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STAFFING SERVICES REDESIGN PROJECT

Presented by:

Gentil MateusRegional Director Human Resources

Lee VanMeterProject Lead, Staffing Services Redesign

June 23rd, 2008

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Interior Health Facts

• • Area Population: 693,000

• Budget: 1.2 Billion

• 35 Acute Care Sites

• 4,427 Residential Beds

• 19,500 Employees

• 1,200 Physicians

• Communities served: 54

• Regional Districts: 10

• Number of Regional Hospital Districts: 7

• First Nation Communities: 55

Growing shortage of health care professionals, and increasing demand for services

Within IH the demand for services is projected to increase 1-2% per year for the next several years

During the next five years, we will lose approximately 2500 employees to retirement

Largest operating cost is our workforce ($850m)

The need to control workforce costs, improve retention and staff morale

The Burning Issues

HISTORY• 1 Payroll system

• 12 Scheduling Offices

• 10 Databases

• Incompatible ESP versions

• Inconsistent Practices

Project History

ANALYSED COSTS ANALYSED COSTS of Existing of Existing Scheduling Scheduling

OfficesOffices

Interviewed Interviewed

550 CASUALS

550 CASUALS

by telephoneby telephone

MgmtMgmt

Workshops

Workshops 53 people

53 people

TALKED TALKED individually

individually with Mgrswith Mgrs

Analysed a Analysed a

full year of full year of

PAYROLL PAYROLL DATADATA

BCNUBCNU

PolicyPolicyInitiatives

Initiatives

Looked at

Looked at CasualCasual

retention

retention

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Business Planning – Gathering the Data

Business Planning Methodology Site visits and interviews with managers across all

HSA’s Survey of Casual Workforce Facilitated workshops across region to gather

group input Consultation with unions Analysis of one year of staff utilization data (2003)

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The Evidence showed:High levels of overtime use, but casuals claiming they

were not being offered workCasuals not actively managed and with high turnoverStaffing levels and skill mix in similar departments

varied significantly and troubling increase in Workload hours

Service levels in existing scheduling offices varied tremendously

Business Planning – Gathering the Data

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RN DemandP

rod

uct

ive

tim

e u

sed

Advance Notice Leave Relief

Short Notice Leave Relief

Unplanned wkld

Typ

e o

f la

bo

ur

bei

ng

use

dPermanent Staff

paid straight time

Casual Labour

End of Shift O’timeFull Shift O’time

19%

2%

79%

5%

3%

10%

Regular shifts from rotation

lines

82%

How demand was being filled

Casual Labour – Used Inappropriately

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Business Planning – Developing the Strategy

Created an Achievable Vision for the Future

Create a cost neutral solution by establishing a Staffing Service with ‘service centres’ in each HSA

Create HSA wide certifications to offer staff more options and remove barriers to the effective deployment of staff

Offer enhanced range of services including:• 24/7 service • Rotation Specialist team to look at more flexible rotation options• Workforce Consultants (WIC) to help manage the relief workforce

Corporate management of new service to create consistency and accountability

Dual reporting relationship to HSA management to ensure strong local partnerships

Adoption of a Balanced Scorecard approach to measure outcomes

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Projected Benefits of Future State Vision

Improved staff retention in the face of a critical workforce shortage

Commitment from front line management to a better work place and a development of a partnership between staff, union and management

Reduction in Sick Time and Overtime due to better scheduling & less burnout

Enhanced ability to respond to workforce trends

Greater visibility into staff utilization across the organization and better information for managers and executive team

Business Planning – Developing the Strategy

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Vision & GoalsVision was:To standardize the staff scheduling and utilization processes throughout Interior Health

Goals were: Better end user service for managers,

casuals and staffImproved staff satisfaction and retentionAutomated processesReduced labour costs

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To deliver extraordinary service toInterior Health by providing highlyresponsive staffing solutions and

workforce planning, in order tocontribute to the delivery of safe,

quality healthcare by InteriorHealth now and into the future.

Our Mission Statement

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Builds upon the ESP Scheduling System to make it a better all round

scheduling process

Creates tools to save managers time, improve staff retention and provide a

better service to all who use it

Staffing Services Redesign

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Design Process divided into six modules

1. Rotation and Position Management

2. Planned Leave Management

3. Short Notice Leave & Daily Staffing

4. Scheduling Relief

5. Relief Staff Management

6. Timekeeping

Collaboration and Participation were at the heart of the design methodology!

Process Design

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Design Team of approximately 40 people reporting to Steering Committee of 12 senior executives that regularly reviewed the work of the Design Team. The Design Team was comprised of:

• Staff, including casuals• Managers• Regional union representatives• Schedulers• Payroll and HR staff

It takes time!

• A “strawman” approach is used to save time• 12 full day workshops over 16 weeks

Process Design

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Design Team

Design Team process was a great success. Group created 22 work flows and came to a consensus on all but one of them.

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Overall, the group was amazed that people from all walks of life came together, with own agendas, own history and cynicism yet, through the process, realized that we are all working towards the same goal.

“These were the most productive meetings of my career”

“If everybody in my workplace could feel a little of what went well here, it would be a better place to work.”

“I came with a lot of cynicism and little hope. I’m leaving with a lot of hope and little cynicism.”

Design Team

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Design Team

Sample comments from evaluations at the end of the process were:

• Awesome, outstanding; impressed that IH put funding behind it

• I feel this process has unified management, staff, and unions around a set of common objectives

• Ground breaking

• The indiscretions of the group was critical to the successful outcome and allowed discussion to be sufficiently well rounded

• Very inclusive, positive. IH participants were not confident that the decisions made by the Design Team would be honored by those "above" with power to over rule. I hope this is not the case. Small breakout sessions allowed quieter people to have a voice, which was great.

Feedback from the Design Process was extremely positive!

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Key to Success

Single ESP database (Version 3.6)

Decision-making must remain with operational management

Development of a “Balance Scorecard”

Strong customer service focus – Managers and Employees.

Ability to provide data to assist managers with day to day staff management and planning.

Service must be adequately resourced: in both pilot offices, additional staff were hired (ratio 1:190)

   

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Key to Success

Service Level Agreement (SLA) between each manager and the Staffing Service Centre. Includes:

Workflow processes

Performance Measurements

Clear delineation of roles & responsibilities

Issue Resolution process

Standardization of Operating Procedures. Standard Interpretation Guideline (SIG) and Staffing Services Administration Manual (SSAM)

Staff & Union involvement is key

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Key to Success: Transition Teams

Prior to implementation ("go live") of the new processes Transition Teams were created.

These Teams included front line employees, managers and union representatives, to continuously bring forward concerns from staff to the Project Team and communicate changes back to staff.

During project rollout the Transition Teams met on a weekly, then bi-weekly and finally monthly basis, as the issues were resolved and fewer meetings were necessary.  

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The Workforce Innovation Consultant plays a pivotal role within the Staffing Service Centre. They hold a dual responsibility for supporting managers in identifying and addressing the root cause problems for overtime, sick time and staff retention. In addition, they support relief staff to improve their work experience and job satisfaction.

Role with local management includes: Project demand for relief staffing and identify needs by area, specialty, seasonal fluctuations, etc. Develop strategies to meet the demand, e.g. by working with external recruitment, developing relief staff skills, etc. Determine the optimal mix of casual and permanent relief positions including the introduction of “Regional Relief Pools”.

The Role of the WIC

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The Rotation Specialists work with managers and staff in an inclusive & collaborative process to determine requirements and provide creative solutions. Their goal is to improve employee satisfaction while meeting operational needs.

Provide services for all Collective Agreements Collaborate with the BCNU/MOH Responsive Shift

Scheduling initiative Maintain a Central Database of Rotations

The Role of the Rotation Specialist

24External Recruitment Services

Staff Utilization Unit

Workforce Innovation Consultant

Scheduling Manager

Skilled Scheduler

Skilled Scheduler

Skilled Scheduler

Skilled Scheduler

Skilled Scheduler

Relief PoolRelief

PoolRelief PoolRelief

PoolRelief Pool

Regional Director, Employee & Labour Relations

Business Consultant

COO

HSA Management

Team

Front

Line

Managers

Face to face time

plus

Regular Service Scorecard results

reported to customers

Rotation Team

Info Analyst

Regional Dir, Staff Utilization

HR Director

Local Structure in each HSA

Co

nso

lidat

ed d

eman

d /

con

solid

ated

cu

sto

mer

bas

e

mo

re e

ffec

tive

ser

vice

• To measure, evaluate and improve the Staffing Service Centres’ performance

• Factors for success originally identified by Steering Committee

• Available “on-line”

Balanced Scorecard

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18 Month Progress Report

Staffing data being provided monthly to assist Senior Management Teams with short/ medium term planning

Decrease in Overtime. Pilot Sites Nursing Overtime is lower in 2007/08 then in 2006/07 and 1.35% lower than the Health Authority average.

Reductions in paid meal breaks and end of shift overtime

Clean up of Casual Registries and $ savings reduction in ESP licenses

High demand for Rotations Specialist services. Team of 3 have created a total of 350 responsive schedules to date (197 BCNU, 109 HEU, 19 HSP & 25 Community

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92% compliance with Advance Booking Guidelines (12 weeks)

Changes to the labour landscape through the amalgamation of union certifications & the creation of Regional Float Pools

Partnering with Okanagan University College to develop a certificate course for scheduling clerks.

Implementation of a single Vacation Policy for contract staff (excluding Community

Formal Evaluation is currently being done by Canadian Management Systems and our Internal Auditor team

18 Month Progress Report

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QUESTIONS???