Masonicare
Kronos for Healthcare improves oversight and significantly reduces staffing expenditures
Masonicare is Connecticut's largest provider of healthcare and retirement living services for seniors. The not-for-profit organization opened its first facility in 1895 with the mission of caring for seniors and orphans with Masonic connections. Since that time, the Wallingford-based organization has expanded to provide services to Masonic and non-Masonic seniors through skilled nursing and rehabilitation facilities, a continuing care retirement community, assisted living communities, a residential care home, and statewide home healthcare and hospice services. Masonicare employs more than 2,500 people statewide.
Scheduling nurses at the organization's main facilities, with a partially automated scheduling processes, was creating staffing inefficiencies and unbudgeted staffing expenses. The centralized nursing office was not always aware of unit staffing needs. Manual staffing of open shifts by unit managers created increased overtime and agency expenses, as they often relied on easier, "always available" nurses rather than calling in the best resources at the most cost-effective rates. With little accountability and schedule enforcement, staff nurses were also able to work extra hours by arriving for shifts they were not scheduled to work. Lack of visibility and real-time access to budgeted, scheduled, and actual staffing data prohibited Masonicare's management from proactively addressing rising supplemental labor expenses, as budget variances were not evident until a week or more after they occurred.
To more effectively schedule nursing staff and better manage staffing expenditures, Masonicare implemented Kronos' Workforce Scheduler™ solution, gaining an integrated workforce management provides reporting accountability. "The Kronos system has been a tremendous success for us," James Albert, vice president for information systems and CIO at Masonicare. "We've seen significant dollar savings in both overtime and pool staff costs. The number of openings in the schedule was greatly reduced by having control over knowing who to plug in and how to plug them in. We also saw a dramatic reduction in pool staff use."
Prior to the implementation of Workforce Scheduler, Masonicare central office employees who scheduled unit staff were often unaware of the needs of individual medical units. This situation sometimes resulted in unit staffing levels that did not match budgets or resident care needs. One primary goal in implementing the Kronos system was to give unit managers increased insight and control of scheduling.
"From a nursing perspective, we wanted better controls in the scheduling process and increased accountability from managers for their units," says Bea Coulombe, vice president for patient care services. "The Kronos for Healthcare scheduling system has given us the tools, controls, and reporting capabilities with which to look at our staffing in relation to our budget numbers."
Knowing the importance addressing process along with technology change, Masonicare developed clear protocols and templates for appropriate staffing patterns for each unit. At a glance, unit managers can review current staffing, compare it to required staffing, and make timely adjustments. "The scheduling system lets you know who is a per diem person, who is going to be in overtime, and the most cost-effective way to fill your gaps," adds Coulombe.
With staff information easily available in the system, filling shift positions is simplified. Using Workforce Scheduler, 15 staff members schedule approximately 500 nurses and certified nurses aide (CNA) staff at two facilities, and three others schedule 250 nursing staff at another Masonicare facility.
Agency staffing hours reduced 75 percent
Masonicare had been relying heavily on agency pool staff to fill open shift positions, averaging about 1,000 hours a week for these staff. Reducing the use of per diem staff and better managing overtime for full-time employees were additional goals with the implementation of Workforce Scheduler.
"We couldn't reduce pool staff until we knew what our numbers were and what they needed to be," explains Jane LaPrino, director of MIS. "Using real-time data in the Kronos scheduling system, our MIS department worked closely with nursing to collaborate and customize the daily reports they needed to quickly track productivity and expenses."
With more detailed workforce scheduling information, Masonicare has been able to reduce agency pool staff hours to fewer than 200 hours per week. In fact, the CNA pool has been eliminated at one facility and almost eliminated at another. When Masonicare first examined reducing use of pool staff, it was spending $45,000 and more a week on nurses and CNAs. Now, it spends less than $10,000 a week on pool staff for RNs, with expenditures some weeks below $6,000, and this amount continues to drop.
"Kronos gave us the information we needed to eliminate most of our pool staff," says Melinda Schoen, assistant director of nursing. "We couldn't have done this without the integrated time and attendance and scheduling data from Kronos, and our custom reports to show us where we've been and where we're going."
Significant cost savings in overtime and pool staffing
While using the reporting information to reduce pool staff, Masonicare was careful to hold the line on overtime hours of full-time staff. Their solution was to better utilize in-house staff and selectively hire additional employees to fill vacant shift positions.
Before the system was in place, Masonicare was racking up more than 700 hours per week in overtime, in addition to 1,000 hours in pool staff time. With its Kronos for Healthcare scheduling solution, Masonicare saved approximately $500,000 in supplemental labor costs in the first four months following implementation, of which 25 percent was attributed directly to Workforce Scheduler. Over the course of a year, Masonicare estimates it will save about $1.4 million in supplemental labor costs.
"That's a significant dollar savings," says Coulombe. "With controls, you can see things on a shift-to-shift basis, eliminating pool staff by using your own staff — but only those who are not getting into an overtime situation."
Reporting system increases staff accountability
The organization has also seen increased staffing accountability. "One of the nice things about the Kronos system is its ability to hold people accountable, because the information is right at your fingertips," notes Schoen. "We're looking at one system, not multiple systems, so we can easily look at someone's schedule and see if they're late or absent."
This accountability extends to improved oversight of individual units, including weekends when the central staffing office is not open. "We can lose our entire budget on the weekend," says Coulombe, who now uses Citrix on Saturdays and Sundays to review use of pool staff shift by shift. "When we first put the system in place, Monday through Friday was great, and then on Monday morning we wondered what had happened."
Now, with real-time tracking of staff, there are no surprises. If nursing supervisors want to call in pool staff for a weekend day shift, they must first call management for approval.
Agencies see accountability benefits
The Kronos system has improved accountability for pool staff agencies as well. Masonicare requires pool staff to swipe in and out of the system, which provides actual timekeeping information and has eliminated questionable signed timesheets and a tremendous amount of pool staff overtime.
An added benefit is direct, real-time billing of staffing agencies from Kronos reports. "The reports tell an agency exactly when a nurse has been here," explains Albert. "When we said we would give them real data and that is all the hours we are going to pay for, they didn't argue."
Scheduling solution to expand enterprisewide
Based on the success of Workforce Scheduler in improving scheduling controls, increasing accountability, and reducing nursing staff labor costs, Masonicare is looking to expand the use of its Kronos solution over the next six to 12 months to other departments. In addition, the company plans to introduce the system's shift sign-up and self-scheduling options to employees, giving them increased control over their schedules, with management oversight.
A clear advantage of the Kronos for Healthcare solution is its enterprisewide scheduling system, which allows Masonicare to better manage its labor resources for maximum efficiency. The result is optimized and equitable scheduling that has increased productivity, reduced labor costs, and enhanced employee satisfaction throughout the organization.
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