Resources
Reference materials for building a more flexible workforce.
Scheduling Policy Core Elements
Schedule length and timing: 4, 6, or 8-week rotation with guidance for timing of scheduling events (self-schedule period, balancing period, manager approval, final posting).
Best practice: The optimal length for a schedule is 6 weeks.
Shift lengths and times: Day, evening, night, or mid shifts from 4 to 12 hours.
Best practice: Ensure shift lengths provide right coverage while promoting work-life balance.
Skill mix: Identified as needed per unit (e.g., charge nurse, chemotherapy certification).
Weekend coverage: Set at system, hospital, or unit level.
Best practice: Every third weekend is the optimal target.
Shift trades: Like-for-like trade regarding hours, skill set, and pay.
Best practice: Automate shift trading using electronic scheduling systems.
Holiday and vacation: Set at organizational level per HR policies.
Self- or patterned scheduling: At unit level during schedule creation.
Best practice: Shared governance should determine the type of scheduling.
Staffing Policy Core Elements
Nurse floating parameters: Requirements for rotation and tracking.
Best practice: Identify the right floating groups/clusters based on skill compatibility.
Maximum continuous work hours: Defined safety limits.
Best practice: No more than 16 hours continuous; no more than three 12-hour shifts in a row.
Low census cancelation: Algorithm for cancelation order (agency first, then premium pay, then voluntary).
Best practice: Complete cancelation at least 1.5 hours before shift start.
Sick call: Nurse responsibilities and recording procedures.
Best practice: Sick call no later than 3 hours before shift start.
Incentives: Defined for extra and open shifts with timing guidelines.
Best practice: Offer incentives early to reduce last-minute costs.
Scheduling and Staffing Technology Platform Criteria
Versatility
- Enterprise-wide and unit-specific support?
- Potential for growth and expansion?
Flexibility
- Organization can customize to meet unique needs?
User-friendly
- Easy navigation with visual cues?
Mobility
- Mobile app available on multiple devices?
- Robust mobile features (self-scheduling, trades, shift sign-up)?
Integration
- Integrates with existing systems (HR, learning, finance)?
Functionality
- Automates scheduling and staffing work?
- Can forecast future needs?
Internal Travel Agency Checklist
Step 1: Set the Stage
- Team established (nurse executive, managers, frontline staff, HR, finance, IT)
- Environmental scan completed (external agency use, current programs, job descriptions, compensation, policies)
- Overall strategy determined (system vs. local, profit model, technology, eligible roles, pilot parameters)
Step 2: Build the Operating Framework
- Agency management team established
- Technology selected
- Job parameters set (descriptions, onboarding, training, competencies)
- Compensation determined (reimbursement, PTO, licensure, incentives, tuition, clinical ladder)
- Operational principles developed (request criteria, contract length, shift assignments)
- Manager education completed
- Program metrics established (KPIs, evaluation plans)
Step 3: ROI Model and Hiring Plan
- Cost savings calculated (based on target for reducing external agency)
- Number of staff needed and hiring plan determined
- Transition plan for internal staff completed
Step 4: Operationalize the Plan
- Recruitment plans completed (flyers, handouts, website, job platforms)
- Technology implemented (VMS in place, training completed)
- Progress monitoring plan completed (feedback timelines, metric analysis, 6-month and 1-year cost savings review)
Vendor Management Lifecycle
The typical vendor management lifecycle in healthcare involves these stages:
- Vendor Selection — Identifying potential vendors through research, soliciting bids, and evaluating based on quality, cost, and compliance
- Contract Negotiation — Clearly outlining terms including pricing, delivery schedules, and quality standards
- Vendor Onboarding — Setting up accounts, providing training, and ensuring understanding of policies
- Performance Monitoring — Tracking metrics, conducting audits, and addressing issues
- Issue Resolution — Investigating issues, identifying root causes, and implementing corrective actions
- Contract Renewal or Termination — Deciding based on performance, costs, and changing needs