Staffing to Demand in the Emergency Department

A ‘Bottom-Up’ Approach: Staffing to Meet ER Demand

When a large healthcare organization’s three regional hospitals needed to make significant, aggressive financial improvements, it sparked a transformation to their staffing approaches and generated more than half a million dollars in savings.

Labor is among the largest controllable expenses for any healthcare organization, with most cost-saving initiatives involving varying degrees of labor changes.

Typically, these adjustments are based on set benchmarks. A target savings is created, then hospital management and department directors are tasked with figuring out how to hit that target without drastically sacrificing patient care — solving the problem from the top down.

But this executive team was open to trying a different way — a “bottom-up” approach.

A task force was created to lead workforce management improvements for each of the three hospitals. By developing a shared vision of how labor management should best operate, the areas and organizational processes in need of the most support were prioritized.

The three hospitals’ emergency departments are a prime example in how this work was performed. Staffing and scheduling was re-built from the bottom up, meaning shifts would be staffed with just the right amount of personnel required to meet predicted patient needs.

The project included three distinct phases:

Data Collection
Analysis was conducted to examine patient arrival patterns around the clock and the typical level of clinical care required as patients arrive. This information provided our taskforce with helpful workload and demand schedules throughout the day.

Workshops
A four-day workshop was hosted for executive leaders as well as department team members to redesign the hospitals’ staffing models and schedules to best meet patient needs. Then a three-day workshop focused on improving the staff scheduling process, leading to the three sites better balancing their schedules and sharing staff and resources.

Sustainment
Improvements weren’t worth making if they couldn’t be maintained to achieve long-term financial savings while keeping the emergency departments fully operational and providing high-quality care.

Key metrics at each hospital were monitored and presented to leadership on a weekly basis for three months after improvements were implemented following our workshops.

Emergency Department

The Results

Through their new emergency department staffing and scheduling processes, this trio of regional hospitals generated savings of $600,000.

Triage response times, a key quality indicator in an emergency room setting, were also improved by the project’s organizational enhancements.

The hospitals’ executive team, task force and ER team members all brought open minds into the process and were willing to try a different approach we were confident would be beneficial all around. The group knew improvements had to be made in order to ensure the long-term financial viability of the hospitals and they owned the process from the beginning.

That mentality ensured the new schedules, staffing processes and other improvements not only covered patient demand, but were appealing to team members and economically and organizationally sustainable — keeping this trio of emergency departments saving lives for years to come.

Are you tired of overspending on staffing or not scheduling to levels that appropriately meet patient demand? If previous “top down” benchmarking approaches haven’t led to sustained savings or long-term results, let us show you the benefits of working with Beyond Benchmarks. Our experts have helped hospitals and healthcare facilities of all sizes improve their internal processes and financial viability without sacrificing patient care or employee response. Connect with the Beyond Benchmarks team today to learn more and get started.