By Cindy Gaines, Chief Clinical Transformation Officer, Lumeon
As the workforce crisis in healthcare deepens, improving productivity is becoming a top priority.
However, productivity has often been seen as a productivity target focusing on decreasing headcount – a mathematical ratio between the number of staff and patients.
As Dr. Christy Dempsey explained in a recent “Orchestrating Healthcare” podcast:
“If you talk to direct care nurses – people who are at the bedside – and use the word productivity, you’ve immediately lost them. This word is like a hammer which we’ve beaten them over the head with. Instead, changing the perception of what productivity means is what we need to focus on, and how it can benefit staff at the bedside.”
Let’s talk about productivity in an entirely new way
Today, productivity is not just a budgetary term or a numbers game, and we need to redefine it: “How do we help enable our teams to provide the best, highest quality care with limited staff available?”
We’ve known for years there’s a nursing shortage coming, and we’ve been preparing for it. We’ve seen our nurse demographics age; we’ve seen that there are more leaving the industry than entering it. However, the pandemic launched us into a staffing crisis that we were not expecting soon.
We still must care for as many patients as before, but we don’t have the number of staff we used to. So, how do we continue to provide high-quality care – for every patient – during a staffing shortage? We need to be able to take all the data that we have now, more than we’ve ever had before, and find actionable ways to drive improvement at the bedside and beyond.
Over the years, if something needed to be done, we just gave one more task to somebody to do. With this approach, we’ve often burdened our teams with things that don’t have anything to do with being a care provider. A lot of faxing, calling, emailing, and chasing, and it’s not what nurses went into nursing for. It’s time to redefine how we do nursing and provide care, or at least think about it differently.
So, what’s the new model?
It’s about taking the time to say – what can we let go of what is not essential to the care we provide, and what can we automate to improve working life?
Automation to orchestrate care
Automation is often a scary word. People tend to think a machine is taking over, a robot is providing the care, it’s become impersonal, or it’s somehow coming between the provider and the patient.
Christy explained in the podcast: “People equate automation with job losses. I will lose my job because a robot will come in and do what I do. I don’t think we’ll ever see that in nursing, but if a robot can help sort pills, I’m all about that. If a robot can call maintenance when I have a leaky faucet in a room, I’m also all about that. So, rather than having a registered nurse call maintenance, with all the education, experience, and training that comes with being a registered nurse – that’s a good day!”
Automation can remove things from a list of ‘to-dos’ like that phone call, communication with another department, or identifying the next thing the patient needs to do. It can deal with coordinating tasks within and beyond the department, helping orchestrate the care for the patients and freeing up caregivers to spend more time with them.
Using data to drive productivity improvement
Today, we can capture all kinds of data, but without using insight from that data to drive improvement, it’s just data. Looking at the data is essential, but only because it helps you solve a goal. The goal must be to look at the data to make improvements and measure process results and outcomes.
Understanding what it takes to improve productivity can be complicated, and we don’t spend enough time measuring it, understanding it, and adding value to each step. What we need to do instead is look at the outcome we want and look at the blend of process, people, and technology required to achieve that outcome.
So that’s redefining productivity – talking about quality, clinical outcomes, and the care we provide. Defining what you want to achieve in the end, and what are the steps to get there?
The people doing the job will have many of the answers. If we explain the things impacting what we do in our unit and the outcome that we want, together we can work out what it’s going to take for us, given all these factors, to get to where we want to be. It’s key to involve the people who do the work, those who know where there is duplication, and those who know who else could do the job in a highly reliable way.
It’s not about working harder; it’s looking for a better way to do things. Using technology the way that it should be used, allowing decisions to be made by the people who are doing the work, unburdening them by using automation, and optimizing the time that they spend at the bedside
Think about productivity as the auto-pilot that brings staff in at the right time, right place, and for the right patient:
- Engage the people at the frontline taking care of patients daily.
- Let data drive decisions. But understand that data by itself is just data. The only reason data is important is that it helps us drive the improvement that we want to see.
- Outcomes should be our goal, but we need to work backward from those outcomes to figure out what we must do to get there.
- Have people do the jobs they were trained for, at the top of their license or training, and work out how to move other things off their plates.
- Use technology and automation in a way that helps people do the job that they were trained to do. Unburdening them enables the team to take better care of the patients.
That’s the kind of innovation that will get us past this crisis.
This article summarizes the podcast titled ‘Rethinking Productivity in a Staffing Crisis‘ from Dr. Christy Dempsey, CNO of Press Ganey Emeritus, and Cindy Gaines, Chief Clinical Transformation Officer of Lumeon.