Escape the Employee Staffing Trap

1. Escape the Employee Staffing Trap Effective Access Management Staffing Models April 18, 2014

2. Learning Objectives • Learn the components of a staff management system • Understand why character is more important in an employee than experience • Understand staffing model preferences and the impact they can have on employee retention and satisfaction • Learn how to identify and select talent in a hurry • Learn how to build a comprehensive work schedule with backup support in 1 try 2

3. The Employee Staffing Trap 3

4. The Employee Staffing Trap Access managers are routinely faced with the challenge of staffing an operation across 3 shifts, 7 days per week. Moreover, access managers must address this challenge in an industry where employee turnover levels can be as high as 50%! Access professionals can meet this challenge by understanding the key components of an effective staff management system. 4

5. The Employee Staffing Trap • At your organization, is this employee joining or leaving your department? • How many attendees expect a call or message while in this conference related to a staffing issue? 5

6. The Employee Staffing Trap • Maybe this looks more like the door at your organization…… 6

7. The Employee Staffing Trap • If the graphics below describe your situation, this learning lab is for you! Welcome Farewell 7

8. Staff Management Systems 8

9. Includes: Staff Management Systems • Employee Selection • Operating Environment • Internal Staffing Philosophy • Core Considerations • Factors that must be considered to staff any access management organization • Staffing Model Preference 9

10. Includes: Staff Management Systems • H.R. Support • Software Tools • Data Analysis • - Reporting, Lessons • Facilitating Considerations • Factors that must be considered to facilitate the support of core staffing processes • Training Programs 10

11. Core • Facilitating Staff Management System • Employee Selection • H.R. Support • Operating Environment • Software Tools • Internal Staffing Philosophy • Data Analysis • - Reporting, Lessons • Staffing Model Preference • Training Programs 11

12. Core • Facilitating Core Staffing Considerations • Employee Selection • H.R. Support • Operating Environment • Software Tools • Internal Staffing Philosophy • Data Analysis • - Reporting, Lessons • Staffing Model Preference • Training Programs 12

13. Core Staffing Considerations • "People are not your most important asset, the RIGHT people are" • “the single biggest constraint on the success of my organization is the ability to get and to hang on to enough of the right people” • Source: Jim Collins, “Good to Great” 13

14. Core Staffing Considerations • Keys To Finding The Right People • Look for alignment of the prospective employee’s needs with your business needs • Understand that character is more important than experience 14

15. Core Staffing Considerations • Alignment of Employee and Business Needs • Basic Skills • General PC Skills • Telephone Manner • Office Administrative Skills • Schedule Availability • Full-time, part-time, PRN; weekends, holidays • 1st, 2nd or 3rd Shift • Goals and Objectives • Development and training? • Compensation, promotion and benefits? 15

16. Core Staffing Considerations • Why Character is More Important Than Experience • All access management experience is not created equal. Very experienced prospects: • May not wish to function in highly productive environments • May be adverse to change • May not wish to be cross-functional • May not function well where teamwork is required • May have different views regarding attendance and punctuality • May not see customer service as a component of care 16

17. Core Staffing Considerations • Characteristics of the “right” people • Self motivated • Dependable • Care about doing a great job • Care about delivering outstanding service • Never satisfied with status quo • Seek to continuously improve processes and services 17

18. Core Staffing Considerations • Tip – Perform “Character” Interviews • Prospects should provide examples of the following: • Productivity and attention to detail • Adaptability • Willingness to learn and perform multiple tasks • Willingness to work with multiple departments • Record of dependability and punctuality • Service and service recovery aptitudes 18

19. Core Staffing Considerations “Get the right people on the bus, the wrong people off the bus, and the right people in the right seats” • Source: Jim Collins, “Good to Great” 19

20. In-House Core Staffing Considerations • Main Registration • ED Registration • All Registration Sites • In-House • Personnel, facilities and procedures are controlled by the access management department. No staffing support is provided to clinical areas. • Financial Screening 20

21. Outsourced Core Staffing Considerations • Radiology/Imaging • O.R. • Bed Management • Outsourced • Clinical department assumes no responsibility for staffing or coverage support. All coverage provided by access mgmt. department. • Clinical Departments 21

22. Staffing Operating Environment • Tip – Establish Outsourcing Limits • When outsourcing coverage to clinical areas: • Establish responsibility for training • Determine a cap for back-up coverage • Avoid involvement in clinical administrative duties 22

23. Characteristics Core Staffing Considerations • Stable Schedules • Stable Shifts • Scheduled Breaks • Normalized • Access mgmt. organization creates stable, predictable schedules whenever possible. • Planned Back-up Support 23

24. Characteristics Core Staffing Considerations • Variable Schedules • Variable Shifts • Random or No Breaks • Random • Access management organization fills whatever roles are available according to need. Schedules tend to be unpredictable. • Ad-hoc Back-up Support 24

25. Staffing Model Preferences Core Staffing Considerations Variable Shift Model • Employee works variable shifts as needed • Pros – Fewer schedule holes to address • Cons - Sub-optimal for employee satisfaction and retention 25

26. Staffing Model Preferences Core Staffing Considerations Static Shift Model • Employee works the same shift each day • Pros - Better employee satisfaction and retention • Cons – May create more schedule holes to address (not in this scenario because we have no “grandfathered-in” promises to keep) 26

27. Staffing Model Preferences Core Staffing Considerations Variable Staffing Model – Rotating Weekend • Weekly staff rotate to the weekends on an ongoing basis • Pros – No need for weekend-only staff. Regular staff is usually perceived to be more reliable • Cons - Higher dissatisfaction and turnover from rotating weekly staff rotating to weekends 27

28. Staffing Model Preferences Core Staffing Considerations Static Staffing Model – Permanent Weekend • Weekend-only staffing in place • Pros – No weekend rotation needed for current weekly staff, higher satisfaction for weekly staff. • Cons - Reliability issues may crop up for weekend-only personnel. 28

29. Staffing Model Preferences Core Staffing Considerations Better Practice • Static models promote higher retention and job satisfaction among access personnel • When properly implemented, static models provide less of a need for managerial involvement in the staff scheduling process 29

30. Core Staffing Considerations Variable Staffing Model – Rotating Weekends 30

31. Staffing Model Preferences Core Staffing Considerations Variable Staffing Model – Rotating Weekend • Determine weekend rotation – make this rotation as stable as possible to maximize employee satisfaction • Give employees the same day off before the weekend and the same day off after the weekend! 31

32. Staffing Model Preferences Core Staffing Considerations • Expand the Rotation • Involve all access personnel in the rotation! Too often, only ED employees are used in weekend rotations. Positions to include: • Outpatient registrars • Inpatient registrars • Financial screening personnel • Bed management personnel 32

33. Staffing Model Preferences Core Staffing Considerations Expanding Weekend Rotation Resources • Advantages: • The more personnel involved, the fewer weekends any employee will have to work • Depending on the size of the access organization, rotations can be as infrequent as every 2 months • Full participation in the rotation is more fair to all department employees 33

34. Staffing Model Preferences Core Staffing Considerations Variable Staffing Model – Rotating Weekend • Determine Your Back-up Plan • Always know your next 3 levels of backup • Best Practices: Establish on-call coverage • Level 1: On-call employees (Usually PRNs) • Level 2: On-call leads • Level 3: On-call supervisors/managers 34

35. Staffing Model Preferences Core Staffing Considerations Variable Staffing Model – Rotating Weekend • Establish leadership roles • Someone should always be in control on all shifts • Better Practices: • Establish lead roles for 2nd and 3rd shifts during the week • Establish lead roles for all weekend shifts 35

36. Staffing Model Preferences Static Weekend Model 36

37. Staffing Model Preferences Core Staffing Considerations Static Staffing Model – Permanent Weekend • Schedule Full-time employees first • Only a 1 week view is needed 37

38. Staffing Model Preferences Core Staffing Considerations Static Staffing Model – Permanent Weekend • Hire and train weekend only staff • Select carefully for reliability • The job must be in the best interests of the employee • Avoid students if possible** 38

39. Staffing Model Preferences Core Staffing Considerations Static Staffing Model – Permanent Weekend • Determine Your Back-up Plan • Always know your next 3 levels of backup • Best Practices: Establish on-call coverage • Level 1: On-call employees (usually PRNs) • Level 2: On-call leads • Level 3: On-call supervisors/managers 39

40. Staffing Model Preferences Core Staffing Considerations Static Staffing Model – Permanent Weekend • Establish leadership roles • Someone should always be in control on all shifts • Best Practice – Hire permanent weekend leads: • Better team building for the weekend team 40

41. Staffing Model Preferences Core Staffing Considerations Static Staffing Model – Permanent Weekend • Establish emergency back-up roles • Best Practice: • Hire and train 10 – 20 “PRN” employees 41

42. Blow-up Your Schedule Discussion Exercise • You were recently hired as the access manager of a new hospital currently under construction and charged with hiring a full registration team. You were provided with the hours of operation and the anticipated patient volumes. Armed with this information and what we know about staffing models, how would you develop a staffing plan? 42

43. 12 Step Process Build A Variable Schedule in 1 Try • Heal Schedule Addiction! • Step 1: Hire full-time (FT) FTEs • Step 2: Hire part-time (PT) FTEs • Step 3: Hire PRNs • Step 4: Designate on-call personnel • Level 1: PRNs • Level 2: Leads • Level 3: Supervisors/Managers 43

44. Build A Variable Schedule in 1 Try • Step 5: Schedule FT FTEs 44

45. Build A Variable Schedule in 1 Try • Step 6: Rotate FT FTEs to Weekend Smith (FT) Jones (FT) 45

46. Build A Variable Schedule in 1 Try • Step 7: Fill FT holes with PT FTEs Escobar (PT) Payne (PT) 46

47. Build A Variable Schedule in 1 Try • Step 8: Lock-in FT & PT schedules Escobar (PT) Payne (PT) 47

48. Build A Variable Schedule in 1 Try • Step 9: Cover scheduled absences with PRNs Escobar (PT) Payne (PT) Tomey (PRN) 48

49. Build A Variable Schedule in 1 Try • Step 10: Add on-call Level I - • PRNs Escobar (PT) Payne (PT) Tomey (PRN) 49

50. Build A Variable Schedule in 1 Try • Step 11: Add on-call Level II - • Leads/Sups. Escobar (PT) Payne (PT) Tomey (PRN) 50