WEBVTT
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Welcome to the Elvation Healthcare Learning Institute podcast, where we explore the strategies and solutions that help independent hospitals thrive in today's challenging healthcare environment.
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As a part of the hospitals nationwide, Elvation Healthcare brings together executives, policy experts, and innovators to discuss practical ways to strengthen financial sustainability, optimize operations, and preserve access to care.
00:00:23.519 --> 00:00:29.679
Subscribe for actionable insights and proven practices to guide your organization's future with confidence.
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Hey everyone, we are thrilled to have you here joining us as we talk about the dynamic landscape of healthcare.
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I'm Jessica Drummond, Associate VP of Workforce Management here at Ovation Healthcare.
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Today with me, I have Knox Community Hospitals Chief Financial Officer Danielle O'Brien and Chief Nursing Officer Carol Emery.
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They're joining us here as we explore some practical insights for optimizing your workforce without compromising care.
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Thank you both for joining us.
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Thanks, Jessica.
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So let's start.
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You know, workforce continues to be one of the top operational and financial priorities for healthcare organizations today across the board.
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Balancing staffing needs, productivity, and cost while still trying to deliver that quality care is really no easy task.
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Let's start with you, Danielle.
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What made you decide to really look into optimizing your workforce?
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Yeah, I would say, you know, as a small rural hospital, we've struggled financially since COVID, as many other hospitals across the country.
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So, you know, we have rising costs in terms of salary and wages, supply cost, less reimbursement from the payers, making it more difficult to get paid for the services that we do.
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So in general, we're always looking for opportunities to save money.
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And really looking at the workforce, that's the biggest out or biggest expense we have on our income statements.
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So that made the most sense to us is to really focus on that and look at overall opportunity around productive hours around our unit of service there in many different areas of hospital.
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Yeah, I I hear that a lot.
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And Carol, anything on your side from the nursing perspective?
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Yeah, so um we really wanted to be able to be more proactive than reactive.
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Um, a lot of our platforms require manual data entry, and then that results in lag in charges being applied, and then those charges showing on some of our uh financial platforms for us to be able to react.
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So we were really looking for something that we could respond to real time and then be more proactive.
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Yeah, great.
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Um so when what do you what would you say, Carol?
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I'll start with you.
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Kind of what was your biggest hurdle when you started looking at implementing and really um you know resource utilization when it comes to workforce?
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I would say competing priorities.
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We had to decide as an organization and make this a priority.
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And as Danielle mentioned, um with our financial situation where it was, this absolutely um was made clear that this was a priority by all of leadership.
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And so we were united in that.
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Um, but then getting down into the details and um really trying to work with specific departments and helping them envision what the word cuts would look like for them because that always strikes fear in the hearts of people.
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So helping them overcome that fear of um trying to rise to the challenge.
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Um and so we had to adjust some timelines, um, we had to adjust our scheduling processes, um, and we looked at new implementation of scheduling and what that would look like.
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So we really created a whole new future state with you guys.
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Yeah, and I think um one thing that um I would add to Carol is you did a really great job of bringing that sort of high-level what the organization wanted as a whole, and bringing that down to kind of even the lower department manager, uh, even that you know, charge nurses, house supervisor, right?
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So you're bringing those goals that are higher up and bringing it how do they get implemented down at the department level?
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You also did a lot of education.
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Thank you for your support in that as well.
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I know uh we also had to um figure out how to be clear on what we were measuring.
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And so I know you were very instrumental in that um as well, in working with Danielle in defining what um that looked like between dollar spend and productive hours, so that we weren't um reducing productive hours, but at the same time then um in reducing FTEs, increasing spend as a result through overtime or anything like that.
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Yeah, Danielle, would you what would you say is your was your biggest hurdle kind of starting out with this?
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Yeah, I think just you know, we have a lot of folks that are new to leadership positions in the organization and just the overall understanding of what productivity is and how we use that on a on a daily basis, even through shifts and different times and points of the day, um, and then understanding how to track it, you know.
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Um, when you think about different volumes, how it fluctuates, then just knowing how to staff that accordingly, when to go up and when to go down, when to make those decisions and so forth.
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So really understanding the data and a tool.
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Yep.
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Um, so Danielle, what do you think is going well right now with your workforce optimization efforts?
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You know, I think it I like the idea that senior leadership is reviewing this on a bi-weekly pay period, right?
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So where we hold our department heads accountable for them to look at daily, um, weekly, bi-weekly productivity.
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Senior leadership is looking at it every two weeks.
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So, for example, we had our operations team meeting today in which I presented several different um several different graphs and so forth and a dashboard that we utilize within strata to show this past pay period ending 5.2, we had a hundred over 102% productivity.
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I show it down to department, I show it down to um overtime agency.
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I also look at productive hours per unit of service where we have opportunity as well as dollars per productive hours and per unit of service.
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So where that opportunity equates to strata gives us that detail as well.
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So I think it's really holding ourselves accountable as well as the um management team.
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That's great.
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Um, and Carol, what do you think's going well now on your side?
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Well, I think early on for me it was the sixth pay period comparison, knowing that it wasn't going to happen overnight, that those changes were not going to happen overnight.
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So we've gotten better at really watching trends.
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Um, and I know your data analysis really helped us from a historical and then a forecasting perspective.
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So I do think we are doing better at adjusting the schedules in response to the peak times.
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Um I think that there's more alignment between even Danielle and I, um, my directors and I, that, and not just, I know I'm speaking to myself as to my experience, but in all the departments, I feel like all of our directors have clear expectations versus just their perceptions.
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Yeah, I mean, I've seen that when I've I've been there as well.
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And I I would say from my own personal experience when I, you know, was working as a staff nurse, understanding that connection and really seeing how I was um helping to balance the productivity, right?
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And and it's just a skill that that needs to be learned.
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Um, where would you say your organization is now in your workforce journey?
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Um how you know, where do you where do you see yourself now and where would you like to see yourself in the future?
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Well, I'll just say from my perspective, um, with our system that we're utilizing right now, we've been over 100% every pay period with the exception of one, and that was like 99%.
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So in 2026, it's really big focus for us.
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Now, do I still think there's opportunity?
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Yes, definitely.
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It's always a work in progress.
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We have to make sure we monitor it and so forth.
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Um, but really making sure that every it's visible, you know, visibility into everybody's um everyday workflow, and then just managing it accordingly.
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But always room for our opportunity, I think.
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Yeah, I think I would echo what Danielle just said as far as it doesn't stop.
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Um, you have to educate and then re-educate and then re-educate.
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Even eight months later, um, you feel like you're saying maybe the same thing, but it can be overwhelming, especially at first.
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So I feel like um we're continuing to re-educate at times, um, especially if someone's been doing well, when they slip anywhere, then they forget some of the things that we evaluated early on, and we get out that reference material and go over that again if needed.
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So it's great to have those resources to reference as well.
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And then the tracking of the data and the changes.
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So we can go back and actually look now that we're actually tracking what changed.
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Um, and if staff have what they verbalize as safety concerns, we can go back and look and say, no, actually, during that time, you there were no changes in staffing, right?
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That would have made an impact.
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Um, we also have the house supervisor make staffing adjustments where previously they would only do it twice a day before beginning of shift change.
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Yeah, I think uh some of the key things that I see helping is that mentality of a continuous process improvement, right?
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Where it's it's a cycle.
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So you improve, you have a target, and then you maybe change that target once you once you reach it, right?
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It's not just a once we're here, we end it.
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Um, and then also you know, putting those processes into place that become new habits that are that help with that productivity, like you're saying, make those um, you know, make those changes so that it's new habits that may not have uh have been into place.
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Uh, but really you get that greater alignment um when you have that.
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Um as we wrap up this episode, uh, are there any sort of considerations you'd like our listeners to know about?
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Are there any certain things that um took longer than expected, shorter than expected?
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Um anything that you would add?
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I would just say for myself as you know, the CFO, it's just not black and white in terms of percentage and you know, productivity by department, bi-weekly, and so forth.
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So, really utilizing the system that we have, they have to input their comments as to why they didn't meet the target.
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So, really developing the department heads to understand that.
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And then I when I read it too, I understand, you know, if we had um a patient in the ED, for example, that needed sitter services for days, you know, how that can impact that productivity and what that means in terms of work FTEs and hours.
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So it's not always cut and dry.
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They can't always staff to be a hundred percent, in my opinion.
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It's just really working together and understanding what causes those variances.
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So proud of the team for what they've done and really getting in and understanding how it works.
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And same here.
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Uh, it's that team and working together, not just on the understanding, but then those solutions.
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Okay, uh, I know I've spent many hours and days and it felt like months, just trying to make one change sometimes in one FTE and figuring out who all it impacted and what uh tasks we needed to adjust to be able to make that change.
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And so not just giving it to the director and saying, here, figure it out.
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Um, actually attending their staff meetings where the staff needed to vent and verbalize and feel like they were being heard um at a higher level if needed.
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Yeah, you both have been really supportive to the managers.
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I know I I've seen it when I've been with you.
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You uh are always there to provide mentorship.
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Uh you work through things together, like let's talk about it, let's let's see what the problem is, let's see what we can help.
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So I think um it's really been a benefit to your organization.
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Agreed.
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Thank you.
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Well, thank you again to both of you.
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Um, thank you to our listeners.
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We hope this conversation offered some meaningful insights into workforce optimization and how you can apply some of these strategies in your organization.
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Please don't forget to follow us on LinkedIn at Ovation Healthcare.
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If you'd like to learn more about ovation healthcare and any of our shared services, please visit ovationhc.com.
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Thank you.
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Thanks, Jessica.
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Thank you for joining us on the Ovation Healthcare Learning Institute podcast.
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We're committed to supporting independent hospitals as they navigate challenges and shape a stronger future for the communities they serve.
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If you found today's conversation valuable, be sure to subscribe, share this episode, and connect with us on LinkedIn at Ovation Healthcare, or visit us at ovationhc.com for more insights and resources.
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Until next time, keep leading with confidence.
00:00:00.080 --> 00:00:09.199
Welcome to the Elvation Healthcare Learning Institute podcast, where we explore the strategies and solutions that help independent hospitals thrive in today's challenging healthcare environment.
00:00:09.519 --> 00:00:23.199
As a part of the hospitals nationwide, Elvation Healthcare brings together executives, policy experts, and innovators to discuss practical ways to strengthen financial sustainability, optimize operations, and preserve access to care.
00:00:23.519 --> 00:00:29.679
Subscribe for actionable insights and proven practices to guide your organization's future with confidence.
00:00:38.079 --> 00:00:46.880
Hey everyone, we are thrilled to have you here joining us as we talk about the dynamic landscape of healthcare.
00:00:47.039 --> 00:00:53.600
I'm Jessica Drummond, Associate VP of Workforce Management here at Ovation Healthcare.
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Today with me, I have Knox Community Hospitals Chief Financial Officer Danielle O'Brien and Chief Nursing Officer Carol Emery.
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They're joining us here as we explore some practical insights for optimizing your workforce without compromising care.
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Thank you both for joining us.
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Thanks, Jessica.
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So let's start.
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You know, workforce continues to be one of the top operational and financial priorities for healthcare organizations today across the board.
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Balancing staffing needs, productivity, and cost while still trying to deliver that quality care is really no easy task.
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Let's start with you, Danielle.
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What made you decide to really look into optimizing your workforce?
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Yeah, I would say, you know, as a small rural hospital, we've struggled financially since COVID, as many other hospitals across the country.
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So, you know, we have rising costs in terms of salary and wages, supply cost, less reimbursement from the payers, making it more difficult to get paid for the services that we do.
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So in general, we're always looking for opportunities to save money.
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And really looking at the workforce, that's the biggest out or biggest expense we have on our income statements.
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So that made the most sense to us is to really focus on that and look at overall opportunity around productive hours around our unit of service there in many different areas of hospital.
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Yeah, I I hear that a lot.
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And Carol, anything on your side from the nursing perspective?
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Yeah, so um we really wanted to be able to be more proactive than reactive.
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Um, a lot of our platforms require manual data entry, and then that results in lag in charges being applied, and then those charges showing on some of our uh financial platforms for us to be able to react.
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So we were really looking for something that we could respond to real time and then be more proactive.
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Yeah, great.
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Um so when what do you what would you say, Carol?
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I'll start with you.
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Kind of what was your biggest hurdle when you started looking at implementing and really um you know resource utilization when it comes to workforce?
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I would say competing priorities.
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We had to decide as an organization and make this a priority.
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And as Danielle mentioned, um with our financial situation where it was, this absolutely um was made clear that this was a priority by all of leadership.
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And so we were united in that.
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Um, but then getting down into the details and um really trying to work with specific departments and helping them envision what the word cuts would look like for them because that always strikes fear in the hearts of people.
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So helping them overcome that fear of um trying to rise to the challenge.
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Um and so we had to adjust some timelines, um, we had to adjust our scheduling processes, um, and we looked at new implementation of scheduling and what that would look like.
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So we really created a whole new future state with you guys.
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Yeah, and I think um one thing that um I would add to Carol is you did a really great job of bringing that sort of high-level what the organization wanted as a whole, and bringing that down to kind of even the lower department manager, uh, even that you know, charge nurses, house supervisor, right?
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So you're bringing those goals that are higher up and bringing it how do they get implemented down at the department level?
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You also did a lot of education.
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Thank you for your support in that as well.
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I know uh we also had to um figure out how to be clear on what we were measuring.
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And so I know you were very instrumental in that um as well, in working with Danielle in defining what um that looked like between dollar spend and productive hours, so that we weren't um reducing productive hours, but at the same time then um in reducing FTEs, increasing spend as a result through overtime or anything like that.
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Yeah, Danielle, would you what would you say is your was your biggest hurdle kind of starting out with this?
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Yeah, I think just you know, we have a lot of folks that are new to leadership positions in the organization and just the overall understanding of what productivity is and how we use that on a on a daily basis, even through shifts and different times and points of the day, um, and then understanding how to track it, you know.
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Um, when you think about different volumes, how it fluctuates, then just knowing how to staff that accordingly, when to go up and when to go down, when to make those decisions and so forth.
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So really understanding the data and a tool.
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Yep.
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Um, so Danielle, what do you think is going well right now with your workforce optimization efforts?
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You know, I think it I like the idea that senior leadership is reviewing this on a bi-weekly pay period, right?
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So where we hold our department heads accountable for them to look at daily, um, weekly, bi-weekly productivity.
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Senior leadership is looking at it every two weeks.
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So, for example, we had our operations team meeting today in which I presented several different um several different graphs and so forth and a dashboard that we utilize within strata to show this past pay period ending 5.2, we had a hundred over 102% productivity.
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I show it down to department, I show it down to um overtime agency.
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I also look at productive hours per unit of service where we have opportunity as well as dollars per productive hours and per unit of service.
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So where that opportunity equates to strata gives us that detail as well.
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So I think it's really holding ourselves accountable as well as the um management team.
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That's great.
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Um, and Carol, what do you think's going well now on your side?
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Well, I think early on for me it was the sixth pay period comparison, knowing that it wasn't going to happen overnight, that those changes were not going to happen overnight.
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So we've gotten better at really watching trends.
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Um, and I know your data analysis really helped us from a historical and then a forecasting perspective.
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So I do think we are doing better at adjusting the schedules in response to the peak times.
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Um I think that there's more alignment between even Danielle and I, um, my directors and I, that, and not just, I know I'm speaking to myself as to my experience, but in all the departments, I feel like all of our directors have clear expectations versus just their perceptions.
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Yeah, I mean, I've seen that when I've I've been there as well.
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And I I would say from my own personal experience when I, you know, was working as a staff nurse, understanding that connection and really seeing how I was um helping to balance the productivity, right?
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And and it's just a skill that that needs to be learned.
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Um, where would you say your organization is now in your workforce journey?
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Um how you know, where do you where do you see yourself now and where would you like to see yourself in the future?
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Well, I'll just say from my perspective, um, with our system that we're utilizing right now, we've been over 100% every pay period with the exception of one, and that was like 99%.
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So in 2026, it's really big focus for us.
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Now, do I still think there's opportunity?
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Yes, definitely.
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It's always a work in progress.
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We have to make sure we monitor it and so forth.
00:09:59.759 --> 00:10:10.720
Um, but really making sure that every it's visible, you know, visibility into everybody's um everyday workflow, and then just managing it accordingly.
00:10:10.879 --> 00:10:13.600
But always room for our opportunity, I think.
00:10:14.159 --> 00:10:19.279
Yeah, I think I would echo what Danielle just said as far as it doesn't stop.
00:10:19.679 --> 00:10:24.480
Um, you have to educate and then re-educate and then re-educate.
00:10:24.639 --> 00:10:31.759
Even eight months later, um, you feel like you're saying maybe the same thing, but it can be overwhelming, especially at first.
00:10:31.919 --> 00:10:53.200
So I feel like um we're continuing to re-educate at times, um, especially if someone's been doing well, when they slip anywhere, then they forget some of the things that we evaluated early on, and we get out that reference material and go over that again if needed.
00:10:53.279 --> 00:10:56.799
So it's great to have those resources to reference as well.
00:10:57.840 --> 00:11:01.279
And then the tracking of the data and the changes.
00:11:01.360 --> 00:11:06.240
So we can go back and actually look now that we're actually tracking what changed.
00:11:06.480 --> 00:11:19.519
Um, and if staff have what they verbalize as safety concerns, we can go back and look and say, no, actually, during that time, you there were no changes in staffing, right?
00:11:19.600 --> 00:11:22.000
That would have made an impact.
00:11:22.240 --> 00:11:31.919
Um, we also have the house supervisor make staffing adjustments where previously they would only do it twice a day before beginning of shift change.
00:11:33.759 --> 00:11:42.320
Yeah, I think uh some of the key things that I see helping is that mentality of a continuous process improvement, right?
00:11:42.480 --> 00:11:44.240
Where it's it's a cycle.
00:11:44.399 --> 00:11:51.120
So you improve, you have a target, and then you maybe change that target once you once you reach it, right?
00:11:51.200 --> 00:11:54.240
It's not just a once we're here, we end it.
00:11:54.559 --> 00:12:12.080
Um, and then also you know, putting those processes into place that become new habits that are that help with that productivity, like you're saying, make those um, you know, make those changes so that it's new habits that may not have uh have been into place.
00:12:12.399 --> 00:12:18.159
Uh, but really you get that greater alignment um when you have that.
00:12:19.519 --> 00:12:28.480
Um as we wrap up this episode, uh, are there any sort of considerations you'd like our listeners to know about?
00:12:28.639 --> 00:12:36.559
Are there any certain things that um took longer than expected, shorter than expected?
00:12:36.879 --> 00:12:39.519
Um anything that you would add?
00:12:41.919 --> 00:12:52.559
I would just say for myself as you know, the CFO, it's just not black and white in terms of percentage and you know, productivity by department, bi-weekly, and so forth.
00:12:52.799 --> 00:12:59.200
So, really utilizing the system that we have, they have to input their comments as to why they didn't meet the target.
00:12:59.600 --> 00:13:03.200
So, really developing the department heads to understand that.
00:13:03.279 --> 00:13:17.039
And then I when I read it too, I understand, you know, if we had um a patient in the ED, for example, that needed sitter services for days, you know, how that can impact that productivity and what that means in terms of work FTEs and hours.
00:13:17.200 --> 00:13:19.120
So it's not always cut and dry.
00:13:19.200 --> 00:13:22.639
They can't always staff to be a hundred percent, in my opinion.
00:13:22.799 --> 00:13:26.960
It's just really working together and understanding what causes those variances.
00:13:27.200 --> 00:13:32.240
So proud of the team for what they've done and really getting in and understanding how it works.
00:13:33.200 --> 00:13:34.639
And same here.
00:13:34.799 --> 00:13:40.639
Uh, it's that team and working together, not just on the understanding, but then those solutions.
00:13:40.960 --> 00:14:00.240
Okay, uh, I know I've spent many hours and days and it felt like months, just trying to make one change sometimes in one FTE and figuring out who all it impacted and what uh tasks we needed to adjust to be able to make that change.
00:14:00.480 --> 00:14:04.639
And so not just giving it to the director and saying, here, figure it out.
00:14:04.799 --> 00:14:16.080
Um, actually attending their staff meetings where the staff needed to vent and verbalize and feel like they were being heard um at a higher level if needed.
00:14:16.639 --> 00:14:20.480
Yeah, you both have been really supportive to the managers.
00:14:20.720 --> 00:14:23.759
I know I I've seen it when I've been with you.
00:14:24.080 --> 00:14:27.360
You uh are always there to provide mentorship.
00:14:27.519 --> 00:14:35.279
Uh you work through things together, like let's talk about it, let's let's see what the problem is, let's see what we can help.
00:14:35.440 --> 00:14:40.080
So I think um it's really been a benefit to your organization.
00:14:41.919 --> 00:14:42.799
Agreed.
00:14:43.600 --> 00:14:44.399
Thank you.
00:14:44.720 --> 00:14:47.440
Well, thank you again to both of you.
00:14:47.600 --> 00:14:49.679
Um, thank you to our listeners.
00:14:49.919 --> 00:15:00.480
We hope this conversation offered some meaningful insights into workforce optimization and how you can apply some of these strategies in your organization.
00:15:00.960 --> 00:15:05.600
Please don't forget to follow us on LinkedIn at Ovation Healthcare.
00:15:05.840 --> 00:15:13.759
If you'd like to learn more about ovation healthcare and any of our shared services, please visit ovationhc.com.
00:15:14.480 --> 00:15:15.120
Thank you.
00:15:16.080 --> 00:15:17.039
Thanks, Jessica.
00:15:26.000 --> 00:15:29.840
Thank you for joining us on the Ovation Healthcare Learning Institute podcast.
00:15:30.000 --> 00:15:36.799
We're committed to supporting independent hospitals as they navigate challenges and shape a stronger future for the communities they serve.
00:15:37.039 --> 00:15:48.559
If you found today's conversation valuable, be sure to subscribe, share this episode, and connect with us on LinkedIn at Ovation Healthcare, or visit us at ovationhc.com for more insights and resources.
00:15:48.799 --> 00:15:51.279
Until next time, keep leading with confidence.
