Roundtable Discussion #3

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COVID-19 is a fluid, and unprecedented situation. Open cooperation among providers, peers, and colleagues is one of the ways we will get to the other side of this challenging time. With a focus solely on helping organizations effectively manage their staff – day-to-day, short-term, and long-term planning – Avantas is holding weekly, all-client calls as a platform to share strategies and learnings from across the country.

In our latest roundtable discussion, Avantas facilitated a discussion with two health systems in the Midwest. The first health system discussed their “big picture” current state and how they are preparing for the next phase of COVID-19: the gradual return of elective procedures. The second health system shared what they are doing in a virtual care setting.


HEALTH SYSTEM #1:

1.
In relationship to infections, their organization has had 14 patients test positive for COVID-19 and 17 who are in rule-out status. The positive cases have steadied and have essentially decreased. They recently opened four drive-through clinics.

2.
On May 4, the states where they have facilities began allowing for elective procedures to commence. However, an uptick of COVID-19 infections is expected. They will monitor closely and will stagger in additional outpatient and, eventually, inpatient procedures as more information unfolds after the re-opening. Their transplant and cardiac critical care units have re-opened; their orthopedic units are still closed, and the maternal/child units have maintained normal volumes.

3.
Two ways they have utilized their scheduling technology to help identify certain buckets of employees are:

  • They built in an N95 skill in their system to mark employees who needed to maintain a certain level of personal protective equipment.
  • An “Involuntary Cancel” code was built to easily identify those employees who were not working up to their FTE and could be eligible to receive unemployment benefits.

4.
This organization felt they have successfully navigated the challenges of low volumes, shift cancellations, and floating, utilizing a number of strategies, some of which were developed in response to the pandemic and some were already part of their culture.

  • Their Open Shift program had already been adopted by most in the organization, so there was no learning curve as they utilized it heavily to recruit for high-volume areas.
  • They have three huddles a day, which has helped team members who are new to each unit acclimate quickly.
  • Staff receive a 10-minute video from the CEO or care providers daily, which provides transparency into the current state and future plans regarding COVID-19. Their teams also get email updates twice daily.
  • New hires currently in orientation are getting the opportunity to do other jobs/tasks they wouldn’t normally get exposure to if a preceptor for their hired position is unavailable. It is keeping new staff engaged and paid.
  • Staff can submit a request to human resources to be reassigned work if they are not getting their hours. This work has include areas like housekeeping and even landscaping.

5.
They learned significant lessons pertaining to employees with PRN status.

  • Historically, this organization has relied heavily on PRNs – they have a large population of available PRNs – and do not utilize outsourced agency resources.
  • Over time, the PRN staff have become accustomed to full-time hours and have been able to self-schedule shifts right alongside core staff in their scheduling technology, leading to the mindset of PRN staff members being entitled to full-time hours at their convenience. Due to this challenge, they are considering altering this scheduling practice and moving PRN scheduling exclusively to an Open Shift model with a 30-day rolling calendar.


HEALTH SYSTEM #2:

1.
This organization is utilizing their scheduling tool to schedule virtual care clinicians. The virtual care unit is set up as a regular inpatient unit.

2.
The virtual care area is divided into four different care types.

3.
The Nurse on-call unit consists of nurses that field patient calls and provide virtual care, e.g., vitals, assessments, etc.

The Nurse on-call unit uses call volume as a workload indicator. The staffing plan is built to staff one nurse for every 4-5 calls/hour.

The nurse on-call unit has a very volatile census, fluctuating from needing 4 nurses to as many as 13 in one hour. Therefore, their scheduling balancers (which account for number of staff needed by volume) in the scheduling system have frequent intervals – much more often than the standard 4-times daily which is the norm for inpatient areas.

Be sure to check back weekly for a rundown of new topics and strategies, as well as new learnings on continuing challenges.

If you need staffing resources, please call our hotline at 800-887-1456.

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