STAFFING SERVICES REDESIGN PROJECT

1. STAFFING SERVICES REDESIGN PROJECT Presented by: Gentil Mateus Regional Director Human Resources Lee VanMeter Project Lead, Staffing Services Redesign June 23rd, 2008

2. Interior Health Facts • Area Population: 693,000 • Budget: 1.2 Billion • 35 Acute Care Sites • 4,427 Residential Beds • 19,500 Employees • 1,200 Physicians • Communities served: 54 • Regional Districts: 10 • Number of Regional Hospital • Districts: 7 • First Nation Communities: 55

3. The Burning Issues • Growing shortage of health care professionals, and increasing demand for services • Within IH the demand for services is projected to increase 1-2% per year for the next several years • During the next five years, we will lose approximately 2500 employees to retirement • Largest operating cost is our workforce ($850m) • The need to control workforce costs, improve retention and staff morale

4. HISTORY • 1 Payroll system • 12 Scheduling Offices • 10 Databases • Incompatible ESP versions • Inconsistent Practices

5. BCNU Policy Initiatives Project History TALKED individually with Mgrs Looked at Casual retention Interviewed 550 CASUALS by telephone Analysed a full year of PAYROLL DATA Mgmt Workshops 53 people ANALYSED COSTS of Existing Scheduling Offices

6. Business Planning – Gathering the Data Business Planning Methodology • Site visits and interviews with managers across all HSA’s • Survey of Casual Workforce • Facilitated workshops across region to gather group input • Consultation with unions • Analysis of one year of staff utilization data (2003)

7. Business Planning – Gathering the Data The Evidence showed: • High levels of overtime use, but casuals claiming they were not being offered work • Casuals not actively managed and with high turnover • Staffing levels and skill mix in similar departments varied significantly and troubling increase in Workload hours • Service levels in existing scheduling offices varied tremendously

8. Casual Labour – Used Inappropriately RN Demand How demand was being filled 3% Productive time used Unplanned wkld Type of labour being used End of Shift O’time 2% Short Notice Leave Relief Full Shift O’time 5% Casual Labour Advance Notice Leave Relief 19% 10% Regular shifts from rotation lines Permanent Staff paid straight time 82% 79%

9. Business Planning – Developing the Strategy Created an Achievable Vision for the Future • Create a cost neutral solution by establishing a Staffing Service with ‘service centres’ in each HSA • Create HSA wide certifications to offer staff more options and remove barriers to the effective deployment of staff • Offer enhanced range of services including: • 24/7 service • Rotation Specialist team to look at more flexible rotation options • Workforce Consultants (WIC) to help manage the relief workforce • Corporate management of new service to create consistency and accountability • Dual reporting relationship to HSA management to ensure strong local partnerships • Adoption of a Balanced Scorecard approach to measure outcomes

10. Business Planning – Developing the Strategy Projected Benefits of Future State Vision • Improved staff retention in the face of a critical workforce shortage • Commitment from front line management to a better work place and a development of a partnership between staff, union and management • Reduction in Sick Time and Overtime due to better scheduling & less burnout • Enhanced ability to respond to workforce trends • Greater visibility into staff utilization across the organization and better information for managers and executive team

11. Vision & Goals Vision was:To standardize the staff scheduling and utilization processes throughout Interior Health Goals were: • Better end user service for managers, casuals and staff • Improved staff satisfaction and retention • Automated processes • Reduced labour costs

12. Our Mission Statement To deliver extraordinary service to Interior Health by providing highly responsive staffing solutions and workforce planning, in order to contribute to the delivery of safe, quality healthcare by Interior Health now and into the future.

13. Staffing Services Redesign • Builds upon the ESP Scheduling System to make it a better all round • scheduling process • Creates tools to save managers time, improve staff retention and provide a better service to all who use it

14. Process Design Collaboration and Participation were at the heart of the design methodology! • Design Process divided into six modules • Rotation and Position Management • Planned Leave Management • Short Notice Leave & Daily Staffing • Scheduling Relief • Relief Staff Management • Timekeeping

15. Process Design • Design Team of approximately 40 people reporting to Steering Committee of 12 senior executives that regularly reviewed the work of the Design Team. The Design Team was comprised of: • Staff, including casuals • Managers • Regional union representatives • Schedulers • Payroll and HR staff • It takes time! • A “strawman” approach is used to save time • 12 full day workshops over 16 weeks

16. Design Team Design Team process was a great success. Group created 22 work flows and came to a consensus on all but one of them.

17. Design Team Overall, the group was amazed that people from all walks of life came together, with own agendas, own history and cynicism yet, through the process, realized that we are all working towards the same goal. “These were the most productive meetings of my career” “If everybody in my workplace could feel a little of what went well here, it would be a better place to work.” “I came with a lot of cynicism and little hope. I’m leaving with a lot of hope and little cynicism.”

18. Design Team Feedback from the Design Process was extremely positive! • Sample comments from evaluations at the end of the process were: • Awesome, outstanding; impressed that IH put funding behind it • I feel this process has unified management, staff, and unions around a set of common objectives • Ground breaking • The indiscretions of the group was critical to the successful outcome and allowed discussion to be sufficiently well rounded • Very inclusive, positive. IH participants were not confident that the decisions made by the Design Team would be honored by those "above" with power to over rule. I hope this is not the case. Small breakout sessions allowed quieter people to have a voice, which was great.

19. Key to Success • Single ESP database (Version 3.6) • Decision-making must remain with operational management • Development of a “Balance Scorecard” • Strong customer service focus – Managers and Employees. • Ability to provide data to assist managers with day to day staff management and planning. • Service must be adequately resourced: in both pilot offices, additional staff were hired (ratio 1:190)

20. Key to Success • Service Level Agreement (SLA) between each manager and the Staffing Service Centre. Includes: • Workflow processes • Performance Measurements • Clear delineation of roles & responsibilities • Issue Resolution process • Standardization ofOperating Procedures. Standard Interpretation Guideline (SIG) and Staffing Services Administration Manual (SSAM) • Staff & Union involvement is key

21. Key to Success: Transition Teams • Prior to implementation ("go live") of the new processes Transition Teams were created. • These Teams included front line employees, managers and union representatives, to continuously bring forward concerns from staff to the Project Team and communicate changes back to staff. • During project rollout the Transition Teams met on a weekly, then bi-weekly and finally monthly basis, as the issues were resolved and fewer meetings were necessary.

22. The Role of the WIC The Workforce Innovation Consultant plays a pivotal role within the Staffing Service Centre. They hold a dual responsibility for supporting managers in identifying and addressing the root cause problems for overtime, sick time and staff retention. In addition, they support relief staff to improve their work experience and job satisfaction. Role with local management includes: • Project demand for relief staffing and identify needs by area, specialty, seasonal fluctuations, etc. • Develop strategies to meet the demand, e.g. by working with external recruitment, developing relief staff skills, etc. • Determine the optimal mix of casual and permanent relief positions including the introduction of “Regional Relief Pools”.

23. The Rotation Specialists work with managers and staff in an inclusive & collaborative process to determine requirements and provide creative solutions. Their goal is to improve employee satisfaction while meeting operational needs. Provide services for all Collective Agreements Collaborate with the BCNU/MOH Responsive Shift Scheduling initiative Maintain a Central Database of Rotations The Role of the Rotation Specialist

24. Relief Pool Skilled Scheduler Skilled Scheduler Relief Pool Skilled Scheduler Skilled Scheduler Relief Pool Skilled Scheduler Relief Pool Relief Pool Staff Utilization Unit Regional Director, Employee & Labour Relations Regional Dir, Staff Utilization Rotation Team Local Structure in each HSA Info Analyst COO Business Consultant HSA Management Team HR Director Front Line Managers Face to face time plus Regular Service Scorecard results reported to customers Workforce Innovation Consultant Scheduling Manager Consolidated demand / consolidated customer base more effective service External Recruitment Services

25. To measure, evaluate and improve the Staffing Service Centres’ performance Factors for success originally identified by Steering Committee Available “on-line” Balanced Scorecard

26. 18 Month Progress Report • Staffing data being provided monthly to assist Senior Management Teams with short/ medium term planning • Decrease in Overtime. Pilot Sites Nursing Overtime is lower in 2007/08 then in 2006/07 and 1.35% lower than the Health Authority average. • Reductions in paid meal breaks and end of shift overtime • Clean up of Casual Registries and $ savings reduction in ESP licenses • High demand for Rotations Specialist services. Team of 3 have created a total of 350 responsive schedules to date (197 BCNU, 109 HEU, 19 HSP & 25 Community

27. 18 Month Progress Report • 92% compliance with Advance Booking Guidelines (12 weeks) • Changes to the labour landscape through the amalgamation of union certifications & the creation of Regional Float Pools • Partnering with Okanagan University College to develop a certificate course for scheduling clerks. • Implementation of a single Vacation Policy for contract staff (excluding Community • Formal Evaluation is currently being done by Canadian Management Systems and our Internal Auditor team

28. QUESTIONS ???