Becker's Hospital Review

29 CMO / CARE DELIVERY Nurse self-scheduling makes a comeback By Mackenzie Bean S elf-scheduling has emerged as an increasingly popular option for hospitals and health systems to provide nurses with greater flexibility. However, the concept is not entirely new. Self-scheduling was first documented at London-based St. George's Hospital in 1963, according to a 2007 study published in the Journal of Nursing Management. In the 1980s and 90s, the practice gained popularity in the U.S., alongside the rise of Magnet organizations, according to Jennifer Mensik Kennedy, PhD, RN, president of the American Nurses Association. ough the American Nurses Credentialing Center created the formal Magnet Recognition Program we know today, its roots tie back to research from the American Academy of Nursing. In fact, the academy first coined the term "Magnet" in the early 1980s to describe hospitals that could successfully recruit and retain nurses during a national staffing shortage, according to research from Sacramento, Calif.-based UC Davis Health and e Journal of Nursing Administration. At the time, these hospitals likely recognized self-scheduling as a valuable strategy to increase nurse satisfaction and retention amid a competitive hiring landscape — a recognition strikingly similar to one health systems are making today. While it's difficult to form a definitive answer as to why self- scheduling's popularity faded at the turn of the century, one theory is that nurse leaders may have sunsetted the practice aer finding it to be too complicated to set up and manage via paper scheduling processes, according to Dr. Mensik Kennedy. Another theory is that the prevalence of self-scheduling may have dwindled as the available supply of nurses increased, allowing hospitals to be more rigid with their staffing and scheduling models. "My guess is that at times when there was an abundance of nursing staff, potentially management had more ability to take harder lines and maybe were more interested in business needs and less interested in staff autonomy," said Alicia Potolsky, DNP, RN, associate chief nursing officer of Mountain View, Calif.-based El Camino Health. Today, nurse leaders are highly focused on creating healthy work environments that promote flexibility and employee satisfaction. As part of this effort, El Camino Health is preparing to pilot nurse self- scheduling in two units this fall, with future plans for expansion. No national data exists to quantify how many hospitals and health systems are now using nurse self-scheduling capabilities, but anecdotal evidence suggests the practice is seeing a resurgence, driven by the rise of electronic scheduling systems and young nurses' demands for more flexibility. "I do think it's surged in recent years," Dr. Mensik Kennedy said. "Nurses are more satisfied when they self-schedule — period. It gives them a voice and freedom to make their own decisions. It increases their own control and flexibility." For nurses managers, self-scheduling is also a win-win, she said. e practice allows them to spend less time scheduling and processing change requests and more time on needle-moving activities such as rounding or mentoring staff. e practice can also decrease absenteeism since staff members are setting their own hours. n CHS' nurse retention rate at 'highest level in a decade,' says CEO By Alan Condon F ranklin, Tenn.-based Community Health Systems has hired almost 3,000 registered nurses during the first half of 2024 and its nurse retention rate is "very strong at its highest level in a decade," CEO Tim Hingtgen said July 25 during the company's second-quarter earnings call. In 2023, CHS added more than 1,000 bedside nurses as part of its centralized clinical recruitment program, which has expanded to include allied health positions in areas including imaging, pharmacy, lab, respiratory and surgical services. "Across these positions, hiring is up by more than 14% year-over-year," Mr. Hingtgen said. "Other facets of cost management have been an area of strength this year with contract labor, supplies and other expenses trending down in the second quarter. Innovative solutions to improve care delivery in our business operations are another area of specific focus." The 71-hospital system is also focused on graduating and recruiting nurses through its education partnership, which is expected to graduate 1,000 new nurses a year. CHS' contract labor costs were down about $3 million sequentially to $45 million and down $29 million (39%) from $74 million in the second quarter of 2023. "This decrease in contract labor was slightly better than our expectation of contract labor remaining at approximately $50 million per quarter for the year," CFO Kevin Hammons said. "We are pleased with the continued progress that reflects our recruitment and retention efforts along with lower hourly rates for contracted nurses." CHS reported a $13 million net loss in the second quarter, compared to a $38 million net loss during the second quarter of last year. n

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