Redesign of Workflow for the Central Staffing Resources Department Client Mr. David MacIntyre BSN, MBA, Nursing Senior Director Coordinators Zac Costello, Continuous Improvement Specialist Jamie Lindsay, Continuous Improvement Specialist Instructors Dr. Mark Van Oyen Mary Duck IOE F2 IOE 481 Team 2 Alondra Vergara-Diaz Jaclyn Gillen Chase Dutton 11/14/2017 J

Background CSR handles requests for extra nurses and allocates those nurses according to the needs of the requesting units RN Float Pool Unit Clerical Staffing for UH, CVC, & CW Agency Nursing Across House Surge Space Staffing & Mgnt CSR Patient Attendant Hiring & Dev Nursing House Oversight J

House Manager vs IT Shift House Manager Manage a cluster of nurses staffed out to different units throughout the hospital IT shift IT Shift Nurse distribution throughout the hospital Handling issues that may arise with both patients and nurses Attending bedside briefings Any additional tasks J

Key Issues Processes are perceived to be outdated and inefficient Have not changed since the department’s creation Current work streams need to be reviewed, evaluated, and streamlined J

Goals & Objectives Overall goal: Establish a current state of the CSR department Goals: Eliminate waste in CSR workflows Re-distribute workload amongst roles Create a sustainable future state that streamlines processes and balances workload Objectives: Survey and interview several roles in the CSR department to understand the workflows associated with each role Perform observations to understand how much time is spent for each task, specifically the payroll and scheduling processes Identify waste (e.g. repetitive processes) within the department through Lean methodologies Identify gaps between the actual tasks performed by CSR and the expected tasks of the CSR department C

Project Scope Within Project Scope Observing the workflows of house managers, administrative assistants, clerical supervisors, administrative managers, non-clinical area trainer, and office supervisor within the CSR department Observing the scheduling process of CSR Not Within Project Scope Studying any nurses or clerks was not in the project scope C

Findings and Conclusions Approach The team used a three phase approach to complete this project. Findings and Conclusions Data Collection Recommendations A

Data Collection Pre-Interview Survey Observations Interview Obtain information on each employee and use the data to tailor interviews to their response Observations See and compare differences in workflows between employees. Interview Obtain understanding of employee’s roles in CSR, where their time is spent, and discuss any areas of improvements A

Pre-Interview Survey 66% Participation Surveys How long have you been with CSR? In your own words, please describe your role. How did you receive your initial training for your position? How well do you feel your skills set matches to your current role? During a typical week, how many hours do you spend performing the following tasks? Leading Meetings Attending Meetings Email Specific Tasks to your Role Specific Tasks NOT Assigned to your Role 66% Participation Surveys A

22 Interviews Interviews What does a normal day/week look like for you? What tasks do you spend the most amount of time and least amount of time on? What improvements would you like to see for your role specifically? For CSR? What are some actionable ideas for these improvements? Are there days/weeks/months where you feel you’re busier than others? Why? What tasks are challenging to complete? 22 Interviews A

2-hour scheduling sessions Observations Observations for the scheduling process were executed to understand: Difference in processes between House Managers How the Administrative Assistants change their workflow according to each House Manager How the differences affected the outcome of the process. 2: 1: 2-hour scheduling sessions 1-hour payroll process A

Findings and Conclusions Task List Miscommunication Throughout CSR Inconsistency in Scheduling Process Variation of House Managers A

Task List What: Created task lists to outline the general processes covered by each role for all the employees within that role. Why: To show the current state of CSR Who: Roles with an accompanying task list include: House Manager, Clerical Supervisor, Administrative Assistant - General, Administrative Assistant - Payroll, and Administrative Manager C

C House Manager

C Clerical Supervisor

Miscommunication Throughout CSR Desire for greater amount of employee and superior dialogue Employees spend a significant amount of time addressing emails Lack of communication and agreement of responsibilities between the three shifts at CSR Knowing whether the IT House Manager is in or out of the office is difficult. 1. 3. 2. 4. C

Weekly Email Time for Employees C

Miscommunication Throughout CSR Desire for greater amount of employee and superior dialogue Employees spend a significant amount of time addressing emails Lack of communication and agreement of responsibilities between the three shifts at CSR Knowing whether the IT House Manager is in or out of the office is difficult. 1. 3. 2. 4. C

Initial Training C

Miscommunication Throughout CSR Desire for greater amount of employee and superior dialogue Employees spend a significant amount of time addressing emails Lack of communication and agreement of responsibilities between the three shifts at CSR Knowing whether the IT House Manager is in or out of the office is difficult. 1. 3. 2. 4. C

Inconsistency in Scheduling Process 1. Allocation of vacation time determined by House Manager 2. Collaboration with the Administrative Assistants 3. House Manager’s preparation for scheduling process 4. Variations within the scheduling process J

J Scheduling Process

Variation of House Managers Workloads non-IT Shift 10 - 60 nurses IT Shift J

Workload for the House Manager’s non-IT Shift hours J Workload for the House Manager’s non-IT Shift hours

Current Total Workload for House Manager J Current Total Workload for House Manager

Improved Total Workload for House Manager with adjusted IT shifts

Miscommunication throughout CSR Recommendations Miscommunication throughout CSR Inconsistency in scheduling process: standardize the scheduling process Variation of house managers workloads: re-distribute IT shift requirements A

Thank You! For questions and concerns, please email Jaclyn at jgillen@umich.edu A

House Manager

Clerical Supervisor

Administrative Assistant - General Part 1

Administrative Assistant - General Part 2

Administrative Assistant - Payroll

Administrative Manager

Scheduling Process

House Manager Workload Comparison

House Manager Workload