Centralized Staffing: How and Why It Could Work at Your Health System

Competing, high priorities in healthcare workforce management—costs, staff satisfaction, and patient experience—are tipping the needle toward use of centralized staffing for many health systems. In centralized healthcare staffing, a central office manages scheduling and staffing rather than individual units.

In the early days of centralized staffing, about a decade ago, hospitals simply set up an office with a direct line to organize call-ins for nurses and other healthcare professionals to help units fill staffing requests. Over the years, the model has gained in popularity among health system employers that need coverage for multiple healthcare facilities. Today, symplr Workforce Management is seeing more healthcare employers opt to use a central staffing office to manage all aspects of day-to-day staffing, including:

  • Filling vacancies
  • Flexing staff as patient care needs change
  • Managing internal resource pools
  • Managing timekeeping

Let’s take a closer look at the centralized staffing model and discuss how your expanding health system or healthcare facility can create a new office or make your existing one more effective.

What’s driving centralized staffing trends?

As health systems grow, they may require a centralized group focused on ensuring optimal staff levels. A central staffing office enables staffing decisions to be made based on a comprehensive, enterprise-wide view of patient needs and available staff, which leads to balanced, data-driven decisions for the entire organization. Further, healthcare-specific technology addresses the complex and dynamic regulatory landscape healthcare organizations face.

Centralized staffing also benefits individual units as it relieves some of the management load for unit leaders. Under such reallocations of duty, unit leaders can still stay engaged on an exception basis, where they get involved only when something is out of the ordinary. 

Benefits of centralized staffing

Centralization can have a positive impact on staff, patients, and the bottom line. Here are some of the outcomes health system employers achieve using an effective central staffing strategy:

Staff satisfaction

  • Staff and units receive equitable treatment: With a full view of staffing across the entire organization, work hours are distributed more equitably across a larger pool of people. Managers don't rely on the same people in the same unit to cover open shifts, and all employees are treated more equally and impartially.
  • Managers save time: Ensuing career satisfaction among nurse leaders and other managers pays off. When managers spend less time on staffing, it reduces frustration and gives them time back to focus on the staff and patient needs.

Patient experience

  • There's more time for patient care: Unit leaders can move on from administrative tasks to maintain a more patient-centered focus.
  • Better physician/nurse/patient assignments are made: Centralized staffing ensures better coordination of resources across healthcare facilities, so patients can be matched with staff who have the skills and competencies to meet specific care needs.
  • Coverage improves: When there’s an open shift, the team in the central staffing office can find available staff anywhere in the organization, which increases the likelihood that the shift will be filled. When patters emerge that reflect a dearth of nurses or others, the system can reach out to job seekers.

The bottom line

  • Premium spend is reduced: Instead of filling open shifts by putting staff into overtime, centralized staffing provides visibility to available staff across the organization, including per diem and float pool staff, so there’s a better chance of filling the staffing gap with someone who won’t incur premium labor costs.
  • Flexing staff comes into play: The central staffing office can take a balanced approach to enterprise-wide staffing, minimizing both under- and over-staffing.

The foundation for a central staffing office

When establishing the foundation for centralized healthcare staffing, here are important factors to keep in mind:

Start with leadership

Shifting staffing accountability from the unit managers to a centralized area is a huge change in authority. It’s important for the leadership team to champion the project and provide support so the entire team can trust the process and remain committed to the change. Ensure that leaders understand the desired outcomes. Establish clear performance measures that reflect the desired outcomes, and then monitor performance keep the project on track.

Design a blueprint to build out the staffing office

Once you have the acceptance and support of the leadership team, it’s time to plan the build-out of the centralized staffing office. Create a model that will reflect what you want the final structure to look like. This final structure may take time to achieve, but a sound plan will give you a blueprint with a phased approach to success.

Your blueprint should include these design parameters:

  • Project scope: What is the scope of the change? Will it be enterprise wide or for select units?
  • Span of control: What is the ultimate span of control for the office? Will it serve only nursing or will ancillary areas be included?
  • Separation of duties: What will the staffing office handle? What’s the role of the unit leaders?
  • Detailed implementation plan: Who will be a part of the implementation team and what will their roles be? Will the rollout use a phased approach, or will there be a single go-live?
  • Structure of the staffing office: Who will staff the central office, what are their requirements and skill sets, and what will their roles and job descriptions be? Will the system need to reach out to job seekers to fill the roles? Will the staffing office be available 24/7 or during select days and hours? What training/education, technology systems, and data will the staffing office need? What other tools might they require?

Creating standardized policies, processes, and data requirements

The ultimate goal of the central staffing office is the have the right person, in the right place, at the right time, and at the right cost. To achieve this goal, policies, processes, and data requirements must be clearly defined, with consensus and standardization in place.

symplr recommends starting with standardization in these areas for healthcare employers:

Data policy: Decisions are only as good as the data used to make them. Define the basic data that is needed for well-informed staffing decisions. Recognize that understanding how to interpret the data and knowing the correct action to take is a new skill set for many people, and it will not happen overnight. Mentoring is often required.

Here is a checklist that can provide a foundation for your health system’s data requirements policy:

  • Departmental Information
    • Budgetary needs
    • Actual needs
    • Skill mix requirements
    • Workload volumes
  • Staff information
    • Licensure
    • Competencies/credentials
    • Expected work hours (capacity)

Employee self-service policies: Define how you will provide staff with the ability to see and request shifts they are qualified to work. Ensure you consider how you enforce rules for all staff to meet their committed hours to work, whether they are per diem or full-time.

Premium spend policies: Determine when it is acceptable to use premium labor, and establish baselines and target levels. Ensure all parties are clear about who is accountable for achieving the target levels.

Data delivery: The key to centralizing staffing success

To achieve the expected financial, clinical, and operational outcomes, the team in the staffing office needs visibility into data at the time when it can impact a decision. Here's how to deliver data to enable that time-sensitive visibility:

  • Automate staffing, moving beyond spreadsheets and manual workarounds
  • Make data easily accessible by all staff at all levels of the organization, and make it easily consumable (i.e., provide enterprise visibility within a single view or dashboard)
  • Make information timely and actionable so it’s easy for staff to know what they should do, not what they should have done
  • Provide a trending view that makes it easy to visualize predictable patterns and variances across different areas, and easy to report on them 

Moving to a centralized staffing approach requires a significant commitment of time and resources. However, the end result delivers the key benefits that health systems need today: improved patient care, staff satisfaction, and labor cost containment. 

Are you interested in discussing how your health system can implement and optimize a central staffing office? Request a free consultation with our team of optimization experts.


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