Aligning Staffing to Operational Volumes
A new system-wide initiative to provide medical advice to residents was being launched, however the approach for staffing this initiative was not yet established.
Workforce Edge was engaged to design the staff scheduling approach for this area. An automated analytical model was developed to translate the call volumes into rotation baseline needs, and master rotations were developed according to baseline needs and Collective Agreement requirements to ensure appropriate coverage and optimal call response times for callers. Unions and managers were engaged to design and conduct a streamlined process for expediting position assignment.
A design team of managers and staff was convened to create the processes and operational structure for a new staffing office to ensure ongoing management of staff schedules, and the analytical model was integrated into staffing office operations to enable responsiveness to changes in call volumes. Additionally, leadership training was provided to managers to help support them in their roles in the staff scheduling processes and help them sustain the new model.
Creating Rotations that Balance Operational and Staff Needs
A large health service had managers creating new rotations for their staff each 4-week period. Employees would request or refuse to work specific shifts, and operational needs were being inconsistently met as managers tried valiantly to meet employee requests and staff their units. The state government had sponsored a special commission of inquiry which linked patient safety incidents to staff deployment and skill mix, and subsequently another consulting firm had been engaged jointly by the health service and the nurses’ union to review the current “request rostering” approach, finding that the current approach was insufficient in meeting patient and operational needs.
The goal of this engagement was to implement rotations that met operational baselines while as much as possible still taking employee preferences into account, and to prepare a centralized staffing office to take on these units as clients using standardized business processes. The health service appointed roster builders and Workforce Edge trained these people to build rotations under this “balanced rostering” approach. Clinical directors and managers were supported in the significant change management activities as the new rotations were implemented, and the centralized schedulers were trained and supported to follow the standard business processes ensuring the integrity of the rotations was maintained.
Maximizing Efficiency of a Scheduling Service
A regional staffing office was responsible for scheduling staff across a large rural area and was encountering challenges including financial cutbacks and a severe shortage in the health care workforce in their area. Building a model of excellence in rural health care against this backdrop requires that every manager in every community work smarter to do more with less, and requires the availability of the most flexible, yet stable workforce possible. The staffing office requested a review of their operations in order to identify process improvements specific to their unique circumstances.
A staffing office review was conducted including a series of one-on-one interview and observation or work processes. Results were presented in a feedback workshop involving schedulers and some of their clients, in order to build common understanding and support for the recommendations to be implemented. Periodic coaching calls were established for a short period after completion of the review, to ensure recommendations were being implemented effectively and respond to unanticipated changes.
Public Policy Analysis
An organization reporting into a provincial Ministry of Health, created at the interface between health employers and unions, contracted with Workforce Edge to analyze the ability of certain healthcare organizations’ to meet provisions and agreements relating to health scheduling and staff replacement. Although all of the included healthcare organizations were subject to the same Collective Agreements, the strategies and approaches used for staff scheduling varied within and between organizations, leading to inconsistent data and an inability to determine whether the agreements were being met.
Workforce Edge completed an assessment of scheduling capabilities and approaches within each organization through a variety of interviews, focus groups, observation, and workshops. This work is presently being completed and is intended to result in recommendations to improve the data and compliance reporting.