Arizona hospital introduces online shift bidding and staffing system, reducing the time nurse managers spend scheduling and saving contract nursing labor costs.
In today’s competitive labor market, healthcare organizations need to retain qualified staff and effectively use existing resources. When faced with the ongoing challenge to fill open shifts, we decided to make the best use of our own workforce by implementing an online shift bidding and staffing system. Today, at Tucson Medical Center (TMC), we have cut the use of temporary contract nurses by nearly half.
Arizona hospital introduces online shift bidding and staffing system, reducing the time nurse managers spend scheduling and saving contract nursing labor costs.
Rosemary Notarantonio is chief nursing officer at TMC HealthCare. Contact her at rosemary.notarantonio@tmcaz.com
In today’s competitive labor market, healthcare organizations need to retain qualified staff and effectively use existing resources. When faced with the ongoing challenge to fill open shifts, we decided to make the best use of our own workforce by implementing an online shift bidding and staffing system. Today, at Tucson Medical Center (TMC), we have cut the use of temporary contract nurses by nearly half.
TMC is a 647-bed, nonprofit community hospital that employs a total of 1,520 R.N.s and nursing support personnel and cares for approximately 33,000 patients a year. It is part of TMC HealthCare in Southern Arizona, which also includes El Dorado Hospital, a freestanding hospice facility and a psychiatric center.
When I arrived at TMC as chief nursing officer in May 2004, our nurse managers were spending about 60 percent of their time each week creating paper lists and telephoning staff to fill vacant shifts. We were increasingly using costly external agencies to fill open shifts at a rate of nearly 20 percent more per hour than we paid our internal staff. Our nurses were beginning to resent working side by side with higher paid resources that were less familiar with TMC’s routines, policies and procedures. There had to be a better way to solve the longstanding problem of efficiently scheduling open shifts.
A Divining Moment
In July 2004, both the nursing director of adult services and the director of forecasting and analysis coincidentally approached me with articles about a company called BidShift Inc. in San Diego that specialized in workforce optimization and shift scheduling technology. We formed a committee with representatives from IT, financial services, and nursing and agreed that shift bidding software seemed to be the logical means to address our workforce staffing issues.
Next, I prepared a business plan, which was authorized by TMC’s executive team. We interviewed two vendors in the shift scheduling market. What differentiated BidShift from the beginning was their team’s clinical framework and depth of experience. Nurses were involved at every level at the company, from executive leadership to client services, which assured us they understood our issues and objectives.
We asked BidShift to demonstrate their software to all of our nursing directors, managers and educators. The concept was easy: Nurse managers post open shifts across care settings on the Internet for qualified employees to review and request to work for a specific wage. Employees log on from anywhere there is Internet access, from the hospital or the comfort of their own homes, to see what shifts are available that match their skills and experience. To be eligible to bid, each employee completes a profile of his or her education, experience and contact information. It only takes a few minutes to complete, and then it’s three clicks to make a bid.
Pay Options and Incentives
To encourage employees to fill open shifts, the system offers a wide variety of different types of pay options and incentives, and can be configured to support variable-rate bidding, where shift openings are assigned a dollar incentive above base pay or a minimum and maximum hourly pay rate. We could also use self-scheduling, where shift openings are posted at set rates, with bonuses, point reward programs or lump sum incentives. Once shift requests are submitted online, the staffing manager reviews the list of employees who requested to work the shift and assigns the shift based on a variety of criteria including skill mix, experience and cost. Employees are notified via e-mail when they have been awarded the shift. If employees don’t get an e-mail, they know they did not win the bid.
We signed the contract with BidShift in February 2005 and the next month piloted the application on the critical care and surgical nursing units using a regular rate self-scheduling pay option. Because BidShift was provided as a hosted applications model for a monthly fee, implementation was fast and easy. We didn’t have to purchase hardware, maintain software or impact TMC’s internal IT resources. The system was so user friendly that staff required no formal training.
After the initial success of the pilot units, the technology was made available to all nursing units in April 2005.
In July 2005, we opened the shift bidding program to patient care technicians, nurses’ aides, unit clerks and respiratory therapy.
Nurses Like Flexibility
In the first six months of using the new system, we filled more than 8,400 shifts internally through a combination of regular and incentive pay, and reduced use of temporary agency personnel by nearly 50 percent. Nurse managers, who use the full capabilities of the new system, now spend an average of an hour per day scheduling staff, compared to the average two hours they used to spend per day.
Today, more than 1,300 R.N.s and nursing support personnel have logged in to the system (88 percent of eligible employees), and more than 1,000 have bid on shifts. Given our experience to date, we are anticipating a 25 percent savings in 2006, mainly through reductions in temporary staffing. We expect additional savings in recruitment, retention and process improvement gains. We already are experiencing a 3 percent reduction in turnover rate.
Process improvement has been a major benefit for nurses and managers as the scheduling technology has completely automated our old paper-based system for posting open shifts. Although shift bidding and scheduling is new to us, we already see huge potential results for this technology, and will continue to pursue our goal of 95 percent participation by TMC nursing staff by mid-2006.
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