Becker's Hospital Review

12 | 5 Staffing Strategies for Engaged Nurses Better Patient Outcomes SOLVING STAFFING CONUNDRUMS: A SYSTEM-WIDE DOMINO EFFECT Written by Max Green, Writer/Reporter S taff scheduling is an ever-present headache in hospitals and health systems of all sizes. Facilities incur major financial expenses and opportunity costs crafting schedules that account for staff availability, qualifications and the budget and needs of the facility itself, among other things. The hurdles resulting from staffing conundrums are attributed to inefficient systems negatively affecting morale, patient outcomes, and ultimately, reimbursements. But new technologies are allowing for improved scheduling that can create a domino effect across a system, resulting in cultural shifts within hospitals, improved outcomes and significant savings, according to Karlene Kerfoot, PhD, RN, chief nursing officer for API Healthcare, a GE Healthcare company. "If you look at the way staffing has been done traditionally, it has been on paper and pencil and spreadsheets," Dr. Kerfoot says. "Further back than that in staffing offices you'd see little yellow stickies or magnets on the wall." In the past, scheduling managers or nursing administrators would physically move the magnets or pieces of paper that represented different staff members to create a schedule. The next evolution of these clunky, analog systems was the spreadsheet, which is more sophisticated than a wall chart but still not equipped to solve major scheduling issues or account for the complexities that arise from managing a large staff. "The problem is that wall boards don't think and spreadsheets don't think," Dr. Kerfoot says. "They don't give you data to really look forward to see what's happening and look backward to see what happened, so you're limited to a very primitive way of doing things." In recent years electronic recordkeeping in healthcare has become the standard, with approximately three-quarters of all physicians adopting some type of EHR to better manage patient care and data. But for whatever reason, staffing procedures and scheduling systems have often been left in the dust, relegated to inefficient sticky notes on a wall or cluttered Excel spreadsheets. This problem is only compounded when mergers and acquisitions come into play. "For systems that are acquiring five hospitals, 10 hospitals, surgery centers and so on — there could be a huge variety in the way people do staffing and scheduling, all the way from paper and pencil to one or two different scheduling systems that don't talk to each other," Dr. Kerfoot says. "The administration can't get a view of the entire system, including staffing, quality and finance, with those tools." For Tulsa, Okla.-based Hillcrest Healthcare System, a six-hospital system with more than 6,000 employees and 1,800 physicians, staffing needed to be streamlined following a merger. API Healthcare's ShiftSelect technology not only addressed immediate staffing needs, but anticipated new problems before they arose. Paring down to a single staffing system Jennie Bible, RN, director of the Hillcrest Health System Resource Team, witnessed complications in managing staff scheduling since the beginning of her career. With more than 30 years of practical

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