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NR 556 Seminar Paper part 3 Alternatives Various alternatives can ensure that adequate staffing and scheduling are achieved. The most important concern is ensuring that the organization can meet the changing demand for healthcare services at different times. Different factors should always be taken into consideration when making staffing decisions. As pointed out from the literature review, task flexibility is a valid alternative in short and long-term periods as the workforce continues to become leaner and provides a capacity cushion that helps to manage the time-varying demands. Non-cyclic scheduling methods should also be utilized because they are more responsive to the changing needs of the healthcare organization (Marchesi, Hamacher & Fleck, 2020). As such, one alternative will be forecasting demand through projection and prediction to meet the organization's staffing and scheduling needs. The approach uses the best information available to forecast demand, combining projecting the behavior of the need of the current patients until they leave the system and ensuring that as they leave, there is new backfilling with new admissions in line with the available future information. In order to adequately do this, there is a need to consider the care pattern. This includes the nursing hours per patient day, the patient class, depending on how the patients are classified in that health organization, and measurement based on events expected to happen to the patient over time (Restrepo, Rousseau & Vallée, 2020). This will help align the available staff with the changing demand. Another alternative is the use of proactive protocols. The proactive protocols are developed for every unit, skill, shift, shortage, and day in the forecasting horizon, which spells out the optimal action to be taken. For example, when a health organization leader is looking for four days out on the medical unit, the night shift is forecasted to be short of three nurses. The
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proactive protocol for this situation (which is displayed for the decision maker) will likely be to call one nurse in for the shift, develop a list of four candidates that may come in if another is needed, or flag this shift and check the following day again(Marchesi, Hamacher & Fleck, 2020). Another approach that will be the most appropriate is the use of the staffing system. Information that is supposed to be in the staffing system includes the nurses who are scheduled to come in each day and shift, skills and qualifications, availability of the nurses, and a framework for adjusting or adding rosters. What needs to be added is the demand forecasting and proactive protocols tailored towards enhancing the framework to consider the near future variability. The approach, which is technology-aided, will show the projected staffing need for a specific unit for some days ahead. The decision maker will be able to look at all the shifts, drill down to one shift by skill, and then bring up a proactive protocol for that situation. Certain actions can then be taken, e.g., selecting the nursing depending on their qualifications and availability and posting the need to the different dashboards of certain staff members(Marchesi, Hamacher & Fleck, 2020). Any adjustment will immediately update the situation and will bring up the new proactive protocol for the new situation. Costs There will be various cost units that will have to be considered in the change process. It is assumed that the health organization will have to continue with the available nurses; therefore, no nurses will be employed in the short run. As such, there will be an emphasis on scheduling and staffing at any given time. Depending on demand, appropriate software, and hardware should be available for scheduling and staffing (Role et al., 2021). The initial installation cost is approximated at $120,000. Subsequent monthly fees are also paid depending on how the system has been used for that month. This will cost the health organization a maximum of $1,200 every
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month. The hardware, including the computer devices, will amount to about $5000. The software and subsequent updates required within the first five years will be approximately $2,000. Since this is a new system, thorough training is required to ensure that the change process is embraced and that every decision-maker can leverage the system for the organization's overall benefit (Marchesi, Hamacher & Fleck, 2020). The decision-makers who will be trained on the system's usability will include the departmental leaders, the healthcare facility leaders, and the human resource personnel. A few accounting department members should also be included to incorporate the aspect of costs in the system. The training will be an ongoing process for the first two years. Benefits The solution is tailored towards ensuring optimized staffing. It will help the organization to navigate the scheduling complexities by managing the nurse-to-patient ratios and qualifications for patient care. With the nursing system in place, the organization will better manage last-minute changes (Abdalkareem et al., 2021). It will also improve how they interact with their staff, thus amounting to improved outcomes and a healthier bottom line. As mentioned earlier, healthcare costs are one of the concerns that healthcare leaders strive to navigate. The system will help to reduce help costs. If the budget below is implemented, chances are high that there will be a cushioning of about $131,300. The organization will be relieved of more costs because of the efficiency realized. An automated staffing and scheduling solution will help to reduce labor costs and decrease the quality of patient care. The managers will minimize labor costs by cutting unnecessary overtime, avoiding turnover by ensuring proper rejuvenation time between shifts and ensuring they utilize the staff effectively (Marchesi, Hamacher & Fleck, 2020). The organization will also use historical data to forecast its labor
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based on actual demand. Scheduling the right amount of staff to the right place at the right time means the organization will reduce overstaffing expenses and plan better for unexpected demand spikes. The nurses can be involved in the staffing and scheduling, which will likely boost their engagement levels. It will give the staff more influence over their work schedules. Empowering the staff to express their schedule preferences will enable the managers to spend less time scheduling and more time addressing other matters(Marchesi, Hamacher & Fleck, 2020). Overall budget A staffing and scheduling system that will serve a 300-bed hospital Amount of money allocated for the
$200,000
initiative Initial cost for the installation of the
$120,000
system Monthly fee (based on how much the system is used
$1,200
Support services
$1,000
Required hardware
$5,000
Software updates
$2,000
Training on the use of the system by departmental managers and healthcare
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leaders
$2,100
Total
$131,300
Amount saved from the budget
$68,700
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References Abdalkareem, Z.A., Amir, A., Al-Betar, M.A., Ekhan, P., & Hammouri, A.I. (2021). Healthcare scheduling in optimization context: a review. Health and Technology, 11(3), 445-469. Marchesi, J.F., Hamacher, S., & Fleck, J.L. (2020). A stochastic programming approach to the physician staffing and scheduling problem. Computers & Industrial Engineering, 142, 106281. Restrepo, M.I., Rousseau, L.M., & Vallée, J. (2020). Home healthcare integrated staffing and scheduling. Omega, 95, 102057. Role, J., Chao, H., Rosario, C., Ho, P., & Hodgkins, M. (2021). Inpatient Staffing Dashboard: A Nursing–Information Technology Collaborative Project. CIN: Computers, Informatics, Nursing, 39(11), 772-779.