By Jackie Larson, Senior Vice President, Client Services, Avantas
In a lot of respects, care staff are just like anyone else when it comes to things they need at work to be happy and successful. They need fair compensation, a safe environment, support from managers, empowerment to do their jobs the right way, time off to recharge, etc. What makes them different is what they actually do – provide hands-on care to people.
Not giving care staff the things they need to feel energized and positive about their crucial role in the continuum of care can create a butterfly effect with terrible ramifications.
Turnover is the eventual outcome of unchecked poor staff satisfaction. By the time the stressors have added up and resulted in turnover, the collateral damage has already been done. The caregiver has suffered, as has their family. The organization has suffered and will incur costs to replace the employee.
And, patients have undoubtedly suffered, not intentionally by any means, but as a result of being cared for by a person who is undergoing a stressful situation – possibly working too many hours or dealing with any number of frustrations. Nurses do their best to provide excellent care regardless of what is going on around them, but few can argue that the best care comes from nurses who are happy with their job, their coworkers, and their organization.
Several recent studies by organizations including the Robert Wood Johnson Foundation and the American Association of Colleges of Nursing cite that “staffing issues” is one of the top five causes of turnover.
Relative to staffing, we have found five factors can erode staff satisfaction:
- No/little control over their schedule
- Floating and/or cancellations
- Last-minute and frequent recruitment calls
- Unfair application of policies
- Lack of transparency
Looking at each one, we can easily identify strategies to increase staff satisfaction:
1. Control Over Schedules
Many organizations find value in giving staff a say in their schedule creation. Some employ self-scheduling or a combination of self-scheduling and a traditional scheduling methodology. Regardless of whether an organization utilizes this methodology, all organizations can provide an avenue to seek employee input in the schedule creation process. The key with this however is to ensure that the result is a balanced schedule that will meet patient demand. No schedule is going to be perfect, but all schedules should provide employees the opportunity to function at the top of their scope while enjoying a healthy work/life balance.
2. Reduced Floating and Cancellations
Both of these staff dissatisfiers can be reduced by better aligning staff resources to patient demand. If you are familiar with Avantas, you know that we have been forecasting patient volumes with our Predictive Modeling for more than 10 years, but even without this technology, you can make some progress in this area. By looking at volume trends, you can identify some very basic patterns in patient volume. For example, Unit A sees a general rise in patient numbers through the week, peaking on Wednesday and Thursday and falling back down during the weekend. Obviously, Monday will require less staff than Wednesday, so your scheduling should try to mirror this.
3. Reduced Last-Minute Recruitment
In addition to the idea discussed in the previous section, a proactive open-shift management methodology that rewards staff for picking up shifts weeks in advance can be implemented. Pairing this with the development of multiple layers of contingency staffing sources that can be deployed just before the shift can alleviate a lot of the unknowns that lead up to “staffing chaos” resulting in last-minute recruitment calls.
4. Fair and Equal Application of Policies
Few things are more frustrating than feeling you are being treated differently than your coworker. Favoritism, even the suspicion of it, is an incredibly destructive force. An organization’s staffing policies must be the same across the system and uniformly put into practice. Beyond ensuring fairness, the standardized application of polices is also a financially responsible practice. Variance creates inefficiency. Ideally, an organization’s staffing and scheduling policies can be embedded and automated with their scheduling solution. If that functionality does not exist, the onus is on leadership to ensure managers are consistent.
5. Providing Transparency
Transparency can mean a lot of things. For instance, organizations that are transparent with regard to financial performance tend to have staff that are more engaged and understand their role in its success. With scheduling and staffing, transparency can refer to the posting of open shifts, the ability to view schedules online, and submit trades and other staff requests 24/7. Transparency also means the breaking down of silos. These silos can exist between peer groups, hospitals and practice sites across the system, and between different groups, e.g., Nursing, Finance, HR, etc. Transparency, whatever definition you focus on, provides organizations with the framework to more effectively communicate, implement change when needed, and operate as a single entity instead of a collection of departments.
Putting it into Practice
These five strategies for improving staff satisfaction sound good, but do they work? According to Press Ganey, they do. One Avantas client that has successfully implemented these strategies has seen RN satisfaction with staffing climb from the 18th percentile in 2006 to the 81st percentile in 2012. This improvement in staff satisfaction was accompanied by millions of dollars in savings.
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