifi cant challenge considering how rapidly the environment changes. The impact of technology on clinical processes and ef- fi ciencies is also profound. Cyndy Dunlap: One of the biggest issues that hospitals and healthcare systems have is the need for workforce metrics that are not only real-time, but also allow for predictive modeling. With that tool, organizations can see what their current, day-to-day needs are and can maintain proper staffi ng levels, as well as use the analytics to predict their staffi ng needs for weeks, months and even a year into the future. Having that ability to forecast work- force needs helps us create a robust staffi ng plan. Alex Wells: I would say retention of clinical staff is one of the big- gest issues. With declining reimbursements, we all are trying to control and reduce variable costs and the most opportunity to do so is in labor. For a small hospital, trying to attract and keep clini- cians is diffi cult in today's healthcare job market when clinical staff have so many opportunities to shop their services. It's diffi cult to compete with larger systems' pay rates, so we attempt to make that up with more fl exible, consistent staffi ng. The challenge is trying to maintain unit costs where you need them to be as patient volumes fl uctuate. Our central staffi ng offi ce has really worked hard to develop pro- tocols with our department directors to make sure we are comply- ing with regulatory ratios without overstaffi ng the units. Q: With the workforce typically accounting for over half of hospital operating costs, how do you work across the C- suite to strategically leverage staffi ng resources? W.C.: Collaboration in the C-suite is more critical than ever — we talk about staffi ng and workforce management strategies regular- ly, if not daily. Also, fi nancial pressures impacting our industry are signifi cant — primarily due to changes in reimbursement models, lack of coverage expansion in our state and the pressures related to compliance, regulatory issues and value-based purchasing. Consequently, productivity and staffi ng models are analyzed and discussed regularly. Currently, there is much discussion about the mix of staffi ng in nursing in our institution. C.D.: Healthcare organizations — whether they are systems or hospitals — must have practices in place to look at how the staff is being allocated across the division or system on a daily basis and to ensure they have the right staff at the right places at the right time. They must also be able to create fl exibility in the workforce that allows for creativity to support the hospital or clinic's capabil- ity to match their volume. A.W.: As a small hospital, we constantly have to ask our employ- ees to wear multiple hats. It's just the reality that we must do more with less, and our employees at ECRMC do a great job. At our weekly C-suite meetings, we constantly talk about new and pend- ing tasks, projects and the staff labor required to meet those chal- lenges. We try to fi nd resources within the organization before go- ing outside the organization. Of course, the cost-benefi t equation is always part of those discussions. Q: What outcomes do you focus on achieving with your workforce management strategy? W.C.: Although there are many outcomes on which we focus, im- provements in the following four key areas are especially impor- tant: patient satisfaction, employee engagement and retention, clinical and quality outcomes, and fi nancial performance. C.D.: The purpose of creating a robust staffi ng plan and workforce strategy is to support our top organizational strategies, which in- clude improving quality, improving patient and staff safety, and ensuring positive outcomes for our patients and their families. For instance, our organization looks at patient falls that result in injury, hospital-acquired infections and various 'never events.' To avoid a lack of performance in these areas, we need to make sure we have a foundation in place for a supportive workforce plan. A.W.: At ECRMC, we are always looking for ways to make our employees feel appreciated for the work they do. Worker satis- faction is a major driver of productivity, so we do all we can to make sure our employees are fairly compensated, recognized for extraordinary work and, just as important, we listen to their con- cerns. We have several committees comprised of a cross-section of the hospital staff that give everyone the opportunity to discuss issues which they would like executive management to address. Q: A growing body of research is connecting the impact of overtime with outcomes like patient satisfaction. How does your organization align your workforce strategy with patient outcomes? W.C.: Years ago, when The Joint Commission required a focus on staffi ng effectiveness, we started measuring patient safety issues (like falls or falls with injury) relative to mix of staffi ng, overtime hours and other workforce issues. That practice has continued and evolved over the years. Sponsored by: That's how workforce management solutions help you connect productivity with care. apihealthcare.com/executives-talk-patient-satisfaction to see how our services help you spark success. Healthcare Corporation. All rights reserved. MANAGEMENT WORKFORCE MANAGEMENT

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