organizational resilience with workforce management strategy Sept. - - PowerPoint PPT Presentation

Advocate Aurora Health builds

• rganizational resilience with

workforce management strategy

• Sept. 24, 2020 | Advocate Aurora Health,

API Healthcare/symplr, Becker’s Hospital Review

Speakers

Mary Beth Kingston

PhD, RN, NEA-BC Chief Nursing Officer Advocate Aurora Health

Karlene Kerfoot

PhD, RN, FAAN Chief Nursing Officer API Healthcare/symplr

Margaret Gavigan

MSN, MBA, RN, NEA-BC, Regional CNO and System VP, Clinical Operations Advocate Aurora Health

Jane Dus

DNP, RN, NE-BC, Regional CNO and System VP, Nursing Education and Professional Development Advocate Aurora Health

Balanced outcomes – Financial, clinical, staff engagement, patient satisfaction, compliance

• Gains in one area impact another

Technology that supports culture and strategy

• Power of integrated time/attendance and staffing/scheduling
• Leverage analytics and mobile technology
• Go beyond nursing

Standardization of policies, processes and technology

• Enables an enterprise-wide approach

People drive success

• Shared governance that includes frontline staff
• Change management

Patient-centered staffing

• Nurse and patients matched based on patient needs and

nurse skills and availability

Building a Workforce Management Strategy that delivers balanced outcomes

Advocate Aurora Health builds organizational resilience with Workforce Management Strategy

Transformation 2025: Destination Health

Consumer First Whole Person Health

Safety Health Outcomes Growth Financial Health Anytime, Anywhere Access Personalized Experience Self Service New Care Models Consumer Health Businesses

OUR PEOPLE • OUR VALUES: Excellence | Compassion | Respect Transform the Core

OUR PURPOSE: We help people live well.

Why focus on effective staffing?

Effective nurse staffing matters to patients and families and is undeniably linked to patient safety, patient satisfaction, workforce satisfaction and safety – as well as cost savings.

Effective nurse staffing supports Quadruple Aim outcomes

Better Outcomes Lower Costs Improved Clinician Experience Improved Patient Experience

• Improves patient/client health, safety and satisfaction
• utcomes, while also improving team member satisfaction
• Ensures optimal work environment through the

implementation of best practices, infrastructure and tools

• Enables effective plan and deployment of clinical labor

resources to best meet the needs of our patients/clients

Effective staffing vision: The right nurse at the right time with the right competencies – at the right cost

Why focus

• n effective

staffing?

To build the scaffolding and structure to staff effectively across the enterprise, to better match clinical resources to patient demand at each site and improve patient and team member outcomes To account for increasing census variation, FMLA, absences, changes in patient acuity and other issues that impact daily staffing

• Team member and AHRQ Survey results from

frontline nurses had significant areas of opportunity around staffing

• Time and resources spent on addressing gaps in

schedules at each hospital site

• Fluctuations in acute care patient census challenged

leaders to staff efficiently and effectively leading to variation in results

• Inconsistent meeting of targeted nursing hours

across the system

Our opportunity and reason for action

What are we solving? Deconstructing the concept

• f staffing

• Budgeting
• Creation / Execution
• Scheduling
• Deployment
• Assignment

Four distinct processes

Advocate Aurora Health effective staffing strategies

Optimize every inpatient unit by matching nursing resources to clinical demand and the creation

• f a flexible workforce

Standardize staffing practices, procedures and scheduling workflows Optimize use of flexible workforce (float pool/clinical resource unit); create site and system infrastructures to review measures of success and ensure sustainment of improved results

• Systemwide standardization of staffing and scheduling practices and leveraged

use of scheduling software to implement optimal care models

• Standardized and streamlined the position approval process
• Created nursing budgeting principles in partnership with finance
• Synchronized scheduling time frames across the system
• Standardized job descriptions for all flexible staff and staffing offices
• Creation of site and system multidisciplinary teams (ecosystem) to ensure

effective staffing through joint problem solving of complex staffing issues, creating structure, changing processes and tracking of key metrics

Standardization to Improve Outcomes

Implementing our effective staffing vision

Site and system ecosystem unites stakeholders

Effective Staffing

Clinical Leadership Finance IT/IS HR/HR Recruitment Clinical Education

Change Management

• Leaders and staff had a solid understanding of why the change was happening
• Leader training was done to develop the mind sets, skill sets and tools so the

leaders could be effective leaders of this change

• A coalition of support among leaders of different disciplines created momentum

throughout the organization

• Resistance was identified and dealt with early in the process
• Senior leaders demonstrated their own and their organization’s commitment to the

change

• Communications were segmented and customized for different audiences
• The organization created a better “backdrop” for the next change initiative

Effective staffing change leadership results

Shared accountability for outcomes

Metrics Responsible Person

• % of time units are meeting targeted Worked HPPD
• Culture of safety staffing composite results
• Unassisted falls
• Patient mortality
• Rescue Events

Site CNE

• Nursing RN overtime hours/dollars by unit
• RN nursing agency hours/dollars by unit
• Essential shift /Report Pay

Site VP of Finance

• 1st year RN turnover
• Overall nursing turnover
• Nurse vacancy report by site/unit
• Time to fill
• Team member satisfaction related to staffing

Site VP of HR

• RN FTE on orientation by month

Site Clinical Education Leader

• Empowering accountability with analytics
• Put data in the hands of decision-makers
• Enterprise-wide visibility and transparency
• Easier to share resources across departments
• and facilities
• Facilitates standardization
• Equitable staffing and pay policies across the organization
• Integration
• Technology platform to support workforce management

Using technology to support the vision

Effective staffing vision: Stability in times of crisis

• Leveraged current enterprise workforce management

strategies (flexible workforce, staffing and scheduling standard processes, shared governance, technology)

• Leveraged the relaxation of licensing requirement to

move team members across state lines

• Reassigned more than 5,000 team members to new roles

Responding to COVID-19

System Virtual Labor Pool Command Center co-led by nursing and HR system leaders

• 24/7 online process to request and reassign staff
• Created a database of available team members
• Allowed team members to volunteer for reassignment

Orientation redesign

• Virtual nursing orientation for new hires and online program for nurse

residency

• Virtual surge orientation and education that focused on helping

reassigned nurses from OR, PACU and other areas to assist in care on medical-surgical and ICU units where appropriate

Meeting staffing needs during COVID-19

Care model and nursing practice changes

• Team-based nursing model implemented where appropriate and

needed

• 300+ nursing practice changes
• Clinical nursing practice support: Created numerous COVID-19

educational videos

Pay incentives

• Continuity pay
• COVID-19 pay

Meeting staffing needs during COVID-19

COVID-19 DASHBOARD

Team Member Experience Accelerate Innovation Foster Partnership Attract & Retrain People Expand Access Transform Care Delivery

22,000 AAH nurses impacted

Critical care onboarding 2,527 S.O.S. 944 S.O.S. ambulatory 325 G.R.O.W. participants 2,195 N.G.N.R. participants 909 AHCMG onboarding 271 PPE guide downloads 35,071 Education video views 22,618 Resource allocation CBT 15,584

Educational assist hours

25,000+

Microsoft Teams messages

3,968 Kudos count 359 Nursing students hired 173 QR code scans 1,767 Employee health hours 2,500+

Convalescent plasma PPE utilization Respiratory toolkit Resource triage team Team based nursing Screening process Created by: NEPD, 04/01/2020, Updated: 08/05/2020

as of 08/01/2020

Infection Prevention Nursing Practice Respiratory Therapy Simulation Employee Health Human Resources

Surge staffing pods

Nursing Education & Professional Development

Transparent and timely communication

• System Incident Command and collaboration meeting with

Site Incident Command (daily, 30-60 min)

• System Nursing Leadership Council calls (3/week, 60 min)
• COVID-19 Information Center Toolkit (daily updates)
• CEO and senior leadership videos (weekly)
• Team member and leader communications (weekly)
• Site and system huddles to identify issues and needs (daily)

Meeting staffing needs during COVID-19

Strength for the future

• System approach to flexible

workforce

• Identify opportunities to sustain

new skills

• Stronger relationships and

engagement with team members

• Maintain a balanced outcomes

approach

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