This opinion is based on past work experience in a different field. During my time as a restaurant manager, I learned a couple of things.
One thing I learned was that if you decrease your focus on the customer and increase the focus on the employees, all aspects of the business improve.
Restaurants and Hospitals aren’t the same but I think the principal can be applied.
The long-term benefit
In the beginning, it requires a little investment with staffing and time but the long term payoff is good.
The focus became more of how can we HELP YOU take care of the customer instead of how can we take care of the customer.
When we focused on the customer, we always put the employees on a line between us and them.
One example of this was staffing for meal rushes. We always based staffing on historical sales.
This was fine if you did not want growth.
When we started staffing for historical sales plus 10% growth, it was a struggle at first but began to pay off and we started beating previous years sales on a regular basis.
The way I see it working is that, when you put your employees first, they have a greater satisfaction in their job and this effects many other areas.
Let’s apply this to what I have seen in 11 years of nursing in the hospitals, specifically ICU’s since that is what I am most familiar with.
The impression we get is that staffing is based on census and “acuity” (note quotes).
The staffing purse strings are usually so tight in most ICU’s that I have worked in that the strict 2:1 and occasional 3:1 ratios are used based on “acuity”.
If there is too much staff, they are often called off or floated and given assignments on other units.
If there is adequate staff and discharges occur, staff is sent home quickly usually with no contingency for afternoon admissions.
The staffing equation
My belief is that the onsite staff should always have the ability to admit 1 without overloading the ratio and there should be a contingency to admit at least 2 more.
This would mean that a census of 3 would call for 2 onsite and one contingency, whereas a census of 4 would call for 3 onsite and one contingency.
This allows for admission without overloading the nurses and would allow the nurses to give the patients the type of care that we all want to give them anyway but often can’t.
If no admissions occur, this allows the nurses to do the extras that often get left out such at medication education.
After this standard has been in active for awhile, the hospital will begin to see the benefits in multiple areas.
First, burnout will be reduced and employee satisfaction will increase.
This will show a great savings in education and training because turnover will drop drastically.
Census will continue to climb as word of mouth gets out as to how well the loved ones were taken care of in the facility.
The hospital would start killing the HCAHPS scores.
If reimbursements are going to be tied to the HCAHPS as we have been told, this becomes very important.
This is just one area of adjustment but focusing on employee satisfaction really would increase all aspects of the business.