Workforce Optimization Partnerships to Create a Sustainable Future in Healthcare

© Copyright IBM Corporation 2009  IBM Corporation Background  In 2009, FH executive approved the creation of the “Workforce Optimization” Portfolio  The portfolio realigned other existing resources to focus on key initiatives that would lead to improvements in the utilization of our workforce and lower costs  The FH model encompasses some of the best strategies from other health authorities as well as some unique to Fraser Health  The difference is the alignment of these strategies under one portfolio, led by Clinical Operations (i.e. where the dollars are spent)

© Copyright IBM Corporation 2009  IBM Corporation The Workforce Optimization Portfolio Workforce Optimization Advisory Committee Director Workforce Optimization Staffing Advisory Committee VP, Clinical Operations Managers Staffing Services Staffing Operations Supervisors Staffing Systems Quality Coordinators Staffing Offices Business Analyst Leader Workforce Redesign Coordinator Manager Work Life Initiative

© Copyright IBM Corporation 2009  IBM Corporation Strategic Workforce Planning  SWFP is the analytic, forecasting and planning process that connects and directs talent management activities to ensure the organization can execute its business strategy by having the right people in the right place at the right time, at the right cost. (M. Young, Conference Board of Canada, 2010)

© Copyright IBM Corporation 2009  IBM Corporation Why?  Labor costs are high (Overtime, Agency Use)  Staff role confusion, inability to deliver critical activities of care (Functional Analysis, 2009)  Care delivery systems are outdated (Leading Practices in Care Delivery System Change, 2009)  Managers are frustrated, unable to implement more effective business practices (Health Service Manager Work Life Review, 2009)

© Copyright IBM Corporation 2009  IBM Corporation What is Workforce Optimization?  Workforce Optimization is a strategic partnership, focusing on establishing leading systems and processes to support Fraser Health Managers to manage their workforces effectively and sustainably.

© Copyright IBM Corporation 2009  IBM Corporation Who is Involved?  Clinical Programs  Support Services  Employees Together, proactively, strategically!

© Copyright IBM Corporation 2009  IBM Corporation Aim  To create great workplaces and environments where employees want to contribute, be engaged and have a relationship with their work.  To maximize the effective and efficient use of our clinical workforce to build sustainable care delivery systems.  To develop clear and consistent administrative management philosophies, best practice/system processes and tools that empower Managers to thrive and be successful.

© Copyright IBM Corporation 2009  IBM Corporation Workforce Management Activities DeploymentWork Systems Employee Retention Finding + Hiring

© Copyright IBM Corporation 2009  IBM Corporation

1. Workforce Management Partnership

© Copyright IBM Corporation 2009  IBM Corporation Workforce Management Partnership Through an Advisory committee structure this is a partnership between clinical programs and support services creating proactive and synergistic approaches to managing workforce resources effectively and sustainably using leading business practices. Goal: To develop systems, processes and tools that support Managers to achieve best practices and meet performance targets.

© Copyright IBM Corporation 2009  IBM Corporation Workforce Optimization Advisory Committee Key Responsibilities: -Identify key workforce utilization performance indicators and targets. -Share department activities and plans which address workforce utilization performance targets. -Develop joint strategies to achieve workforce utilization performance targets. -Provide feedback on systems, tools and processes being developed to support workforce optimization. -Monitor, evaluate and report on progress in meeting performance targets.

© Copyright IBM Corporation 2009  IBM Corporation Workforce Utilization Key Performance Indicators  Sick Time - % productive or base hours  Over Time - % productive hours  Productivity - % total hours  Productivity - per patient day  Vacancy Rate – calculated rate, coding due to vacancies  Vacation Relief – hours of relief, to identify patterns/trends  Agency Use (RNs and other) Balancing Measures : Quality Data

© Copyright IBM Corporation 2009  IBM Corporation Approach  Identify Clinical Program needs  Identify Key Performance Indicator targets  Monitor KPI (dashboard)  Identify and develop strategies to meet performance targets  Meet with Programs to identify priority strategies and assist in implementation  Target interventions and development of new strategies to achieve results

© Copyright IBM Corporation 2009  IBM Corporation

© Copyright IBM Corporation 2009  IBM Corporation Workforce Optimization - Achievements to Date  Attendance Promotion Program Initiated (Consulting Services)  Screening and support for employees with over 6% sick time.  2,000 employees analyzed. 249 enrolled for ongoing support.  During first monitoring period, sick time decreased from 13.45% to 5.98% in enrolled group.  Early Intervention Program (Workplace Health)  Earlier contact with employees, participation rate increased from 28% to 93%.  Enhanced Disability Management (Workplace Health)  97% of workplace incidents now reported via call center.  Completed form to WorksafeBC within 1 hour.  Overtime Scheduling Practices Review (Joint)  Mandate for Managers to authorize ALL overtime  Education of FH Standards for OT and Tools for auditing OT

© Copyright IBM Corporation 2009  IBM Corporation

© Copyright IBM Corporation 2009  IBM Corporation

2. Care Delivery Model Redesign

© Copyright IBM Corporation 2009  IBM Corporation Care Delivery Model Redesign Building high quality, sustainable care delivery systems that are responsive to the needs and expectations of our patients, residents and clients.

© Copyright IBM Corporation 2009  IBM Corporation What is a Care Delivery System?  Who delivers care (Role, Scope + Function)  What care is delivered (Content)  How care is delivered (Processes)  How care is organized (Structure)

© Copyright IBM Corporation 2009  IBM Corporation Where to Start?

© Copyright IBM Corporation 2009  IBM Corporation No one model or systems approach will fit for a system as complex as health care. What is needed is an approach or strategy of change which will allow the emergence of supportive and sustainable health care delivery systems. (Leading Practices in Care Delivery System Change, 2009)

© Copyright IBM Corporation 2009  IBM Corporation CDMR Strategy  Develop the capacity of front line staff to lead transformational work in care delivery systems.  Using Leading Practices, engage front line staff in strategic redesign of their work systems.  Create a Learning Community to share and sustain changes.

© Copyright IBM Corporation 2009  IBM Corporation Why?  Improving patient care is cost effective.  Decreased length of stay  Decreased complications  Decreased adverse events  Engaging front line care givers in redesign of their work is cost effective.  Increased productivity  Decreased turnover  Increased satisfaction

© Copyright IBM Corporation 2009  IBM Corporation FH CDMR Learning Collaboratives Interdisciplinary Teams Coached by Faculty Learning Leading Practices and Change Management Strategies Time for Care Reduce Waste  Processes  Systems  Resources  Time Quality Care Elder Friendly Mission Critical Activities  Assessment  Care Planning  Education Activities Meaningful to Patients/Families Patient Centered Care Collaborative Practice Maximize Role, Scope and Function Interdisciplinary Collaboration Right Staffing Assignments  Patient Needs  Skill Mix  Care Model Improving Staff Retention Operational Infrastructure & Capacity Service Location Unit Population/Capacity Resourcing Skill Mix CDMR Work Informs Key Measures – Examples Staff Vitality, Patient Experience, Voluntary Turnover, Time Spent in Mission Critical Activities, Workload, Length of Stay, Unplanned Readmission Rate

© Copyright IBM Corporation 2009  IBM Corporation Care Delivery Model Redesign - Achievements to date  Strategy and change framework developed  Leading Practices identified  Pilot teams engaged (5 Medical and 3 Surgical).  Partner in Provincial CDMR Learning Collaborative  Some early results:  Staff report feeling “empowered” and able to make positive change. Improvement in staff morale.  Time saved reinvested into improvements in care.  Evidence of earlier discharges due to improved communications.  Decreased need for workload.

3. Manager Work Life Initiative

© Copyright IBM Corporation 2009  IBM Corporation Goal Create and sustain a positive work environment for Managers allowing them to support staff to deliver safe, effective health care services.

© Copyright IBM Corporation 2009  IBM Corporation

© Copyright IBM Corporation 2009  IBM Corporation Facts  40% of Managers surveyed have less than 2 years experience.  79% of Managers surveyed were not able to complete work to their satisfaction.  72% of Managers surveyed did not see themselves continuing in their role beyond the next 2 years.

© Copyright IBM Corporation 2009  IBM Corporation Recommendations 1.Develop clear and consistent administrative management philosophies and tools that empower Managers to thrive in their roles to the benefit of staff and patients. 2.Establish a management development program with meaningful supports and positive messaging to support Manager recruitment and retention. 3.Implement effective administrative structures that support the work of Managers and ensure that the right people are doing the right job. 4.Establish communications systems that are effective (technology), inclusive (decision making), supportive (relationships) and timely. 5.Develop strategies to respect the need for work life balance to ensure the long term well being and effectiveness of Managers.

© Copyright IBM Corporation 2009  IBM Corporation Manager Work Life Review - Achievements to date  Reorganization of Staffing Offices (Staffing Services)  Manager Development Pathway launched (Organizational Development)  HR On Boarding service started (People Services)  Posting/Hiring software updated to decrease steps (People Services)  Attendance Promotion Program implemented (Workplace Health)  Early Attendance Reporting Line (Workplace Health)  Workplace Injury Line (Workplace Health)

4. Staffing Systems Support

© Copyright IBM Corporation 2009  IBM Corporation Goal Creating effective scheduling systems to match provider resources to clients’ needs. Services include:  Systems support  Education  Best Practice/Processes development  Rotation Development  Short Call Operations (Staffing Offices)

© Copyright IBM Corporation 2009  IBM Corporation Staffing Services Model Decentralized Staffing Operations  Short Call Staffing Offices (nine sites)  Program Schedulers Centralized Staffing Systems Support  Staffing Advisory  HR/Staffing Committee  Technical/Content/Process Experts  Education Courses  Scheduling Standards (Guidelines, Tools & Processes)  Computerized Staff Scheduling

© Copyright IBM Corporation 2009  IBM Corporation Challenges  Implementing Service Plans  Introducing Staffing Plans  Providing expert intervention to assist Managers to match their resources to their deployment needs  Increasing full time positions (regular relief)  Improving Vacation Planning Processes

Benefits of Workforce Optimization

© Copyright IBM Corporation 2009  IBM Corporation  Clear and consistent messaging on workforce performance expectations.  Stronger accountability for results.  Improved utilization of resources creating more capacity within the system.  Improved cost effectiveness and productivity that is sustainable.  Innovative workforce strategies.  Improved relationships through partnering.  Improved business systems redesign.  Improved staff engagement and retention.

Questions?