Achieving Exemplary Practice through Staffing and Scheduling Process Change

Purpose:
A magnet designated, 205 bed community hospital achieved exemplary practice through improvement of staffing and scheduling processes utilizing a multidisciplinary approach.

Significance:
Significance:
Decentralized nurse staffing and scheduling processes were identified as an opportunity for improvement. Staffing and scheduling processes were changed to promote standardization, increase nurse satisfaction and provide cost savings.

Strategy and Implementation:
A multidisciplinary team led by nursing, with the involvement of direct care nurses embarked on a journey to improve processes related to staffing and scheduling. The culture of decentralized nurse staffing and scheduling was challenged by involving staff and management in examining process and moving toward standardization. Electronic open shift management was enhanced. Staffing and scheduling software systems were evaluated and upgraded systems implemented. The registry tiered system was revised to optimize required base hours and provide greater flexibility. Reporting of data metrics drove continuous improvment through regular reporting and discussion. A shared governance council plays a role in continuous monitoring of data results and provides input for change.

Evaluation:
Effectiveness was demonstrated through improvement in NDNQI Nurse Satisfaction results over a three year period. Premium labor expenses including agency cost, overtime and incentive pay were monitored and improvements in processes led to significant monetary savings.

Implications for Practice:
Involving nurses in improvement in their work environment related to staffing and scheduling yields great benefit for the organization. Adequate staffing is key to patient safety and fiscally sound methods to improve are challenging and rewarding.