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Will Affordable Care Act Ultimately Result in Greater Contract Labor?

Posted by Tim Teague on Tue, Jun 21, 2016 @ 02:32 PM

Two of the driving tenets of the Affordable Care Act are the push for better patient outcomes and reduction of costs. Since labor spend accounts for the largest percentage of acute care expense, it is a prime target for cost cutting.

 

This presents a conundrum for the hospital. How to cut labor costs while improving the quality of care (decreased re-admission rates).  A corollary to this dilemma has been the “just-in-time” staffing models the industry has used for years.  The difference is while a manufacturer can judge work in process by the amount of incoming orders, the healthcare industry has not been able to predict the number of orders (average length of stay) in a reliable manner.

 

Peter Drucker, foremost business analyst declared just before his death in 2005 that “increasing the productivity of knowledge workers was the most important contribution management needs to make in the 21st century.” The question here is how can data be used to transform the healthcare industry to both decrease costs and improve quality?

 

The answer is equal parts simple and complex. There is enough historical data from millions of hospital admissions across the country to fine-tune a census model that provides extremely accurate daily figures for a unit-by-unit count. Several firms have been working on the analysis of these figures for years. In the same way the electronic medical records have grudgingly made their way into our healthcare system, strategic census models will soon be the norm.

 

When this data becomes granular for hospital systems, the current models for large scale census predictors will become extinct.  This new model for just-in-time staffing will finally provide a day-to-day, week-to-week picture of labor needs. Fine tuning the levels of FTE’s will become better, and non-fixed-cost labor will boom.

Tags: Affordable Care Act, Staffing Agency, Affordable Healthcare Act, Contract Labor, staffing

Float Pools- Are they working the way you expect?

Posted by Tim Teague on Fri, Dec 11, 2015 @ 10:51 AM

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If your float pool or staffing bank is not providing the results you need, you are not alone. One of the great challenges in the acute care setting is the ability to meet the challenge of daily staffing expectations. Two of the major drivers in this challenge can be the random “call-offs” in an already short-staffed cost center, coupled with a census that is becoming more and more volatile.

From a budgetary perspective, what I call “just-in-time” decisions for staffing don’t seem too onerous on that day, but as days turn to weeks, and weeks to months, these daily “quick fixes” can grow out of control.

Just as I tell my kids to scrape the last bit of peanut butter from the jar before throwing it away, too many staffing departments are “buying” new jars before they have truly utilized what is available.

The solution to maximizing a float pool is most often a technical solution. There are a few basic questions that can determine if the float pool is really being maximized.

During the development of the pool, were all affiliated offices, facilities, and units informed of the intent?

  • Are there any “crossover” competencies from participants that might be of use? (Maybe an L&D nurse has had come ED experience.)
  • Is there a true “search and find” function that quickly uncovers all possible matches that include-
    1. Availability (granular down to the hours available)
    2. Matching competencies
    3. Current credentials
    4. Location (within established distances)
    5. Prior experience and amount of time worked (if any) in the requesting unit.
  • Is there a true “interactive” system of delivery and response to needs that incudes text message response to accept or reject?

We find that those facilities that are answering “yes” to these questions are truly “getting every last bit of peanut butter” from the jar and are maximizing available resources while minimizing cost.

Tags: Healthcare, medical staffing, VMS, hospital float pool,, staffing