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Management Tools
"Information is power. Raw data is useless"
The Bi-Weekly Productivity Report
Oftentimes, institutions are data rich and information poor (DRIP). Solid
information tells a story and enables directors and managers to plan
proactively and make decisions based on the timely feedback. The purpose of the
system is to pinpoint the exact cause or reason for the variance whether – or
+. This way, management knows exactly what to focus on in order to meet their
goals. All without having to search through multiple monthly reports that
arrive 2-3 weeks after the monthly close. Instead of 12 feedback opportunities
to reflect change, managers have the feedback and ability 26 times a year.
The Biweekly Productivity Report reflects the productivity performance of the
entire organization on a 2-week (pay period) interval, while maintaining the
year to date perspective. The report includes all hospital departments and
reflects the FTE and salary statistics with relation to volume and cost and
reflects the effects of premium spending.
Global and Specific Department Level Assessment
The Baseline
As senior level management tries to gauge the performance of the institution
prior to the end of a month, very little information is available. Knowing that
labor accounts for more than 50% of the expenses and equivalent admissions
project a reliable indicator for revenue, we believe in looking at the
relationship between the two as an interim forecast at a high level. The
Baseline Report is a management report reflecting the overall labor performance
of the institution by marrying the salaries, ftes, and equivalent admissions to
project performance standards such as cost and ftes per equivalent admission on
a pay period basis. Targets are set and variances are reflected based on the
fiscal year goals. Information reported illustrates each pay period and a
running year to date total.
Global Level Assessment
The Bi-Weekly Totals
A very basic method of determining the control of labor is to monitor ftes and
the distribution of hours. The buckets of hours include productive, overtime,
outside agency and non-productive. There is a delicate balance of what hours
are to be utilized at varying times of the year and, without applying volume
standards, a tip in the distribution can be very costly. The Bi-Weekly Totals
Report reflects the ftes of the institution on a pay period basis with
percentages indicating the distribution. This is extremely important to monitor
even during times of low vacation and holidays. Targets are set and available
for review every two weeks. Information reported illustrates each pay period
and a running year to date total.
Global Level Assessment
The Bi-Weekly Productivity Summary
Using the information from The Bi-Weekly Productivity Report, the ftes for each
department are reflected for each pay period and group by director or vice
president in the same format. This allows management to see various growth or
reduction trends by department. After multiple years or during cost reduction
efforts, fiscal year results or targets fields can be added for comparison
purposes. Information reported illustrates each pay period and a running year
to date total.
Global and Specific Department Level Assessment
The Nursing Costs
"As nursing goes, so does the institution" is very often the motto of many.
Although our approach focuses on productivity and volume management within
every department reflected in The Bi-Weekly Productivity Report, if the nursing
is not managing all labor expenses under nursing, targets will not always be
achieved. In other words, it isn’t always enough to manage the volume dependant
areas, we must manage the expenses all areas. The Nursing Cost Report reflects
the overall cost per patient within the entire nursing grouping on a pay period
basis with a salary variance. At the end of each period a salary figure is
calculated to indicate what was over / under paid. Targets are set and
available for review every two weeks. Information reported illustrates each pay
period and a running year to date total.
Nursing Level Assessment
The Nursing Reconciliation
Historically, nursing has been managed by looking at acceptable standards or
care, ratios involving skill mix, and worked hours per patient days.
Unfortunately the management of nursing departments has become exponentially
more difficult. Additionally, if an institution still manages to those targets,
they are seriously missing the big picture. Where do overtime, agency,
no-productive time and skill mix fit? Also, how do we know that we have the
appropriate compliment of patient days?
The Nursing Reconciliation reflects these issues every 2 weeks to show where
you are performing well and what needs to be worked on. Targets are set and
reviewed every two weeks to track progress. The information reported
illustrates each pay period and a running year to date total.
Nursing Level Assessment
The Overtime & Agency Summary
In today’s management of labor in healthcare, the biggest obstacle is premium
spending. Premium spending is defined as the markup of expenses due to
temporary staffing (agency) and or overtime expenses. Although these types of
expenses are sometimes unavoidable due to staffing shortages and increased
volume, they should not be a consistent element of everyday staffing. The
Overtime & Agency Summary is a detail of the activity by department in the
form of ftes. Each pay period, the detail is reported by department and rolled
up according to the responsible department head. Trends are very evident and
easy to identify. Information reported illustrates each pay period and a
running year to date total.
Global and Specific Department Level Assessment
Productivity Charts
Although reporting systems are important, it is always easier to tell a story
and monitor progress with the help of charts. The information generated from
the various reporting systems are summarized in a series of charts available
each pay period. The detail could range from a global cost per inpatient
admission to the hours and cost per operating room minute. These charts are
often posted in common areas of administration or online for all to monitor.
Information reported illustrates each pay period and a running year to date
total.
Global and Specific Department Level Assessment
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