Three Ways Organizations Create Their Own Staffing Shortages and Changes They Can Make

We’ve heard a lot about the nursing shortage that has impacted healthcare. The gap is projected to grow as patient demand increases and healthcare professionals reach retirement. This scenario has been a cause for panic, pressuring provider organizations to ramp up their recruitment efforts.

The nursing shortage is problematic – impacting staff morale, patient satisfaction and quality of care. While provider organizations may feel overwhelmed and unable to control this lack of nursing resources, there are opportunities to leverage the workforce they currently have to mitigate problem.

It’s not an easy pill to swallow to realize that organizations’ staffing and scheduling practices have fed their own nursing shortage. But that’s the reality for many organizations. The good news is that with the right tools and strategies, it is within their realm of control to fix. Three overlooked practices that are attributing to their staffing dilemma are:

  1. Full-time employee (FTE) leakage
  2. Not scheduling to volume patterns
  3. Turnover related to scheduling issues

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FTE leakage

When feeling understaffed, the first metric to monitor is “FTE leakage.” This refers to the hours lost due to core staff not being scheduled to their FTE commitment. For example, Nurse Jane carries a 0.9 FTE commitment, so is expected to work 72 hours within a two-week period. In one week Jane works 36 hours, but in week two she calls in sick for a 12-hour shift and does not work any hours to make up for the missed shift. The FTE leakage caused by Jane’s failure to either work or submit benefit time is 12 hours. As a result of these lost hours, FTE leakage creates a unit’s own nursing shortage. This requires the organization to fill these shifts with more expensive contingency labor – core staff in overtime or float resources – or pull staff from other units to cover the need.

Not scheduling to volume patterns

Scheduling that is not aligned with patient demand is typically at the root cause of staff shortages. The number of core staff scheduled for each shift should vary according to the trends in patient volume and predicted demand. For example, if a unit experiences its peak volumes on Wednesdays and Thursdays, the number of staff on those days should be higher than the number of staff on days with lower volumes. Establishing the correct number of core staff in a facility relative to that unit’s forecasted demand, and scheduling staff to that demand, reduces instances of over or under staffing.

Turnover related to scheduling issues

Core staff working on a unit that is constantly understaffed, forcing them into extra hours and overtime, is quickly going to become frustrated and burned out. Exhausting your core staff leads to job dissatisfaction and them seeking options outside of the organization. Turnover is costly for organizations, and a high turnover rate can significantly impact revenue. With the average cost of nurse turnover ranging $35,000 to$50,000 per RN, there are significant cost-savings opportunities associated with retention efforts.

While recruitment of new staff takes a concerted effort, there are strategic ways an organization can leverage the workforce they currently have to mitigate understaffing problems. Predictive analytics can accurately forecast staffing needs months in advance, allowing provider organizations to optimize their staff and schedule to demand. Technology-enabled solutions are also able to effectively monitor if staff are meeting their FTE commitments each schedule period, reducing instances of FTE leakage. Creating more accurate schedules sooner and ensuring core staff is working to their commitments will improve staff morale, ultimately having a positive impact on patient care.

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Jackie Larson

Jackie Larson
Jackie Larson is president of Avantas, a provider of workforce management technology, services, and strategies for the healthcare industry.

Jackie Larson

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