Aligning the Management of Clinical Quality, Productivity, and Costs
Private Hospital Magazine
By Sharon Lowry, RN, BHSc, MSc,
Manager Asia Pacific Healthcare Division, Kronos
Improving care is a primary issue of concern within healthcare. Efforts to improve clinical quality largely focus on the implementation of clinical information systems as a valuable contributor to quality improvement initiatives and strategies. However, clinical information systems do not usually have the granular capacity to manage the effective and efficient planning and deployment of staffing resources to align with fluctuating service demands. Numerous studies have shown that understaffed clinical departments place patient safety at risk and may jeopardise quality patient outcomes. In addition, understaffing or inappropriate skill mix has been cited as a significant dissatisfier for nurses and can lead to loss of staff from the organisation due to stress and burn out. On the other hand, overstaffed departments consume precious dollars without improving care.
To comprehensively address the issues of care quality, staff retention, and containment of costs, organisations must align employee productivity with clinical imperatives and goals — ensuring that the appropriate people with the right skill mix are at the right place at the right time. This capability will be crucial in the coming years due to several industry challenges. The statistics within nursing alone, indicate this urgent need. As nurses are working greater amounts of overtime, there is an increased use of agency nurses, and hospital beds remain closed due to inadequate staffing levels1 . Further, the federal government estimate the shortage of skilled nurses in Australia will hit 40,000 by the year 20122.
Workforce management solutions can help organisations deal with the improvement of quality standards and industry challenges. Implementing workforce management solutions can provide the necessary tools to consolidate employee-related information into a centralised source, provide decision makers with unprecedented visibility into operational performance, and optimise efficiency in staff deployment.
Consolidating Workforce Information
Traditionally, gaining insight into workforce information has been a challenge due to the fragmented and siloed approach to data management and retention. The result of this fragmented approach has meant that information is at best incomplete and at worst completely inaccurate and unreliable. This lack of workforce related clarity and visibility has in effect stifled productivity by making it difficult to obtain a consolidated view of employee and staffing data and its impact or relationship with operational efficiency or clinical outcome.
By consolidating information, integrated workforce management solutions provide an unprecedented opportunity to draw substantiated correlations between data elements and provide managers with real-time alerts to pre-empt clinical compromise and mitigate risk while at the same time reducing unnecessary spend. This way, issues can be proactively, rather than retrospectively, managed.
Transforming Data into Actionable Information
Access to timely and meaningful workforce intelligence allows organisations to create a track record that can be used to develop objective workforce performance measurements for departments and individuals. Once established, variances in productivity or costs can be detected quickly so issues can be resolved to keep performance on target.
Dashboards and access to workforce intelligence provides executives with the right information about staffing and productivity, enabling a more proactive approach to monitoring operations while also facilitating more timely intervention within the operational period.
The dashboards display workforce performance metrics based on user-defined variables. This allows executives to quickly spot and resolve staff deployment issues and make informed and timely adjustments within the budget.
Attracting and Retaining Staff
With nursing shortages and escalating labour costs expected to continue into the next decade, recruiting and retaining qualified employees becomes an important component of any quality improvement effort. Workforce management is not just a departmental issue, but an enterprise issue that requires a comprehensive view of operations to be effective. With workforce related costs accounting for in excess of 70 percent of the typical hospital's operating budget, even modest productivity improvements can have a substantial positive impact on the bottom line — at least 1- 2% of payroll in most organisations.
The effective use of workforce management solutions can help organisations balance nurse-to-patient staffing ratios and increase rostering flexibility to maintain high employee satisfaction levels. The healthcare organisations that will be best positioned to succeed in the coming decade are those that can align their efforts to increase productivity and reduce costs with the overall business goal of delivering high quality outcome for both patients and staff.
1 Australian Institute of Health and Welfare; 2006, Australia's Health 2006; Health Services Series No. 30; Cat No. Aus 73; Canberra AIHW
2 Australian Bureau of Statistics; 2006
