Start a Staffing Agency Business

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					Written: October 1998                                       Nursing Policy: S-48
Revised: 11/98; 12/99; 3/01; 4/01; 7/04; 06/05              LSUHSC -Shreveport, LA
2/06; 2/09; 4/10


To provide an automated scheduling and staffing system (ANSOS) that assigns a sufficient
number of qualified nursing staff to meet patient care needs throughout the inpatient care service
areas based on patient demands, projected workload measurements, unit-specific parameters,
departmental policies, and JCAHO staffing standards.


I.    Position Control and Employee Database

      A.     Nursing Business Office (NBO)/designee shall maintain an accurate employee
             database for position control, which includes employee demographic information,
             new hires, transfers, terminations, and vacant positions.

      B.     Administrative Directors/Unit Managers shall be responsible for communicating
             employee information to NBO using an ANSOS personnel action form, electronic
             mail, and/or a phone call at the time an employee is selected for a vacant position,
             transfers (including medical school), or resigns/terminates and upon notification of
             any changes in employee demographic information. NBO notification shall occur
             immediately and no later than five (5) days after the employee action occurs.
             Directors shall be notified when information is not received within five (5) days.

      C.     NBO shall assign unit position (UPOS) numbers, create/maintain budgeted
             positions, and maintain FTE position control balance in the automated system’s
             database. NBO shall enter reference notes to UPOS positions and update data in
             Unit Budget FTEs.

      D.     NBO enters data for employee transfers or promotions into ANSOS and sends an
             ANSOS personnel action form to the Staffing Office for entry of new employee
             information into the computer. The individual employee database shall be kept as
             accurate as possible for scheduling purposes and management reports.

      E.     Employee wage information is entered into ANSOS by NBO/designee. The
             employee wage/shift differential data changes shall be entered upon receipt of a
             Human Resource Management (HRM) form with an effective date. The form shall
             be forwarded to the Patient Care Standards Office (BG13) for departmental files and
             distribution. (Access to enter wage data or view ANSOS wage screens is limited to
             designated administrative staff and management). Overtime codes will be
             determined based on worked hours in a pay period by Nursing Management.

S-48: Nursing Business and Staffing Office Guidelines                                   Page 2 of 6

II.   Centralized Schedule Preparation

      A.     Unit-specific parameters (rules), including core coverage, shall be determined by
             Directors and shall reflect available FTEs and minimum staffing requirements.

      B.     The Staffing Office shall maintain an accurate employee scheduling profile in
             Controller, which includes non-duty shift length, overtime code, maximum work
             stretch, rotations, tours, fixed skeleton, and week-end patterns.

      C.     Managers shall be responsible for scheduling changes or timely notification of the
             Staffing Office of any employee shift changes, etc., which impacts the scheduling

      D.     New employees shall be scheduled for the first available Nursing Orientation after
             hire date. Scheduling codes for new employees in orientation shall change to count
             in staffing coverage at the completion of six (6) weeks from hire date, unless
             specific instructions are received from the Director/Manager.

      E.     The work week shall start on Monday at 0001. Employees shall not be scheduled to
             work more than sixteen (16) consecutive hours. Unit-specific start times and
             scheduling codes appear on the posted schedules. Scheduling exceptions may be
             necessary to provide minimum coverage and meet patient needs.

      F.     Employees shall be hired for primary shifts as indicated by their UPOS and may be
             required to rotate as necessary for coverage.

      G.     Unscheduled absences (one or both days) on a scheduled weekend shall require a
             “make- up weekend” (both days-Saturday and Sunday) if possible in one of the next
             two (2) posted schedules or at the Unit Manager’s discretion based on staffing need.
             The employee may be re-assigned to another unit in the service area as needed on
             the make-up weekend.

      H.     Employees can request leave a year in advance. Generally, leave should be requested
             a minimum of two weeks before the next posted schedule starts. The Staffing Office
             shall distribute a list of Leave Request Due Dates each fiscal year for units to post as
             a time frame reference for employees.

      I.     The Manager shall receive and review employee leave requests for approval or
             disapproval in accordance with scheduling guidelines, hospital leave policies, and
             the employee’s accrued leave balances, prior to scheduling requests.

S-48: Nursing Business and Staffing Office Guidelines                                  Page 3 of 6

      J.     Scheduled leave for the same shift on a unit shall be limited to a maximum of two
             (2) employees during the scheduling process on a “first requested, first granted”
             basis. Scheduled leave shall be based upon the Manager’s approval, the date that the
             request was received, and availability of staff. Emergency and/or unscheduled leave
             is entered into Staffer by the Manager. Requested leave that can not be scheduled
             shall have the reason noted on the leave form and the request form shall be returned
             to the Manager.

      K.     Employees shall be scheduled for external educational offerings and/or all day
             workshops as determined by the Director/Manager of the area and upon receipt of
             approved leave requests. Mandatory Education Day (MED) shall be scheduled for
             ancillary staff in accordance with the annual MED master list supplied each fiscal
             year from PCS-Standards office.         Licensed staff shall self-schedule MED

      L.     Employees requesting changes or “swaps” in posted schedules shall obtain approval
             from the Manager. Swaps or changes in schedule cannot place either employee into
             overtime. Employees who fail to work the approved “swap” are subject to the
             departmental call-in policies.

      M.     Managers may enter future schedule changes until 4pm each day provided the
             change does not impact the staffing for the next 24-hours. Staffing changes that
             impact the next three shifts, 3-11, 11-7, and 7-3 must be communicated to the
             Staffing Office.

      N.     Holidays shall be scheduled off in an alternate pattern in accordance with the official
             Civil Service memorandum distributed each fiscal year. Official Holidays
             (Christmas12/25, New Years 1/1, Easter Sunday, and Fourth of July 7/4) that may
             occur on a weekend date shall be scheduled in an alternate pattern each year or with
             a Unit Holiday Preference List as directed by Nursing Administration.

S-48: Nursing Business and Staffing Office Guidelines                                Page 4 of 6

      O.     Vacation requests (40 hours annual leave or more) shall be submitted with as much
             advance notice as possible (one year). Vacations shall not be requested or scheduled
             during the holiday week of Thanksgiving, Christmas, and New Years. On an
             individual basis, annual leave requests for 16 hours or less may be considered based
             on staffing and coverage needs during the holiday period.

      P.     Scheduling “holes” shall be covered with rotations, excess core coverage within a
             division, available flex staff, and a minimum of overtime to provide sufficient
             coverage to met patient needs. Flex nurses (PRNs) shall be utilized in accordance
             with written policies and scheduling needs.

      Q.     Managers shall post final schedules one week prior to the beginning of the new
             schedule start date.

      R.     The Staffing Office shall be responsible for implementing a manual back-up
             scheduling/staffing system in the event of extended computer downtime for a 24-
             hour period.

      S.     The staffing/scheduling system shall be evaluated periodically and annually.

II.   Daily Staffing Activities

      A.     Staffing shall be based on unit-specific core coverage requirements as identified by
             Administrative Directors.

      B.     The Staffing Office shall maintain an employee call-in log with actual time and
             reasons stated, and enter the data into the computer. Employees shall call-in
             absences within a minimum of two hours of their scheduled shift start time.

      C.     Unplanned absenteeism shall be covered with actual staff when staff is in excess of
             required (target) numbers within service area groups. Available flex staff shall be
             utilized when possible. Re-scheduling shifts and hours of work to cover extended
             absences (more than 3 shifts) may be done as necessary to minimize the need for
             overtime. Overtime is the last coverage option to use.

      D.     Employees are oriented and competency documented on the nursing and
             disease processes and procedures. Therefore, employees may be re-assigned
             from their home unit to other units as necessary to achieve targeted number of staff.

S-48: Nursing Business and Staffing Office Guidelines                                   Page 5 of 6

      E.     Staff shall report to work as scheduled unless otherwise instructed. Nursing staff
             shall provide accurate staffing information, ie census, patient activity, nurse patient
             ratios, etc. to the Staffing Office/ House Manager to assist with re-assignment to
             other units based on service area and competencies. Staff that is not needed on any
             unit may be canceled by the House Manager/Staffing Office prior to the shift in the
             following order: overtime, flex, agency/contract staff, excess regular staff when
             notified by the Unit Manager/designee. Canceled regular (excess) staff may use paid
             leave or unpaid leave pending their manager’s approval.

Staffing factors to consider:
Low Census=50% or more decrease in occupancy (budgeted census) or closed unit.

Admissions, Discharges, Transfers = greater than six (6) of these activities/shift increasing or
decreasing staffing requirements. Assessment of unit activity must be done.

Core coverage = Minimum staffing requirement (may include a predetermined unit’s nurse-
patient ratio). Staff shall be utilized a) for required coverage, b) to minimize overtime, c) to
complete FTE worked hours.

S-48: Nursing Business and Staffing Office Guidelines                             Page 6 of 6

_______________________________________________         _______________________
Jamie Jett, MBA, RN                                          Date
Administrative Nursing Director
Psychiatry, Coordinated Care and
Professional Practice

_______________________________________                 ____________________
Jean DiGrazia, MBA, RN                                        Date
Assistant Administrator and CNO
Patient Care Services


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