Workforce Management Strategy is Delivering Results for Legacy - - PowerPoint PPT Presentation

How a Patient-Centered, System-Wide Workforce Management Strategy is Delivering Results for Legacy Health

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3

Karlene Kerfoot, PhD, RN, NEA-BC, FAAN

Chief Nursing Officer API Healthcare

Danielle Bowie, DNP, RN, NE-BC

System Director of Clinical Resource Management Legacy Health

Legacy Health

Danielle Bowie, DNP, RN, NE-BC

System Director of Clinical Resource Management

This is Legacy Health

Northwest Regional Integrated Delivery System with revenues of 2 billion+

• 13,500+ employees
• 4200 nurses

8 Hospitals

• Regional trauma/burn center, specialty surgical, pediatric,

behavioral health and community based hospitals

• 64,000 Discharges
• 290,000 ED visits
• 42,000 Surgeries

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This is Legacy Health

• 108 ambulatory settings

– 795 provider multispecialty group – 1.1 million Ambulatory Visits

• Joint ventures in outpatient

surgery and urgent care

• Retail pharmacy
• Cancer Center
• Hospice
• Regional Laboratory
• Research Institute
• Health plan

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Legacy’s Integrated Workforce Strategy

How a Patient-Centered, System-Wide Workforce Management Strategy is Delivering Results for Legacy Health

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Legacy Nursing Workforce History - Background

• Centralized staffing office developed in the late 90’s
• Centralized staffing for inpatient departments utilizing

a common technology platform

• System Wide Resource Pool - specialty based
• Centralized contract labor management

Issues

• Enterprise technology platform had

high variability of use amongst nursing units

• Unit centric control and decision making
• No acuity system or daily productivity

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Legacy Health Reset

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• Staffing and Scheduling

126 inpatient nursing units, 5000 end-users (June 2016 – October 2017)

• Open shift notification

60 inpatient nursing units, 3500 end-users (December 2016 – August 2017)

• Mobile time management app (All Legacy Health)

(October 2017)

• Business Analytics

126 inpatient units (May 2018)

• Patient Classification

46 inpatient nursing units (March 2018 – November 2018)

Legacy Health Nursing Workforce Project Overview

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Legacy Health Nursing Workforce Technology Integration Plan

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• 2. Staffing and

Scheduling Integration

• 1. Time and

Attendance

• 3. Broadcast

to Work (recruitment)

• 4. Patient

Classification (acuity)

• 5. Business

Analytics

• 6. Attendance

Plus

Integrated Workforce Goals & Outcomes

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Staff by acuity – Future work Workforce data & analytics Standardization

• f workforce

technology and workflows End user engagement and adoption

End User Engagement Strategies & Outcomes

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Strategies for Staff Engagement

Shared Governance

• Four-day 3P event to re-envision nursing workforce management-

(75 system-wide representatives) July 2015

• Governance and workgroup developed-

(See next slide) September 2015

• System-wide work group for selection of workforce technology products-

(30 members) Feb 2016

• Rapid Process Improvement for Staffing and Scheduling Policies

(45 representatives) July 2016

• Pilot Phase- Every implementation had pre and post-go live user meetings

to test build, workflows and receive feedback

(over 75 meetings) December 2016 – October 2017

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Organizational Structure

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Executive Steering Committee

• System CNO
• CNIO
• System Director of Clinical Resource Management
• Nurse Executive Council/Hospital CNO’s

Project Team Core Work Group

Responsible for project team deliverables. Attendees are representatives from…

• 3P event
• System wide staffing committee
• Unit based staffing committee

Broad Support Team

• Site based “Staffing Committee” frontline reps
• Site based “Staffing Committee” dept manager reps

Frontline Nursing Staff and Nurse Managers

• Operational Business Owner
• Manager of Central Staffing Office
• Functional System Administrator:

IS, Staffing Application Specialist

• Project Manager
• Training Coordinator: Nurse Educator
• Trainers: Staffing Specialists

Work Breakdown Structure

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Core Work Group

Made up of representatives from…

• 3P event
• System wide staffing committee
• Unit based staffing committee

Responsible for Project Teams

IS Design and Implementation

Deliverables

• Software selection
• Design
• Implementation

– Order – Staff Edu – Mgr Edu – Reports

Team Leads: Project Team Member & Nurse Rep Deliverables

• Review policies
• RPI to develop core guidelines
• Recommend decision points

– System – Unit – specialty

Guiding Principles

Team Lead: Nurse Leader

Leadership Education

Deliverables

• Foundational Edu

– Core – Position control – Forecasting

• Standardization

Team Lead: Nurse Leader

Communication

Deliverables

• Timely
• Transparent
• Consistent
• Stakeholder Specific

– Executives – Managers – Frontline – Project Team

Team Lead: Nurse Leader

Nurse Engagement Outcomes

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Diff from: Adequacy of resources and staffing item 2018 LH % Units above April 2018 Natl Avg April 2018 Natl Avg 2017 I get the tools and the resources I need to provide the best care/service for our clients/patients 3.83 46.00%

• .02
• .01

I have the sufficient time to provide the best care/service for our clients/patients 3.56 56.00% +.06 +.03 My work unit is adequately staffed 3.53 74.00% *.39 +.13 Adequacy of resources and staffing 3.64 64.00% +.14 +.05

Standardization of workforce technology and workflows

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Standard Use: Staffing and Scheduling Technology

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Certifications tracked in E+ or excel

spreadsheets at unit level (ACLS, BLS etc.)

Competencies at both the unit and

• rganizational level (Balloon pump, ABG etc.)

Unit roster, employee shift and phone lists (if paper copy exists) Vacation sign-up, employee availability, extra-shift, trades

(unit paper method)

HR Lawson: Licensure (RN),

New Hires, Transfers, Position, FTE, Employee contact information

• Automated notifications
• Standard reports
• Recruitment
• Audit trail and history

Condenses multiple data entries into “one source of truth”

Staffing and Scheduling

Legacy Centralized Staffing Office

Key Service Metrics

• Open 24/7
• 4 staffers 0300-0800 & 1500-2000

– 1 staffer overnight

• 8 Hospitals
• 53 Inpatient Units
• 7 Procedural Areas
• 5 overflow units - census driven
• 11 float pools
• 4000 end-users
• 14,000 calls a month

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Daily Staffing Workflow

Critical Care/IMCU/Respiratory Staffer

11 units + 2 pools, core of 140

Med-Surg Staffer of the 3 largest hospitals

12 units + 2 pools, core of 280

Peds/Med-Surg Staffer remaining hospitals

10 units + 2 pools, core of 110

Women’s/ED/Unity Staffer

17 units + 3 pools, core of 235

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Legacy Enterprise Float Pool

• 11 Pools – 225 Employees
• Float across the system within their cluster
• Minimum FTE of 0.6
• Held to the same staffing/scheduling policies

and clinical competency expectations

• Receives their department assignment

1½ hours prior to the start of the shift

– Notification through Centricity,

Mobile App or email preferences

– May also call an automated phone line

to get assignment

• Minimum of 3 years of experience

within their specialty

• Dual licensure – OR & WA

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Staffing office overview – staffing multiple hospitals with a float pool

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Central Management of Extra Shifts

Recruitment Process

• Utilize our current Staffing and Schedule

Software, Broadcast to Work technology or Open Shift Notification (OSN)

• Technology was built to align with

the premium pay practice

• Recruit for all units below core,

by shift, proactively

• Only CSO staff has access to activity codes

for premium pay

• Engages staff with technology

and recruitment process

• Staff must be signed up to receive OSN

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Central Recruitment Workflow

7 Day Recruiting

• 7-Days prior to the shift the CSO will send a broadcast/ “Open Shift

Notification” (OSN) to all employees who have made themselves “AVAILABLE” in the system that are qualified for the shift.

• OSN will be sent out for any that is below core.

2 Day Recruiting

• 2-Days prior to the shift the CSO will evaluate core staffing needs,

projected census/staffing needs and resources available for the cluster.

• If there is a staffing need not met by current resources, the CSO will

send out additional text pages to all staff that are qualified for the shift.

• CSO will filter the qualified staff list for those that match the shift

and are not currently working or have made themselves unavailable (meetings, educations, vacations, etc.).

Day of or last minute needs

• Will continue to send OSN as needed

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Reduction in Annual Nursing Contract Labor Spend

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Nursing Contract Labor Spend

FY17 $3,232,000 FY18 $2,102,000 FY19- YTD $1,485,000

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Workforce Data & Analytics

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Future Work – Staffing by Acuity

Patient Acuity System- Charge RN View

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Patient Acuity System- Charge RN View

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On The Horizon

• More workforce management dashboards
• Develop more efficient compliance tracking methods
• Continued partnership with end-users and vendor to enhance usability and experience
• Create the full staffing picture: Reporting patient outcomes and workforce metrics together

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Thank you! Questions?