Improving patient care through safe effective staffing

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There are two pressures facing almost all developed healthcare systems. The first is the need to improve the quality and outcomes of patient care and the second is the requirement to manage tighter budgets and cost savings programmes.

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Yet when it comes to managing the healthcare workforce, history is littered with examples of organisations treating these two pressures of managing quality and cost as competing demands. This seems like a missed opportunity when we consider the workforce uniquely represents both the largest single cost for healthcare organisations as well as the frontline for quality care delivery.
The idea that investment in quality initiatives can contribute to savings or better productivity is not new. It’s just that all too often organisations approach workforce optimisation projects such rostering solely as a cost saving project, rather than a quality improvement programme that can free up staff to deliver better quality care, reduce negative outcomes and unlock savings at the same time. While subtle, the difference in emphasis reflects a misconception that increasing the quality of patient care will always lead to an increase in workforce costs, while reducing staffing costs will lead to a decrease in patient care. What this misconception fails to address, however, is that the savings made by ensuring you deploy your permanent workforce in such a way that ensures you have the right people, in the right place at the right time can have a positive impact on patient care, and productivity.
At Allocate this means e-Rostering is as much about matching skills and numbers of staff to patient needs as it is about managing time and attendance. It is about empowering frontline staff so that they are freed from unnecessary admin, releasing more of their time to care. It is about using the permanent workforce effectively, reducing spend on agency staff. To do this it is essential senior teams have a deep understanding of where the workforce is deployed effectively and where there are still inefficient practices.
As workforce legislation and industrial awards in health operate at a state level rather than under a single national framework, in-hospital practices vary throughout the country. One thing all hospitals do have in common though, is the major expense of their workforces and it is our experience that there are some common areas for executives to focus on to uncover what is working and where, as well as what isn’t and why.
The first step is to increase transparency into budget, leave, overtime and skill-mixes.
A recent Allocate Software roster assessment of hospital wards found that poor visibility into staff availability, employee skills and award constraints were common. In one assessment of a seven-day period, Allocate discovered that despite 68 unnecessary extra shifts being assigned, 10% of the duties necessary to meet patient needs weren’t fulfilled. The organisation had rostered additional staff, which increased costs, yet failed to deliver the skills to ensure improved patient care. While this was not intentional, the lack of visibility into staffing and skill gaps made effective rostering much more difficult.
Without sufficient visibility into staff availability, organisations can overspend on unnecessary shifts, agency staffing and excess overtime. Improved visibility enables the rostering manager to cost a roster as it is being created as well as evaluate the quality of the roster in terms of quality and safety. This provides the opportunity to evaluate and improve the roster, before incurring avoidable costs or unacceptable risk. Through recommended changes to rostering practices, the above-mentioned organisation saw a 49 per cent reduction in overtime, a 95 per cent improvement on the accuracy of leave entitlement recording and a 15 per cent reduction in agency costs. Each department also saved 16 hours per week in roster creation and administration. This illustrates the substantial effect that efficient staffing can have on the bottom line.
Poor workforce management can have a major financial impact on any industry –but in healthcare, the stakes extend beyond economics. A poorly managed workforce can have an unacceptable effect on patient care.
So what are the signs that an organisation is missing the opportunity to use workforce optimisation and e-Rostering as both a quality and productivity programme? Well these can vary, but board members are encouraged to pay attention to projects that solely focus on time and attendance or awards interpretation and instead ensure your programme uses these key elements as a foundation for patient demand driven staff deployment.
By enhancing visibility into staffing practices, skill-mix and budgetary implications, organisations can move beyond rostering for availability, to staffing based on clinical demand and required skills. This not only helps meet compliance and audit goals, but leads to higher quality patient care and improved patient outcomes.
Call us for more information on 1300 767 837 or email info.au@allocatesoftware.com or visit www.allocatesoftware.com/au/healthcare/resources