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Benefits of Workforce Optimization

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					          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?