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 Marlborough: PartnersImprove Productivity By Candra Szymanski, RN, MS Chief Operating Officer Marlborough Hospital  Our Productivity Problem Marlborough Hospital, a member of UMass Memorial Health Care, is a small community facility of 700 FTEs. For years, we faced a serious productivity issue on Friday afternoons and Monday mornings as we struggled to get payroll done. For at least four hours apiece, 35 managers across all departments – eight of them nurse managers – would huddle in their offices punching calculators. This translated to about 105 hours of management time each week, a staggering 5,460 hours per year - the equivalent of 2.6 FTEs. With a growth in inpatient volume in recent years, we soon outgrew our manual systems. Because productivity data was only available retrospectively at the end of the month, managers couldn't accurately adjust staff to meet patient care demands and often found themselves defending their decisions without the necessary data. Nursing and Finance Forge a Partnership Prior to our tenure at Marlborough, the CFO and I both worked at facilities that tied the data from their automated staff scheduling and productivity application into the payroll system. We both recognized the value of an integrated system and worked together to find synergies between our departments that would enable us to build a successful collaboration. From the financial perspective, the benefits included position control and workflow improvements as well as the ability to electronically generate reports. On the clinical side of the house, I wanted to automatically build schedules based on department-specific metrics and patient volume and decrease the time managers spent manually creating schedules to staff their units. Both Finance and Nursing hoped to realize a financial benefit by reducing our expense in agency staff through better utilization of our own per diem staff. We also wanted a system that would help us meet reporting requirements such as the Massachusetts Hospital Association (MHA) Patients First initiative. Patients First is designed to provide transparency on staffing levels. It uses the staffing guidelines proposed by MHA and the Massachusetts Organization of Nurse Executives (MONE) to ensure that appropriately credentialed care providers are available for all patients. After the CFO and I agreed on these mutual goals, we used a joint top-down approach to show the importance of the project at the executive level. To ensure there was consistency with the UMass Health Care System, Marlborough implemented McKesson's ANSOS One-Staff™ enterprise productivity management solution. Improved Visibility Decreases Staffing Costs As you might expect, automating the scheduling process was incredibly valuable. Eliminating the transcription of hardcopy schedules probably saves each nurse manager 5-6 hours weekly. With the integration of the scheduling and payroll systems, the payroll clerk's data entry has been reduced from 3 days a week to about 4 hours. Now she can focus on charge entry work, which has expedited our A/R. Now that the system is automated, managers are able to identify holes in the schedule and fill them with per diem staff or regular staff ahead of time. Since existing staff - even those on overtime - are cheaper than agency staff, it works well for our employees, for patient care continuity and for our bottom line. All departments at Marlborough now are using the ANSOS One-Staff system for scheduling and productivity management. Many of these departments weren't using any productivity tools before, and the process has opened their eyes to the impact that their staffing decisions have on productivity. Our managers are now empowered to make staffing decisions based on real-time data. And our new-found ability to differentiate between productive and non-productive time enables managers to justify their staffing decisions in support of patient care – a huge benefit. Seeing the immediate impact of leadership decisions is really rewarding. Candra Szymanski, RN, MS, joined the UMass Memorial Health Care system as an Emergency Department staff nurse in 1981 and later became Director for Emergency Services at the facility. Candra joined Marlborough in 1999 as the Vice President of Patient Care and in 2005 moved into the COO position responsible for Patient Care and Facilities Services.
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By using a centralized staffing office with automated staffing, Sharp HealthCare is optimizing staffing resources to avoid agency usage, improve patient care and empower nursing staff.
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