Nurse Scheduling Problems Solved by Predictive Analytics

By Marcia Faller, RN, PhD

 Problems Solved img_300x200

Surveys of nurse attitudes reveal a striking paradox. Nurses declare the highest career satisfaction of almost any profession – nurses love being nurses. But when asked about their own particular jobs, satisfaction rates drop by about 20%. And then, when asked if they often feel like quitting and if their job is affecting their health, significant percentages say yes.

What is causing this disconnect? Research shows that common scheduling and staffing procedures are causing dissatisfaction and even burnout among nurses. These antiquated management processes also negatively impact patient care, safety and satisfaction, along with the healthcare facility’s bottom line. Among these practices are mandatory overtime, cancellations of shifts, forced floating to other units and departments, undesirable or rotating shifts, cancellation of time off, and nurses given non-nursing tasks.

As many nurses can attest, problematic scheduling and staffing practices often spill over into their personal lives, when something as simple as scheduling a family vacation six months in advance can become very difficult. Unplanned mandatory overtime or forced floating to a different unit with a new schedule can be very disruptive. A 2010 study on factors contributing to nurse job satisfaction, published in the Journal of Nursing Management, concluded: “The capacity for a work–life balance through the ability to combine work hours with a social life seems critical for nurses.”

Here is the essence of the problem: Healthcare has become exponentially more complex in recent decades, driven by the continuous advancement of treatment, diagnostics, technology, marketplace pressures and regulatory mandates, and more recently by a surge in patient demand for services. But scheduling and staffing practices have remained a patchwork of outdated procedures that are often ineffective in the modern world of healthcare.

Outmoded scheduling and staffing procedures can also affect retention of quality healthcare professionals -- a very important issue for hospitals and health systems facing rising demand and constrained supply. Healthcare facilities are having increasing troubles finding the people they need, and this problem will get worse as shortages grow and our aging population needs more care. A 2011 study published in Nursing Economics concluded that scheduling is an important predictor of whether a nurse remains in nursing.

With mounting evidence that understaffed units and overworked nurses result in worse patient outcomes, state legislatures are debating mandatory nurse-patient ratios. Health systems often oppose mandatory ratios because they reduce flexibility to operate in the fast-changing healthcare environment.

An effective alternative could be technology-enabled scheduling and staffing solutions. Predictive analytics utilizing big data can provide healthcare facilities with accurate forecasts of future staffing needs, along with expert healthcare labor management to optimize existing clinical staff. The result can be a significant reduction in the staffing and scheduling problems that traditionally afflict healthcare facilities and their workforces.

One such labor management company seeing results with this approach is Avantas, an AMN Healthcare company that pioneered the application of predictive modeling and advanced labor management techniques to healthcare staffing. Its documented results include a 4% to 7% savings over the prior year of labor spending, which is substantial considering that labor costs are more than half of all expenditures for hospitals and healthcare systems. Other results include more than 75% of open shifts filled at least two weeks in advance and time savings of 7-15 hours per manager per pay period.

Advanced scheduling and staffing procedures result in even more fundamental solutions: improvement in patient care, outcomes and experience; greater job satisfaction and less burnout for healthcare professionals; smoother transition to new models of value-based, patient-centered care and population health programs; and optimization of current staff. Many of the stresses that healthcare workers experience are endemic to the profession and to healthcare in general. But stresses caused by scheduling and staffing problems can be controlled today.

As the survey paradox shows, nursing is a rewarding and difficult job. For nurses, stability in work scheduling and staffing results in less work-related stress and greater satisfaction. For healthcare enterprises, it means greater patient satisfaction, better patient safety and outcomes, and reduced staff turnover, thus improvement in patient care and reduction in costs.

This combination of benefits makes it worthwhile for all care provider organizations to consider predictive analytics and expert labor management now available in the healthcare industry.