How a Strong Workforce Management Foundation Helped Advocate Aurora Health Navigate COVID-19

Workforce management should be a primary focus for healthcare organizations, and for good reason. Not only does a well-crafted workforce management strategy and effective technology help lower costs and increase efficiencies, it also plays a vital role in improving patient outcomes and positively impacts staff experience.

Healthcare workforce management is crucial under normal circumstances, and it has become even more important during COVID-19. The pandemic has caused a sharp increase in provider burnout rates, and despite the medical community’s best efforts to control the spread of COVID-19, the U.S. continues to regularly set new case records.

In a recent webinar hosted by Becker’s Hospital Review, nurse leaders Mary Beth Kingston, PhD, RN, NEA-BC, Margaret Gavigan, MSN, MBA, RN, NEA-BC, and Jane Dus, DNP, RN, NE-BC from Advocate Aurora Health shared how the organization has responded to COVID-19.

In this post, we’ll take a look at how Advocate Aurora Health’s efforts over the past few years helped revamp their approach to workforce management to better standardize to leading practices and streamline their processes — and how that paid off during COVID-19.

Who is Advocate Aurora Health?

Advocate Aurora Health is one of the 10 largest not-for-profit, integrated health systems in the country, with 26 hospitals and 500+ sites of care across Illinois and Wisconsin. Advocate Aurora has 75,000 team members, more than 10,000 volunteers, and 8,300 physicians, all serving 3 million unique patients. The system's purpose is to "help people live well" during times of crisis and calm, fully embracing a whole-person health focus and commitment. Leaders have leveraged the size of the system while moving with speed and agility to navigate the changes created by the pandemic.

A Proactive Approach to Workforce Management

A few years ago, Advocate Aurora leadership began looking for opportunities to improve staffing practices to maximize facility efficiency and ensure high-quality patient care. A primary focus for leadership was optimizing staffing at Advocate Aurora hospital sites.

Fluctuating patient care needs made it more difficult for leadership to forecast staffing needs at hospital sites on any given day, resulting in understaffed or overstaffed facilities, incurring unnecessary labor costs. Attempting to adjust to these scheduling gaps on the fly required an otherwise-avoidable expense of time and resources. In addition, these reactive scheduling changes made it more difficult for nurses across the Advocate Aurora Health system to consistently meet their targeted hours. Systemic change was necessary.

Effective Staffing at Advocate Aurora Health

With more than 22,000 nurses on staff, it is clear Advocate Aurora recognizes the integral role nursing plays in patient outcomes. Dr. Kingston’s approach to nurse staffing is straightforward: making sure the right nurse with the right competencies is available at the right time, and at the right cost.

With that in mind, Advocate Aurora’s revamped staffing strategy focused on three core areas:

  1. Eliminating gaps in nursing schedules;
  2. Creating a more efficient scheduling process, and;
  3. Ensuring available clinical resources matched patient demand.

To address these needs, leadership introduced the “effective staffing” outlined here:

Advocate Aurora leveraged scheduling software to standardize staffing and scheduling practices across the system. Scheduling timeframes were also synchronized system-wide, ensuring all leaders had the same data regarding staffing coverage and needs. Leadership also created an ecosystem of multidisciplinary teams working together to track key metrics and navigate complex staffing issues. Finally, Advocate Aurora standardized job descriptions and streamlined the position approval process, making it easier to identify and hire the right staff for each role.

COVID-19: A Test of Advocate Aurora’s Workforce Management Strategy

Overhauling the workforce management strategy was a significant undertaking for Advocate Aurora Health, but when COVID-19 reached the U.S. this year, the organization’s foresight and proactivity paid dividends.

Healthcare organizations across the country struggled during the first wave of COVID cases, and for many, the root cause was staffing issues. Some organizations without an effective work force management strategy and technology were unable to match the needs of the patients with the number of staff needed and experienced over or under staffing. Organizations were unable to heed Dr. Kingston’s mantra of having the right staff for the job, leaving many hospitals understaffed or overstaffed in the wrong areas.

Advocate Aurora’s stability throughout the pandemic is a testament to the value of a solid, enterprise-wide workforce management strategy. In May, when new cases reached their peak in Wisconsin and Illinois, Advocate Aurora used their existing workforce management strategies to quickly and effectively respond to changing staffing demands, managing the pandemic in two states with different needs.

Like many organizations, Advocate Aurora closed down elective surgery and ORs. Unlike most organizations, however, Advocate Aurora had the organizational and staffing flexibility to reassign more than 5,000 team members to new roles within the organization. Depending on their skillsets and organizational need, furloughed staff members were able to contribute in a variety of different areas, including as screeners, call center staff, employee health staff, and in HIT & data management roles.

Co-led by nursing and HR system leaders, Advocate Aurora also implemented a system-wide Virtual Labor Pool Command Center, which included an online process for requesting and reassigning staff and volunteering for reassignment, as well as a database of available team members for greater visibility — all available 24/7. Advocate Aurora also established a virtual nursing orientation for new hires, as well as a virtual education resource to help reassigned nurses from OR, PACU, and other areas to assist with care in medical-surgical and ICU units.

There have been over 300 nursing practice changes as a result of the lessons learned during COVID-19, and Advocate Aurora has also established a library of COVID-19 educational resources to help providers stay current with information about the virus. Advocate Aurora has established strong foundational principles for future success, including a system-wide approach to leveraging workforce flexibility and identifying opportunities for staff to learn and sustain new skills.

Through multiple surges in new COVID-19 cases in Illinois and Wisconsin, Advocate Aurora’s commitment to building an adaptable and resilient workforce — one that strikes the right balance between cost and quality of care — has ensured the organization is well-equipped to manage any challenges that may arise.


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