Advocate Aurora Health builds organizational resilience with workforce management strategy Sept. 24, 2020 | Advocate Aurora Health, API Healthcare/symplr , Becker’s Hospital Review
Speakers Mary Beth Kingston Margaret Gavigan Jane Dus Karlene Kerfoot PhD, RN, NEA-BC MSN, MBA, RN, NEA-BC, DNP, RN, NE-BC, PhD, RN, FAAN Regional CNO and System Chief Nursing Officer Regional CNO and System Chief Nursing Officer VP, Nursing Education and VP, Clinical Operations Advocate Aurora Health Professional Development API Healthcare/symplr Advocate Aurora Health Advocate Aurora Health
Building a Workforce Management Strategy that delivers balanced outcomes Balanced outcomes – Financial, clinical, staff engagement, patient satisfaction, compliance • Gains in one area impact another Technology that supports culture and strategy • Power of integrated time/attendance and staffing/scheduling • Leverage analytics and mobile technology • Go beyond nursing Standardization of policies, processes and technology • Enables an enterprise-wide approach People drive success • Shared governance that includes frontline staff • Change management Patient-centered staffing • Nurse and patients matched based on patient needs and nurse skills and availability
Advocate Aurora Health builds organizational resilience with Workforce Management Strategy
Transformation 2025: Destination Health OUR PURPOSE: We help people live well. Whole Transform Consumer Person the Core First Health Safety Anytime, Anywhere Access New Care Models Health Outcomes Personalized Experience Consumer Health Businesses Self Service Growth Financial Health OUR PEOPLE • OUR VALUES: Excellence | Compassion | Respect
Why focus on effective staffing?
Effective nurse staffing supports Quadruple Aim outcomes Improved Better Clinician Outcomes Experience Effective nurse staffing matters to patients and families and is undeniably linked to patient safety, patient satisfaction, Improved Lower workforce satisfaction Patient Costs and safety – as well as Experience cost savings.
Effective staffing vision: The right nurse at the right time with the right competencies – at the right cost • Improves patient/client health, safety and satisfaction outcomes, while also improving team member satisfaction • Ensures optimal work environment through the implementation of best practices, infrastructure and tools • Enables effective plan and deployment of clinical labor resources to best meet the needs of our patients/clients
To build the scaffolding and structure to staff effectively across the enterprise, to better match clinical Why focus resources to patient demand at each site and improve patient and team on effective member outcomes staffing? To account for increasing census variation, FMLA, absences, changes in patient acuity and other issues that impact daily staffing
Our opportunity and reason for action • Team member and AHRQ Survey results from frontline nurses had significant areas of opportunity around staffing • Time and resources spent on addressing gaps in schedules at each hospital site • Fluctuations in acute care patient census challenged leaders to staff efficiently and effectively leading to variation in results • Inconsistent meeting of targeted nursing hours across the system
What are we solving? Deconstructing the concept of staffing
Four distinct processes • Budgeting o Creation / Execution • Scheduling • Deployment • Assignment
Advocate Aurora Health effective staffing strategies Optimize use of flexible workforce Optimize every inpatient (float pool/clinical resource unit by matching nursing Standardize staffing practices, unit); create site and system resources to clinical procedures and scheduling infrastructures to review demand and the creation workflows measures of success and of a flexible workforce ensure sustainment of improved results
Standardization to Improve Outcomes • Systemwide standardization of staffing and scheduling practices and leveraged use of scheduling software to implement optimal care models • Standardized and streamlined the position approval process • Created nursing budgeting principles in partnership with finance • Synchronized scheduling time frames across the system • Standardized job descriptions for all flexible staff and staffing offices • Creation of site and system multidisciplinary teams (ecosystem) to ensure effective staffing through joint problem solving of complex staffing issues, creating structure, changing processes and tracking of key metrics
Implementing our effective staffing vision
Site and system ecosystem unites stakeholders Clinical Leadership Clinical Finance Education Effective Staffing HR/HR IT/IS Recruitment
Change Management
Effective staffing change leadership results • Leaders and staff had a solid understanding of why the change was happening • Leader training was done to develop the mind sets, skill sets and tools so the leaders could be effective leaders of this change • A coalition of support among leaders of different disciplines created momentum throughout the organization • Resistance was identified and dealt with early in the process • Senior leaders demonstrated their own and their organization’s commitment to the change • Communications were segmented and customized for different audiences • The organization created a better “backdrop” for the next change initiative
Shared accountability for outcomes Metrics Responsible Person • % of time units are meeting targeted Worked HPPD Site CNE • Culture of safety staffing composite results • Unassisted falls • Patient mortality • Rescue Events • Nursing RN overtime hours/dollars by unit Site VP of Finance • RN nursing agency hours/dollars by unit • Essential shift /Report Pay 1 st year RN turnover • Site VP of HR • Overall nursing turnover • Nurse vacancy report by site/unit • Time to fill • Team member satisfaction related to staffing • RN FTE on orientation by month Site Clinical Education Leader
Using technology to support the vision • Empowering accountability with analytics • Put data in the hands of decision-makers • Enterprise-wide visibility and transparency • Easier to share resources across departments • and facilities • Facilitates standardization • Equitable staffing and pay policies across the organization • Integration • Technology platform to support workforce management
Effective staffing vision: Stability in times of crisis
Responding to COVID-19 • Leveraged current enterprise workforce management strategies (flexible workforce, staffing and scheduling standard processes, shared governance, technology) • Leveraged the relaxation of licensing requirement to move team members across state lines • Reassigned more than 5,000 team members to new roles
Meeting staffing needs during COVID-19 System Virtual Labor Pool Command Center co-led by nursing and HR system leaders • 24/7 online process to request and reassign staff • Created a database of available team members • Allowed team members to volunteer for reassignment Orientation redesign • Virtual nursing orientation for new hires and online program for nurse residency • Virtual surge orientation and education that focused on helping reassigned nurses from OR, PACU and other areas to assist in care on medical-surgical and ICU units where appropriate
Meeting staffing needs during COVID-19 Care model and nursing practice changes • Team-based nursing model implemented where appropriate and needed • 300+ nursing practice changes • Clinical nursing practice support: Created numerous COVID-19 educational videos Pay incentives • Continuity pay • COVID-19 pay
Nursing Education & Professional Development COVID-19 DASHBOARD as of 08/01/2020 Attract & Retrain People Team Member Experience Educational assist hours 25,000+ Critical care onboarding 2,527 S.O.S. 944 Microsoft Teams messages 3,968 Kudos count 359 S.O.S. ambulatory 325 Expand Access Accelerate Innovation 22,000 AAH G.R.O.W. participants 2,195 Nursing students hired 173 nurses N.G.N.R. participants 909 QR code scans 1,767 impacted AHCMG onboarding 271 Employee health hours 2,500+ Transform Care Delivery Foster Partnership PPE guide downloads 35,071 Infection Prevention Nursing Practice Respiratory Therapy Simulation Education video views 22,618 Employee Health Human Resources Resource allocation CBT 15,584 Convalescent PPE Respiratory Resource Team Screening Surge plasma utilization toolkit triage team based nursing process Created by: NEPD, 04/01/2020, Updated: 08/05/2020 staffing pods
Meeting staffing needs during COVID-19 Transparent and timely communication • System Incident Command and collaboration meeting with Site Incident Command (daily, 30-60 min) • System Nursing Leadership Council calls (3/week, 60 min) • COVID-19 Information Center Toolkit (daily updates) • CEO and senior leadership videos (weekly) • Team member and leader communications (weekly) • Site and system huddles to identify issues and needs (daily)
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