Can You Really Flex Staffing?

Many hospitals attempt to "flex" staffing; that is, department managers are encouraged to adjust employee work schedules to match workload. This often amounts to little more than cajoling employees to go home early during "low census" periods or when workload is light. The problem is that full-time employees expect to earn full-time pay, a reality that makes sending full-time people home a short-term tactic at best.

What is surprising is how few hospitals have explored the extent to which workforce structure ties department heads' hands and drives up labor costs. Here are steps that the hospital can take to facilitate real "flex" staffing that will reduce costs, optimize quality, and improve employee relations.

• Analyze department workload patterns by time of year, day of week, and by shift. Compare current workload patterns against current employee work schedules by job class. If the structure of today's employee work schedule was determined long ago, do the assumptions upon which it was based still hold?
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  To what extent does the department schedule its work? Many departments either do not attempt to do so or employ dysfunctional scheduling systems. Yet a fairly significant portion of most departments' workload could be scheduled. That is, it is either not "time critical" or can be done at times that would allow the department to schedule it to optimize use of department staff time, vastly improving department productivitiy.

• As a side note, evaluate routine day shift tasks (particularly clerical and other "paper work" tasks) that are not "time critical" to determine whether some or all of these could just as easily be done on other shifts, particularly shifts that may have a lot of "stand by" time. If there is no real operational reason not to do so, consider the effect on workload of redistributing some or all of these tasks to other shifts.

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  Start with the assumption that employees who are hired to work full-time deserve to work full-time. Based on your analysis of workload patterns, what is the optimum mix of full-time to part-time employees by job class on each shift? Let's call that optimum mix your "target staffing structure."


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  Now, how does your "target staffing structure" compare to the current staffing structure? Develop a plan to get from where you are to where you should be. Take into account the realities of the labor market but don't let labor market difficulties prevent you from developing a plan and working toward it.


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  Develop staffing matrices that project required staffing by job class to match observed workload patterns by time of year, day of week, and shift. Identify "trigger points" (changes in workload) that will prompt management action to consider sending part-time employees home or bringing part-time employees in. Remember that staffing matrices are a tool designed to augment, not over-ride, professional judgment.

Effective scheduling of work and staff can produce productivity gains in the range of twenty to twenty-five percent. This is an opportunity that should be aggressively pursued by every department manager.