hire targets top tips
PROBLEM WITH BUDGET-BASED
Hiring to budget sounds intuitive - and it certainly is for fixed departments. However, in variable departments, it's not so straightforward.
Annual budget FTEs are simply an average of monthly FTEs, regardless of the distance between the min and max months. This means that seasonal areas (Emergency Departments in Maine, Florida, etc) are almost never staffed correctly.
If your organization approves positions according to department budget, consider reviewing volume fluctuations closely and consider alternatives that optimize the hired-in FTE value in variable departments. You will likely identify significant staffing pain points and you may find significant savings in premium pay!
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CFO TELLING YOU NO?
Raise your hand if you've been forced to use premium labor because your department was unfavorable to productivity
The philosophy behind holding on positions when missing target is, of course, a relatively good one. The thought is, if we are missing productivity, we don't want to add more staff to miss by even more hours.
That said, in variable hospital departments the equation is a bit more complex. Is more volume coming in 60 days? Are you missing due to 5 orientees that will be replacing contractors in a few weeks? Did 3 night RNs resign and will be leaving soon? If we hold on positions in each of these scenarios, we will spend more on labor than if we had approved them - or we will be understaffed.
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HARDWIRING PREMIUM PAY
Approving positions based on productivity performance can be considered advanced, but use caution! Any single labor metric can be misleading without context. Be sure to consult multiple metrics when approving positions, including premium pay utilization and temporary needs, like orientation.
Inadvertently holding on necessary FTE approvals can create gaps in schedules as volume seasonally increases. This can lead to increased overtime to fill schedule gaps and increases the likelihood of staff burnout and turnover. Remember - once we approve positions, new employees cannot begin work immediately. They must be oriented, which not only delays premium pay relief, but these orientation hours can cause another productivity miss.
Think strategically - do not get caught in the premium pay death spiral!
#hospitalmanagement #hospitalfinance #hospitaloperations #nurseleaders #healthcareleadership #hospitaladministration
HIRING TO PAID FTEs
Be sure you do not neglect the final step to implementing department FTE hire targets - adding nonproductive time!
Worked shifts represent productive FTEs while hired-in FTEs must also include paid employee time on top of worked hours. These "nonproductive hours" represent PTO, bereavement, jury duty, etc. Departments that make the mistake of hiring to productive instead of paid FTEs will be will be short staffed in excess of 10%!
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