Workforce Optimization Partnerships to Create a Sustainable Future in Healthcare Background In 2009, FH executive approved the creation of the “Workforce Optimization” Portfolio The portfolio realigned other existing resources to focus on key initiatives that would lead to improvements in the utilization of our workforce and lower costs The FH model encompasses some of the best strategies from other health authorities as well as some unique to Fraser Health The difference is the alignment of these strategies IBM Corporation under one portfolio, led by Clinical Operations (i.e. where the dollars are spent) © Copyright IBM Corporation 2009 The Workforce Optimization Portfolio VP, Clinical Operations Workforce Optimization Director Staffing Advisory Advisory Committee Workforce Optimization Committee Leader Business Managers Workforce Redesign Analyst Staffing Services Coordinator Staffing Systems Staffing Manager Work Life Quality Operations Initiative Coordinators Supervisors IBM Corporation Staffing Offices © Copyright IBM Corporation 2009 Strategic Workforce Planning SWFP is the analytic, forecasting and planning process that connects and directs talent management activities to ensure the organization can execute its business strategy by having the right people in the right place at the right time, at the right cost. (M. Young, Conference Board of Canada, 2010) IBM Corporation © Copyright IBM Corporation 2009 Why? Labor costs are high (Overtime, Agency Use) Staff role confusion, inability to deliver critical activities of care (Functional Analysis, 2009) Care delivery systems are outdated (Leading Practices in Care Delivery System Change, 2009) Managers are frustrated, unable to implement more effective business practices (Health Service Manager Work Life Review, 2009) IBM Corporation © Copyright IBM Corporation 2009 What is Workforce Optimization? Workforce Optimization is a strategic partnership, focusing on establishing leading systems and processes to support Fraser Health Managers to manage their workforces effectively and sustainably. IBM Corporation © Copyright IBM Corporation 2009 Who is Involved? Clinical Programs Support Services Employees Together, proactively, strategically! IBM Corporation © Copyright IBM Corporation 2009 Aim To create great workplaces and environments where employees want to contribute, be engaged and have a relationship with their work. To maximize the effective and efficient use of our clinical workforce to build sustainable care delivery systems. To develop clear and consistent administrative management philosophies, best practice/system processes and tools that empower Managers to thrive and be successful. IBM Corporation © Copyright IBM Corporation 2009 Workforce Management Activities Finding Deployment Work Employee + Hiring Systems Retention IBM Corporation © Copyright IBM Corporation 2009 Workforce Optimization Workforce Care Delivery Manager Staffing Management Model Worklife Systems Partnership Redesign Initiative Support IBM Corporation © Copyright IBM Corporation 2009 1. Workforce Management Partnership Workforce Management Partnership Through an Advisory committee structure this is a partnership between clinical programs and support services creating proactive and synergistic approaches to managing workforce resources effectively and sustainably using leading business practices. Goal: To develop systems, processes and tools that support Managers to achieve best practices and meet performance targets. IBM Corporation © Copyright IBM Corporation 2009 Workforce Optimization Advisory Committee Key Responsibilities: - Identify key workforce utilization performance indicators and targets. - Share department activities and plans which address workforce utilization performance targets. - Develop joint strategies to achieve workforce utilization performance targets. - Provide feedback on systems, tools and processes being developed to support workforce optimization. - Monitor, evaluate and report on progress in meeting IBM Corporation performance targets. © Copyright IBM Corporation 2009 Workforce Utilization Key Performance Indicators Sick Time - % productive or base hours Over Time - % productive hours Productivity - % total hours Productivity - per patient day Vacancy Rate – calculated rate, coding due to vacancies Vacation Relief – hours of relief, to identify patterns/trends Agency Use (RNs and other) IBM Corporation Balancing Measures : Quality Data © Copyright IBM Corporation 2009 Approach Identify Clinical Program needs Identify Key Performance Indicator targets Monitor KPI (dashboard) Identify and develop strategies to meet performance targets Meet with Programs to identify priority strategies and assist in implementation Target interventions and development of new strategies to achieve results IBM Corporation © Copyright IBM Corporation 2009 Integrated Workforce Optimization Approach Clinical Program Vacation Relief KEY Needs and Management Health STRATEGIES Priorities Manager Worklife Coaching Initiative Program Implementation Plan Leadership Care Delivery Continuity Early Intervention Model Redesign Manager Program Key Indicators: (CDRM) Business Sick Time New Manager PARTNERSHIP Program Overtime Orientation Productivity Program Vacancy Rate Casual Vacation Relief Re-engagement Agency Use Scheduling Best Employee Absence Practices Reporting Targets Chosen Attendance (EARL) (FH + Program) Support Services Staffing Promotion Systems Development Plans (APP) Monitoring and People + Organization Reporting (Dashboard) Development - Recruitment - Consulting Services - Workplace Health - Organizational Development Staffing Services Outcomes Payroll Services Overtime Reductions Sick Time Improvements Finance Decreased Vacancy Rates Information Management Increased Productivity Minimize Agency Nursing Costs Strategic Transformation Team Professional Practice & Integration IBM Corporation Increased Capacity Increased Accountability Increased Efficiency Improved Staff Engagement + Retention © Copyright IBM Corporation 2009 Workforce Optimization - Achievements to Date Attendance Promotion Program Initiated (Consulting Services) Screening and support for employees with over 6% sick time. 2,000 employees analyzed. 249 enrolled for ongoing support. During first monitoring period, sick time decreased from 13.45% to 5.98% in enrolled group. Early Intervention Program (Workplace Health) Earlier contact with employees, participation rate increased from 28% to 93%. Enhanced Disability Management (Workplace Health) 97% of workplace incidents now reported via call center. Completed form to WorksafeBC within 1 hour. Overtime Scheduling Practices Review (Joint) Mandate for Managers to authorize ALL overtime Education of FH Standards for OT and Tools for auditing OT IBM Corporation © Copyright IBM Corporation 2009 BCNU Overtime Hours by Period (2008/09 & 2009/10) 50,000 45,000 40,000 35,000 30,000 25,000 20,000 FH incurred 138,000 fewer hours of BCNU overtime in fiscal 2009/10 with respect to 2008/09, a 25% drop. 15,000 2008/09 From Period 6 onwards there was an 2009/10 average drop of 38% from 2008/09. 10,000 5,000 IBM Corporation - Per 1 Per 2 Per 3 Per 4 Per 5 Per 6 Per 7 Per 8 Per 9 Per 10 Per 11 Per 12 Per 13 © Copyright IBM Corporation 2009 Facilities/Community Overtime Hours by Period (2008/09 and 2009/10) 50,000 FH incurred 167,000 fewer hours of Facilities/Community overtime in fiscal 2009/10 with respect to 2008/09, a 44% 45,000 drop. From Period 6 onwards there was an 40,000 average drop of 55% from 2008/09. 35,000 30,000 25,000 20,000 15,000 10,000 2008/09 2009/10 5,000 IBM Corporation - Per 1 Per 2 Per 3 Per 4 Per 5 Per 6 Per 7 Per 8 Per 9 Per 10 Per 11 Per 12 Per 13 © Copyright IBM Corporation 2009 2. Care Delivery Model Redesign Care Delivery Model Redesign Building high quality, sustainable care delivery systems that are responsive to the needs and expectations of our patients, residents and clients. IBM Corporation © Copyright IBM Corporation 2009 What is a Care Delivery System? Who delivers care (Role, Scope + Function) What care is delivered (Content) How care is delivered (Processes) How care is organized (Structure) IBM Corporation © Copyright IBM Corporation 2009 Where to Start? Care Processes Skills Systems Mix Care Delivery System Care Roles Model Environment IBM Corporation © Copyright IBM Corporation 2009 No one model or systems approach will fit for a system as complex as health care. What is needed is an approach or strategy of change which will allow the emergence of supportive and sustainable health care delivery systems. (Leading Practices in Care Delivery System Change, 2009) IBM Corporation © Copyright IBM Corporation 2009 CDMR Strategy Develop the capacity of front line staff to lead transformational work in care delivery systems. Using Leading Practices, engage front line staff in strategic redesign of their work systems. Create a Learning Community to share and sustain changes. IBM Corporation © Copyright IBM Corporation 2009 Why? Improving patient care is cost effective. Decreased length of stay Decreased complications Decreased adverse events Engaging front line care givers in redesign of their work is cost effective. Increased productivity Decreased turnover IBM Corporation Increased satisfaction © Copyright IBM Corporation 2009 FH CDMR Learning Collaboratives Interdisciplinary Teams Coached by Faculty Learning Leading Practices and Change Management Strategies Time Quality Collaborative for Care Care Practice CDMR Reduce Waste Elder Friendly Maximize Role, Scope and Work Processes Mission Critical Function Informs Systems Activities Interdisciplinary Resources Assessment Collaboration Time Care Planning Right Staffing Education Assignments Operational Activities Meaningful Patient Needs Infrastructure to Patients/Families Skill Mix & Capacity Patient Centered Care Care Model Improving Staff Retention Service Location Unit Key Measures – Examples Population/Capacity Staff Vitality, Patient Experience, Voluntary Turnover, IBM Corporation Resourcing Time Spent in Mission Critical Activities, Workload, Length of Stay, Unplanned Readmission Rate Skill Mix © Copyright IBM Corporation 2009 Care Delivery Model Redesign - Achievements to date Strategy and change framework developed Leading Practices identified Pilot teams engaged (5 Medical and 3 Surgical). Partner in Provincial CDMR Learning Collaborative Some early results: Staff report feeling “empowered” and able to make positive change. Improvement in staff morale. Time saved reinvested into improvements in care. Evidence of earlier discharges due to improved communications. IBM Corporation Decreased need for workload. © Copyright IBM Corporation 2009 3. Manager Work Life Initiative Goal Create and sustain a positive work environment for Managers allowing them to support staff to deliver safe, effective health care services. IBM Corporation © Copyright IBM Corporation 2009 IBM Corporation © Copyright IBM Corporation 2009 Facts 40% of Managers surveyed have less than 2 years experience. 79% of Managers surveyed were not able to complete work to their satisfaction. 72% of Managers surveyed did not see themselves continuing in their role beyond the next 2 years. IBM Corporation © Copyright IBM Corporation 2009 Recommendations 1. Develop clear and consistent administrative management philosophies and tools that empower Managers to thrive in their roles to the benefit of staff and patients. 2. Establish a management development program with meaningful supports and positive messaging to support Manager recruitment and retention. 3. Implement effective administrative structures that support the work of Managers and ensure that the right people are doing the right job. 4. Establish communications systems that are effective (technology), inclusive (decision making), supportive (relationships) and timely. IBM Corporation 5. Develop strategies to respect the need for work life balance to ensure the long term well being and effectiveness of Managers. © Copyright IBM Corporation 2009 Manager Work Life Review - Achievements to date Reorganization of Staffing Offices (Staffing Services) Manager Development Pathway launched (Organizational Development) HR On Boarding service started (People Services) Posting/Hiring software updated to decrease steps (People Services) Attendance Promotion Program implemented (Workplace Health) Early Attendance Reporting Line (Workplace Health) Workplace Injury Line (Workplace Health) IBM Corporation © Copyright IBM Corporation 2009 4. Staffing Systems Support Goal Creating effective scheduling systems to match provider resources to clients’ needs. Services include: Systems support Education Best Practice/Processes development Rotation Development Short Call Operations (Staffing Offices) IBM Corporation © Copyright IBM Corporation 2009 Staffing Services Model Decentralized Staffing Operations Short Call Staffing Offices (nine sites) Program Schedulers Centralized Staffing Systems Support Staffing Advisory HR/Staffing Committee Technical/Content/Process Experts Education Courses Scheduling Standards (Guidelines, Tools & IBM Corporation Processes) Computerized Staff Scheduling © Copyright IBM Corporation 2009 Challenges Implementing Service Plans Introducing Staffing Plans Providing expert intervention to assist Managers to match their resources to their deployment needs Increasing full time positions (regular relief) Improving Vacation Planning Processes IBM Corporation © Copyright IBM Corporation 2009 Benefits of Workforce Optimization Clear and consistent messaging on workforce performance expectations. Stronger accountability for results. Improved utilization of resources creating more capacity within the system. Improved cost effectiveness and productivity that is sustainable. Innovative workforce strategies. Improved relationships through partnering. Improved business systems redesign. IBM Corporation Improved staff engagement and retention. © Copyright IBM Corporation 2009 Questions?
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