All About Nursing Show 4

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Welcome to All About Nursing with your host, Dr. Joyce Bachelon, executive nurse advisor, Dr. Bachelou, who will present the significant role of nurses play in providing healthcare in a multitude of healthcare settings. Listen to some of today's key nurses who work in practice in academia settings and talk about the challenges they face in today's modern medical world.

So please welcome the host of All About Nursing, Dr. Joyce Bachelor. Good evening. I'm your host, Dr.

Joyce Bachelor, on All About Nursing, and we're live on the BBM Global Network and Tune in Radio. Last week I had Dr. Marcia Fowler, who is the Chief Clinical Officer from AIMM and Health Care on the show, who shared the findings of an RN survey and other research that she led. Marcia described that one of the options that nurses have is to work for a company that places them in what we call traveler assignments.

Many hospitals use travelers to assist them with fluctuations that they may see at peak census times or high turnover or retirements. Marcia also talked about the fact that there are a lot of baby boomers who plan to retire in the next three to five years and planning for this kind of exit as the experience nurses is key. Tonight we're going to continue to discuss the important role in nurse playing hospital settings and specifically talk about nurse staffing since it is linked to patient outcomes and patient satisfaction. So what are hospital leaders doing to assure that they have enough nurses?

People come to the hospital for nursing care. Otherwise, a lot of the care that people might need could be done in an outpatient treatment center at home or in a clinic. So it makes sense that it's important for leaders to assure that they have the right number of staff to care for patients and their organizations. No one wants to hear that the organization is close to admissions or can't admit patients because they don't have enough nurses.

Having spent most of my career in hospitals, I can honestly say I have been asked numerous times do you have enough staff now? My answer usually has been it depends. And it depends on a lot of factors. For example, the number of patients that the staff are going to be needing to take care of.

In addition, how complex or sick the patients are as well as the experience level of the staff, now being called the expertise gap as more baby boomers retire. The mix of staff, the number of licensed versus unlicensed personnel, the number of anticipated admissions transfers, discharges that the department might experience. In addition, the unit might need to be looking at the number of vacancies, resignations, transfers, retirements, and of course sick calls that are needing to be managed. Some positions are also more difficult to fill or take a lot longer to develop.

An example would be nurses who work in surgery have very highly specialized knowledge and skills. Nurses that come right out of school and even those with experience require much longer orientation and training process. There are a lot more details that most charge nurses and leaders automatically think about when they start working on these staffing issues. Fortunately, we do have some advanced, we have advanced with some of the automated staffing scheduling systems to help us to assure that we're doing this well.

This is really key because how you staff impacts not only patient care, but staff morale and engagement. The bottom line is that nursing great leaders know that their budgets will always be in the spotlight since we're a rather large item on the expense sheet. I shared with you the first week that I'm a former system chief nursing officer and when I was involved in my role, I really assisted in workforce planning since we were opening three new hospitals in two and a half years at the same time implementing a new electronic healthcare record. Making sure we had the right number of nurses with the right level of experience and training was critical to assure positive patient outcomes and satisfaction.

Having tools to assist with this planning is essential. The great part from my perspective is that companies have continued to improve these systems. My guest is the solution consultant is going to share with us how predictive analytical tools can be used. Larry has more than a decade of healthcare consulting experience and a track record of uncovering opportunities to help provide organizations overcome workforce management challenges to drive substantial and sustainable cost and quality improvements.

His experience covers the continued care, acute care to ancillary, medical groups, outpatient surgery centers and senior living. An experienced public speaker, Larry has presented at regional and national healthcare conventions and conferences. He's a member of the following organizations, the American College of Healthcare and Secutives and the healthcare financial management association. I'm delighted to have Larry on the show this evening.

Larry, let us start with you telling us a little bit about how you got interested in working on predictive analytics to assist with staffing. Yeah, you've had, first of all, hi, Joyce. Thanks for having me on the show. I did listen last week in your conversation with Marcia, so it's an honor to be with you.

How did we get involved with predictive analytics? Well, I think it really stemmed from our own frustration back in the late 90s when we looked across our own five hospital system, which at the time was a lead to health in Nebraska. We consistently saw calling off resources floating to different areas on one unit with a different, very similar med surgery in a different hospital, would be looking for additional resources or putting someone over time or, first of all, looking at travelers in more expensive forms of resources. It really was a lack of transparency across those systems.

So I think we knew that we needed to create some transparency across our organization to understand where those gaps were and how we could more efficiently fill those. But we also needed to do that in a way that we could predict and begin to predict 30 and 60 days in advance of the shift, the number of resources that we needed with some degree of accuracy so that we could align those resources against that volume or number of patients that needed care. So we needed to get to a point where it would impact the quality of care that we were able to provide. So we developed a predictive model which helped determine the number of individuals that are needed on any given unit, on any given service line, any given hospital across an entire organization.

And the real benefit that we found within our own healthcare organization was in the first year that we implemented this process, this kind of predictability, the ability to predict the number of resources you would need based on predicted volume, the organization saw an eight and a half million dollar savings. But it was beyond just the cost and the same time that healthcare system was named the number one quality system in the country and staff satisfaction improved and we reduced turnover. So we really were able to in our first year improve staff satisfaction, reduce cost, improve quality. And I think that's a kind of a way to take a look at the tier four.

We thought maybe we couldn't do all three at the same time but we proved that you could do that. So predictive analytics for us was really born out of necessity. So how do predictive analytics really work with all those staffing complexities? I mean what does that mean?

Like what goes into helping with all those predictions? Is it a software program? How does it work? Yeah, it is.

So there is a software solution to predictive models built within our own healthcare system. We were predicting volumes outside of the software solution that we ended up developing back in 2007 to predict volume. How is built into a software solution, software solutions called Smart Square. There are a few ways that we predict on a daily basis, on a weekly basis, you know, you look at the variability of the schedules.

The point is to create a roadmap to better initial schedules for managers. So they have access to a prediction 30, 60 days in advance of the ship. They'll begin to create a more clearer picture of what their actual staffing needs are. So they can align by skill mix on their unit or underserved line across a large organization the number of resources they need, which eliminates, I think you mentioned before, you were asked, do you have enough staff and you said it depends, right?

It's kind of that chaos that we get into in that day of the ship and we have a couple of absence calls or somebody takes PTO or volume spikes and we have this for one to one. All of that variability is something that is a reality in data to healthcare. And so being more predictable allows us to align those resources well and advance the shift. And I know that I've heard you talk about this before, that it's also helping leaders to not have to be on the phone calling and begging staff on a frequent basis because I know is that correct?

Yeah, we think about what we do in healthcare, Joyce. We hire great individuals who are really good at what they do. We make them managers and then suddenly we turn them into schedulers, right? And they have to deal with this day to day chaos of managing calls and time off and trades and phone calls and ships swaps and getting on the phone trying to find the initial resource on the unit.

It's all of that chaos that they have to deal with through a more predictable way to manage resources. You can eliminate a lot of that chaos of managers deal with move that administrative work off of their workload and allow them to focus on the real work of providing care to patients. And we'll continue to talk more about that. This is all about nursing and I'm Dr.

Joyce Bachelor, live on BBM Global Network and it's time to take a short break. Dr. Rob Moyer is the director of the Ocean River Institute and he is passionate about saving the ocean by helping dolphins suffering from nitrogen pollution. Nitrogen is a dangerous pollutant affecting our oceans, altering ocean ecosystems and contributing to global warming.

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You're listening to All About Nursing Live from the BBM Global Network and Tune in Radio. I'm Dr. Joyce Batch, the host of this show. And this evening I have Larry Putney with me, who is before the break, was explaining a little bit about how predictive analytic tools can be used to really assist leaders when they're trying to meet the day-to-day staffing challenges that many organizations face.

And I know when I had been a nursing director, one of the things that was not my favorite job was to always be on the phone begging people to come in when I had call-ins or unanticipated changes. And so, Larry, maybe we can come back to hearing a little bit more about how these predictive analytic tools are really assisting people in helping to get rid of some of that chaos. Yes, let me give you another example. You know, Joyce, you think about what you did as a manager and what directors are using on a day-to-day basis, they continue to try to identify, okay, how many gaps am I going to have out of the future and how can I post those shifts to individuals so they can pick those up?

How can I be really strategic about not over-posting some of those available open-extra shifts that have to be posted, but I also don't want to underestimate because that might have an impact on the quality of care that the organization is able to provide. So through the predictive analytics, and because we are helping initially create a schedule, which is more balanced based on the prediction, so by skill mix, by service line, you can do not have a line to your resources against that prediction. So we know we have a more clear, accurate picture. So those are what we consider core resources that are scheduled to the unit.

We also have a prediction. So 30 days in advance of the shift, we re-predict and this is continually re-predicting any extra open available shifts that may need to be filled through an open shift process can be posted automatically to the individuals who are competent and oriented to pick up those shifts. So no work for the managers, no more than they have to go longer. They have to guess to try to determine how many needs.

And if you want to get really strategic about the way you manage an open shift program, you can actually assign incentive dollars. So as you know, in healthcare, in order to get individuals to pick up shifts in areas and times of high need, we sometimes have to offer incentives or shift bonuses to pick up shifts. We can assign those incentives by demand. So the higher the demand, the harder the shift is to fill, the higher the incentives.

And in real time, this is what you would do on Amazon shopping is you pick up a shift, the availability drops, so the incentive drops. So what you're doing is incentivizing the organization, your entire healthcare system and your staff to get out there early, pick up those shifts that are really hard to fill, your meeting that needs to be organization, but you're also meeting that needs to be your staff. Maybe they like to pick up an extra shift with some shift information. So it meets their needs, it also meets the organization and it takes all of that burden and work away from the managers, directors, house supervisors.

And that sounds really awesome. I was thinking that I was just curious if you could share a little bit about how accurate are these tools and really being able to predict what's going to be needed? Well, that's the key, right? You have a system that works in an approach that works.

You have to have an accurate prediction. So we have done some studies around the accuracy of our prediction. Now remember, we've been doing this since the late 90s within healthcare. So for more than 20 years, we've been predicting volume within a healthcare setting.

So we've been studying the accuracy of the prediction, tweaking our algorithms, tweaking the models, tweaking the indices that we use to help predict within a healthcare system. We just finished an accuracy study on our predictive model. We took a look at 17 different healthcare systems, 970 different units, more than 25 million shifts within those systems from May through September of last year. And what we found was 30 and 60 days before the shift, we are within one resource, 96% of the time.

Now if you just took a look at, you know, in terms of numbers predicted versus numbers needed, we're above 98% in total numbers. So the accuracy of the predictive model is really what drives the entire program because when you have an accurate prediction, you're better able to align your core resources initially through your scheduling process or your self scheduling process. And then you're also able to better manage the OpenShift program using incentive. You know, as you're describing that, I'm thinking about how important this is because when people come into the hospitals, the patients, their families, loved ones, they don't know all this kind of stuff is going on behind the scenes.

They just expect that there's going to be qualified experience kind of people to take care of them. And yet as we're talking, you can hear the complexities that people really do go through on a day to day basis. Having that kind of predictive analysis is just very appealing, especially since, you know, I think it's very important that nurses also feel like it's a, that they can be competent when they come to work. They have people to work with because that is one of the dissatisfieds of some nurses is that when they're working in organizations, they feel like they're working short.

So that's, that's wonderful. Are there steps that help? I think just quickly jump in. I think the two top staff dis-satisfiers that we see from nurses and individuals who are providing care are one being asked to work with non-enough resources, trying to provide patient care and not having enough individuals.

And the second is when they're constantly being asked to float. And so what floating means for those who may not be in the business is constantly being asked to move to a different unit outside of maybe their core competency or a unit that they typically work on every day. They help drive the quality of the patient care, the culture of the organization, they want to continue to work on that unit and provide outstanding care. It's what makes them feel good about, you know, when they go home at night.

And so a more predictive approach, any more transparent schedule and a more predictable schedule that feels the needs of the organization allows them to provide better care. So you're exactly right. It's a staff-satisfier but also improves quality. Yes, I can be remembering that when I was a critical care nurse being told I had a float to a medical surgical unit and not being a very nice person about it because it was, I could tell that the patients needed the help and the staff were appreciative I was there, but that's not what I really wanted to do.

So yes, we do have those challenges for sure. That's awesome. So, Larry, are there steps that healthcare systems who do not utilize predictive analytics can take to really help them become more efficient as a simple starting point? Yeah, I think you know, you can take a look at your historical volume and try to identify ebbs and flows, whether they're seasonal seasonalities or even weekly or maybe there are big events in your area that may drive increased volume or resource scarcity.

You know, we all know in the first day of school. You know, moms want to be with their kids the first day of school. So there's got a resource drain there. So you can take a look and do some of your own analytics.

We also know that regardless of what you use to schedule and staff and manage productivity and deploy resources, if you don't have the right number and pipes and resources within your system assigned to various units, you're going to struggle. And so the first thing you need to do is make sure that you are right size from a core perspective, but you also have the right number and level of individuals within a float pool. And float pools are really key to your role strategy as well. So we are coming to you live from the BPM Global Network and TuneIn Radio for the All About Nursing Show and I'm Dr.

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Get in touch today. I'm your host, Dr. Joyce Batchelor on All About Nursing and we are live on the BBM Global Network and Tune in Radio. Before the break, Larry was talking a little bit about what organizations can do that do not have predictive analytic systems in place and some of the simple things that they can start to do including talking about the film, the flow pool.

Larry, can you share a little bit more about that? Yes, I think you know, for interesting layman's terms, a flow pool is a pool of individuals who maybe have an HR profile where they like variability, they like to move across the system. They are trained in multiple areas. They can work on oriented and can work on multiple units.

Those individuals, you know, in a high-performing organization which has layered strategy on top of strategy, you get to a point where you have your own internal set of resources. So when you are, you know, the day of and you have an individual or three individuals calling sick, you have a backfill or seven individuals who can then flow across the organization to fill in those needs to continue to provide, you know, great patient care. Now there are strategies around how you go about building out your flow pool. We work with some organizations who previously thought they just put a bunch of FTEs within a flow pool.

They can share those across the organization. It would be effective. There really is a strategy in the way you go about using the individuals and how you layer that flow pool. So you want some individuals who are highly skilled to work across the organization.

All the way down to your, you know, the individuals who may be specific to a, you know, like a NICU or a burn unit who have very specialized skills but it is all considered across the organization of flow pool and ideally those individuals can go to multiple places across the organization to provide patient care when those individuals who are core to the unit aren't able to be on that unit. That's very interesting. I know that when I had an internal setting pool we used to incentivize them to also have more than one specialty that they could go to, what really did help us with flexibility on being able to cover depending on the senses of the different specialties that nurses work in. And you were talking about that there is, you know, that's another layering of strategy choice.

So if you think about how you build out your flow pool in the right way, incentivizing individuals to work across multiple units, to have multiple skills and to cross multiple hospitals and then increasing the incentive that they may be able to get through an automated system based on those vacancies. That's another layering of strategy to help you build out your flow pool and also have enough individuals and that flow pool to provide care. Yeah, and it really did help us. And we even had gotten to a point where we were hiring nurses to work for the specialty and meaning like perinatal they could work in the NICU but the NICU could be at different hospital sites.

And so even for some of the permanent staff, particularly the younger nurses who like to have a diversity in terms of experiences, they were really excited about being able to work at different hospitals as long as you've planned it in advance. And so I think what you're discussing is really, really very important. And you had mentioned contingency resources. Is that the same as travelers or agency?

What do people mean when they talk about contingency? Yeah. Your clients, you've seen those. Yeah, we should define core and contingency.

So the way we define it is core is anyone who is working within their hired FTE on a unit. Everything else is contingency. So if you're working in overtime, your contingency, if you're working up to regular but over your FTE, that's contingency. Agency would certainly be contingency.

What we're trying to do is set up a system so that you can manage all resources within your system and be less reliant on external resources. Now, we know there's always going to be a need for those external resources, whether it's long-term F and LA, or you know, you're experiencing high volume, you've had a lot of turnover, you have some vacancies. There always will be a need for those. But reducing the reliance on those is what really continues to drive the quality that the organization can provide.

That's great. And as you were talking, I was thinking about how, again, the variation, the things that I know used to work in terms of what the trends were has really changed over time. And I think that the things that we used to have as tools just don't seem to be helping us like they used to. So the predictive analytics seems like it's just really become a lot more precision in terms of helping, which is really delightful to hear.

I just remember being what I felt like being held hostage for how much money I would have to throw at somebody for them to stay extra when we were really in a tight situation. And I used to tell them I didn't like being held hostage. It was not a good feeling. So I think there's a choice where we hire really smart people.

We hire smart people. And we're surprised when they play the game and wait until the last minute because they know we're going to increase the incentive. So by using predictive analytics, if you can put a high-density in it early on so that they become accustomed to picking those up earlier in the process rather than waiting late. Yes, I used to try to explain to my boss when he would hear that we were doing things like double time or time and a half extra, et cetera.

I would potentially also throw in one of his cars as an incentive for someone to stay because I just wanted to make people understand that you've got to cover the shifts. And when you're feeling like you don't have any other choice, you may come up with some crazy ideas. Fortunately for him, I never gave his car away. And fortunately for me, I never gave his car away.

But anyway, so tell me more about the float pool concept. Is that something else? Is that a different approach that organizations are really using that seems to really be helping them? And how do they try to number powers?

Okay. Go ahead. Say hi-hat. The float pools have been around for a long time.

And I think the sophistication of the float pool and understanding how you continue to build out an effective float pool by using data, a data-driven float pool. So there are some metrics that we look at, some super-prietary data points that can really help you build out a specific layering of what we think of a funnel. At the high end, at the top of the funnel, it's wider. You would have individuals who could work across multiple locations.

Maybe they're your system-based FTE individuals who can cover up on the last minute needs because they're able to go multiple places all the way down the bottom where they may not have as much variability in the kind of care that they can provide. But we know they have to be part of that pool and we really have to analyze the data to be certain how we build those out. And then the other piece of it, two choices, is building out an infrastructure. So the one thing I want to emphasize here is predictive analytics is key to the entire process.

I mean, it's the bedrock of what the strategy is built on. But there are multiple strategies to allow any organization, any healthcare organization, to be effective in better managing resources. So it starts with understanding how many individuals you meet from a core perspective. Have you built out your float pool in the right way?

Have you layered it in the right way? Have you looked at your data to be able to build it out? And the third piece we talked about is creating a central location to manage much of that administrative work. So the clinicians determine to dictate and decide what are the policies, practices, strategies that you will implement within the organization.

But do you have a central location to be able to help make all of those decisions to deploy resources in real time across the organization so that a manager is not taking multiple phone calls, multiple blabs and calls, but all centralized into one location and being able to use that resource management center to make those tough decisions based on all the rules the clinicians have set up. We are coming to you live from BBM Global Network in TuneIn Radio. And this is all about nursing show. And I'm Dr.

Joyce Batcha the host of the show. We will be right back. Dr. Joyce Batcha the host of the show.

I'm joined this evening with Larry Putney, who has been sharing with us a little bit about the tools and the types of initiatives that they help organizations with to be able to really manage their nursing staffing cost effectively. So Larry, maybe you can continue to tell us a little bit about the centralized resource management pool that you were describing prior to the break. Yeah, you guys, so a resource management center is really that's been for location where all decisions are made around the deployments of resources. So if we think about kind of a work flow process, your managers are initially creating a schedule.

OpenShift happens automated within the system that can predict what you need and send those out. It's really those decisions as you look across the entire enterprise like a large multiple healthcare system to be able to deploy those resources in any area they're most needed. So through the OpenShift management process, you're having individuals who are picking up shifts and they don't know yet precisely where they're going to be working, but they do know they're going to work a seven to seven shift on Tuesday. We don't know for sure until Tuesday happens where the apps and calls are going to happen, where fluctuations might be, where the volume might increase, where they're getting for a one to one additional resource.

So it's this resource management center that is a central location that takes all that information and has access to an immune system, how do we care purposes, where do they potentially go? So it's the administrative duties of assigning those individuals across the entire organization that help their system. And do you find that sometimes the staff that work in the centralized pool will end up finding a home that they like as they float into different units? It's funny to say that we're going to get a university of Kansas possible, which is an academic benefit of about $500 to $500.

And they have to put new grants in their football. So early people, whether they're considering putting those individuals and they've had tremendous success. They have a full full of $190 and they have a retention rate within that local 89%. And some of those are going to losing it.

They're losing to internal sure. Those individuals have expanded to a unit. But it really helps in respect as well. Yes, I think that's a great opportunity, especially if someone also is new to coming into a city and they're not sure if there is a big system, which organization they want to work in, it gives them the opportunity to move around and work in different hospitals within the same system and kind of get a feel for where they might want to actually take a permanent position.

So I think that's pretty awesome. I was curious if you are also able, with the tools that you have, able to produce reports that help leaders really look at how much their nurses are working. You know, nurses love 12-hour shifts and we know that a lot of times 12-hour shifts are 14 hours and so we do get concerned about the impact of fatigue, especially if they're working a lot of overtime. Is that something that you're able to pull and provide for leaders so they can take a look at that kind of impact that they may be having with people working too many hours?

Well, I think that's one of the key metrics that organizations are looking at, right? And both sides of it, perspective, you mentioned one side, which is no, certainly don't want to hold a lot of our clinicians because one thing we know and the research shows is that longer shift times errors increase and so we really want to make sure that they're continually not working too many hours, but also on the website. I think there are tools and metrics that help make sure that individuals are working up to their entities. So sometimes we see organizations which are making under scheduling individuals who are committed to that team and that has a cost to the organization as well, which is those individuals are benefiting from that level.

So it's on both sides of that spectrum, making sure that they're not working too much and putting contractors and metrics around that so they can't ever schedule themselves and also tracking their time and calculating their time. And then do you have special training that helps the leaders understand how to utilize these tools so that they're able to really manage? Oh, so that there's a way to really help them learn how to manage with all the different data. You know, my experience is that the information that we have in these tools is so robust that it's important, especially when someone is new as a charge nurse or as a manager or as a director to be able to really look at how do you teach them about the tools, how do you teach them about the data that's in the system, and how to really utilize the information that is in all those tools so that they're really able to manage very effectively.

So I was just curious if you have special training programs for the individuals when they become a new manager or a new charge nurse so that they can really understand how to leverage the amazing capabilities that you've been describing here this evening. Yeah, it's ongoing. So not just the initial training on how to use the system and what metrics to look at, what hit trackers to see how effective and efficient managers are at developing schedules, but we also hold classes at multiple locations across the country on a quarterly basis. So we're actually going out to our clients in the field and inviting individuals into conversations around that's practice, labor management.

Part of that is optimizing the tool. Part of that is helping them understand what productivity is, how to better manage that. But part of it is just high level strategy, what is working with any healthcare system to say from a peer to peer basis, where we get to share with each other. I used to say that those are the times when you want to really be able to steal shamelessly from each other.

There's no reason not to be sharing best practices if people are finding something that really seems to be working very well. For example, your description around new graduates in a float pool, I think, would potentially make some chief nursing officers a little bit nervous, but it'd be great to be able to hear from an organization where it is working so that people can see that it is in fact definitely a possibility. This is all about nursing. I'm your host, Dr.

Joyce Bachelor. We are live on BBM Global Network in Tune & Radio and it's time to take a short break. Attorney Renee Marie Smith is changing away. We sell real estate.

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You are listening to All About Nursing live from VBM Global Network in TuneIn Radio. I'm Dr. Joyce Batch, the host of this show. Before the break, Larry Buttony and I were discussing some of the things that his organization has done to really help train new leaders and ongoing experience leaders on how to really leverage the tools and capabilities and strategies that his company has been working with many organizations to implement.

And so, Larry, is there a little bit more that you'd like to say about the training and the sharing that goes on? Or before we move to really having you talk more about the outcomes? I think that I would just share that I had a system where I was really trying to get the nursing leaders to really buy in and understand how to use the tools. And sometimes I found that they would always tell me they already knew everything they needed to know.

And I had to this little question and answer where they voted by using their phones. And it was great because I didn't see who got what answers right or wrong. But it helped them to do their own assessment. And I can tell you I had 76 people that signed up for training sessions the next day because they had done their own little self assessment and knew that they needed help.

So is there more that you'd like to say about that before we move in to talk more about the outcomes that you're seeing? Yeah. So we have what's called a health care enterprise labor management. It's an entire curriculum.

We have an education department at a dentist that does a terrific job of learning from our clients but also learning within our own health care system. Because, you know, we are the 24, 7, 365 resource management for a 13 hospital system at Omaha. We do this every day. We experience the challenges within a health care system on a regular basis.

So our education department is learning from within our own four laws. But also talking to our clients. You know, these are high performing organizations like Penn State Health, University of Kansas, and Mercy and Wellstar and SSM Healthcare, you know, for quality and no motivation. And they're facing different challenges based on the dynamics within their health care system, whether it's regional or cultural differences, they're continually facing new challenges.

So getting these individuals together on a regular basis to walk through problem solving processes to help them better manage the resources that come up with new innovative ways to manage. I think it's a key core competency of what Amanda does. So can you share a little bit about what kind of outcomes you're finding that the organizations are having as a result of having adopted this kind of technology? Yeah, we talked off the top.

You know, what we're really trying to do is achieve three different outcomes. One, we want to improve staff satisfaction because that really leads to better quality. So we also want to improve quality of the organization. We only have happy staff or happy to do their job.

They provide better quality. But also, it reduces turnover. So you have longer tenure individuals. They don't jump around and not look at the ground.

But also the third is, you know, can't believe in today's environment, you know, moving away from a fee for service model. You know, we're going to be held accountable to outcomes. And so finding ways to reduce costs because there's so much downward pressure on cost right now with health nurses is a key component of some of the outcomes. I think the organizations in which we work with tell you that they have been able to do all three.

Some are at different places in the journey. So there are multiple strategies that we continue to layer on. They may have implemented this software but maybe haven't got to a resource management center or haven't fully developed as local yet. But organizations who are fully engaged and develop and have developed a successful window, like well-star, like Penn State Health, like the new ballot health, which is formerly Mountain State's health alliance, they've seen remarkable outcomes.

I think about ballot, which was formerly Mountain State's health alliance. They saved $4.5 million in their first year. And over the 10 years that they've been better managing resources through the implementation of the software and strategies, they've audited and saved $31 million in labor savings. Just last year they rolled this strategy out across their ambulatory service lines.

So in all of their medical, recent clinics and other ancillary departments, ambulatory departments, they saw $10 million in those areas. University of Kansas, I think I mentioned previously, you know, they had a flow full of their flow full of $190 now and their outcomes have really been more around staff satisfaction and quality. They had a 63% reduction in the number of times individuals are asked to work extra. So last minute of work requests have decreased by 63%.

A 65% reduction of the number of times they've been asked to float across the organization. And their turnover is at the lowest point it's ever been in the history of tracking. So they were above 15% for having an engagement that we get working in now. They're at the lowest point they've ever been to.

So both quality outcomes, staff satisfaction, but also financial outcomes as well. You know, as you're describing all of that, I'm thinking about how nurses are very much like a lot of other people where they want to be on a winning team. And when you've got the same people you're working with, you don't have a lot of tight turnover, you can feel confident that when you come to work, you have a lot of your own peers really working with you and that things are being done systematically and they're known for giving good care and don't have a lot of complications. That's an attractor that I think a lot of people are looking for.

They want to be on a winning team. So that's pretty amazing. I also think it's exciting because I know leaders are also trying to look at how they can really do the kinds of things they need to do and not as we discussed earlier, beyond the phone-bagging staffing. Staff to come in all the time.

I remember a company telling us that they could send out like a group call and I thought, oh my gosh, this will be like a group whining call that we send out to people saying we need you this evening. I just know that staff get tired of getting those kinds of calls. So what you're describing is very, very exciting and the kind of quantification that the tools are able to assist with are awesome. Is this a puzzle?

I think you've said this a little bit, but these tools can be used in other areas besides the nursing areas. Is that accurate? That's probably some of the more exciting work that we've done in the last five years is that this is truly enterprise-wide. So if you think about it, you know, as you would know, for years, nurses have been asked to be great stewards of their dollars within the health organization.

They have been asked to flex based on their volume based on their work load indicator forever. What we're seeing is the strategy is now being applied and used across the entire enterprise. So many of our clients have rolled this out across all their ancillary departments, the labs, pharma, even EBS, food services, maintenance, wherever there is some sort of variable workload indicator. It's a strategy that is highly effective.

So if you think about in maintenance, it might be square foot in housekeeping. It might be most of what pounds of laundry, you know, it might be scripts in the pharma. Whatever that volume indicator is, or that workload indicator that drives the need for resources, we can evaluate, analyze, predict, and assign resources based on that workload indicator. So you can be more variable in those other areas.

And I know there are signals across the country right now jumping up and down saying, thank goodness, finally everybody is taking this. But it really has been an effective approach to the entire organization. The other exciting piece is if you think about the ambulatory world, right, so medical groups, those have typically been fixed resources for as long as I can remember. So individuals who work in a medical group may know that they're going to have a fixed schedule Monday through Friday.

But now based on visit type, we can take a look at what drives the need for resources based on that specific visit. Because we know a visit is not a visit, there's a different workload for each kind of a visit. And by taking all of the visits that are scheduled for a day, we can begin to aggregate that workload, understand how many resources that might call for, and then better align those resources with an out facility so that we're only providing care to what would be the most typical volume point or workload point. And then, in times when you have spike or decline, you might build out a flow pool that's specific just to those medical groups.

So now you've built out a full flow pool strategy for what typically has been a very fixed environment. This is all about nursing, and I'm your host, Dr. Joyce Bachelor. We are live on the BBM Global Network and TuneIn Radio.

We will continue this conversation when we come back. Animal lover, author, artist and public speaker, Patricia Gailleife is a Renaissance woman in her own right. A lover of animals from a young age, Patricia lives on a farm in Virginia and has rescued neglected thoroughbred horses, keeping them or finding them safe havens. She is also a published author, and her book's document, Real Life Experiences, that she shares in her passionate stories, taking the reader around the world in a colorful kaleidoscope of life.

An accomplished artist, Patricia Gailleife's oil painting, speaks to animals, portraits, stills nature and abstract, and she allows the brush to paint the image in an organic, natural way. A public speaker, Patricia, is motivated to continually wonder about life and advocates for all of us to do the same and document our own unique history. To learn more about Patricia Gailleife, visit www.literarylady.com and www.petricia-life.com or email her at pdlife at gmail.com. Hello, I'm Steve Fagan, and I'm President and CEO of Fagan Associates, but I'm also a Life Coach.

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And I'll be glad to help you move forward to live the life of success. I'm your host, Dr. Joyce Bachelor, and we're live on the BPM Global Network and Tune in Radio. Prior to the break, Larry, some of the technology as well as other strategies that this company uses to help organizations be able to manage their resources really, really well.

I especially enjoyed when Larry was talking about putting other departments in the spotlight along with nursing. I was always happy to share that spotlight with my colleagues in pharmacy, respiratory therapy and other parts of the organization that also needed to be looking at their productivity and staffing. And one of those Larry that along with the other C-nodes that you were discussing would be cheering about the fact that you're able to use these tools throughout the whole of the organization. So that's really wonderful.

I think when I had started off, I said that staffing depends and started talking about all the things that depends on. And some of the strategies you've been talking about, predictive analytics is just one part. So maybe you'd like to recap a little bit about all the different things that can be used, that organizations may want to really take very seriously and begin to implement. Dr.

Joyce, again, I appreciate the opportunity to share. Avantis was the developer of Helm, which is healthcare enterprise labor management. And 20 years ago, we understood and realized that if you're going to be effective in the way you manage resources across a large hospital or multiple hospital systems, you have to have some way to be able to predict what you will need. Otherwise you're always left with the chaos that happens in those moments leading up to the shift.

I think through that journey that we have taken, that our clients have taken with us, we begin to understand that there is no one strategy that will create labor optimization. Certainly predictive analytics is a part of that. Having a predictive model that allows you to be 95 plus percent accurate and predicting volume is a key component. But it's really the layering of strategies.

So if you think about right sizing your core and using your own data and metrics to make sure you have the right number of individuals on a unit. And I think many of you, we've done that work and we understand that. I think we're talking about maybe a little bit more sophisticated look at your data to really understand, you know, are you accounting for your non-productive time on a unit? You know, if you have education orientation, PTO, FMLA, you know, are you accounting for that by having additional individuals to the unit?

Because if you are, you're creating more of a need for non-productive time. So there's a strategy around making sure you have right size to core individuals on a unit by leadership by shift basis. Then taking that data and understanding how do you build out a flow pool? You know, how can you create and support a flow pool in a specific to your organization?

I think I've probably said before, we have one client that has a 91 to 9 quarter contingency ratio, we have a client that has a 72 to 28 quarter contingency. It's really based on their data. Their flow pool is built based on their data to support their organization. So that's a strategy.

Another strategy would be a resource management system. You have a central location to manage resources across the organization so that you can take that administrative work home and work home and work home to managers. And then finally, including a tool that allows you to schedule, staff, deploy, manage productivity and predict all at once. Is that long strategy to help you be affected?

I think it's been wonderful to hear about how all this complexity goes on behind the scenes and it really helps to make sure that the patients and families and loved ones that come into the organization can feel confident that we are working very diligently to assure that the care that they will get is stellar. And so this is all about nursing and I'm your host, Dr. Joyce Bachelor. We are live on the BBM Global Network and TuneIn Radio.

Tune in next week. Thank you very much. Have a great evening. You've been listening to All About Nursing with your host, Dr.

Joyce Bachelor. Tune in each week and get a daily dose of nursing and the healthcare services they provide and how nurses are finding innovative ways to address the key healthcare issues they're facing today. Here on Dr. Joyce Bachelor's All About Nursing.

We've been listening to the BBM Global Network. The ideas, views and opinions of this broadcast are those of the participants of the program and are not necessarily the ideas, views and opinions of the BBM Global Network Company.