Staffing Robot - Healthcare Staffing, Marketing and Technology Blog

My Interview on Staffing Talk

Last Friday, Gregg Dourgarian of Tempworks Staffing Software and the blog Staffing Talk had me on his call in show. We discussed several topics such as ShiftWise Healthcare Vendor Management, the current economic state of the healthcare staffing industry, the social media application foursquare, Social Media Marketing (SMM) and staffing agencies and my blog Staffing Robot.

Gregg is an active blogger and continues to try new things. He is definitely helping to further advance the use technology and social media in the staffing industry. Thanks for having me on your show Gregg.

You can watch the show here.

Should Hospitals Focus on Eliminating Their Agency Staff?

It's a question that never seems to go away. Can hospitals truly eliminate all of their agency usage? Perhaps a better question is - should they? From a management perspective, the healthcare staffing industry seems to be one of the last to see the usage of temporary labor as being negative.

By now we've all read the L.A. Times article that highlighted some bad practices of a few staffing agencies and used these examples to paint the entire industry with more negative stereotypes.

The American Staffing Association had a great response to the article that was necessary and expected. What was nice to see, however, is people like Rebecca Hendren from Healthleaders Media who has written a couple of excellent articles on how hospitals can better manage staffing agency professionals. In her first article Rebecca discussed how positive work environments and better orientation practices can improve the process for working with agency staff.

This week, Rebecca wrote another article about how hospitals are making effective use of technology to reduce their reliance on agency staff. She points out hospitals that have effectively deployed internal staff scheduling software to fill more shifts with internal staff, offer more scheduling flexibility and improve morale. The Healthleaders Media article made several great points on this topic and I wanted to add a few of my own.

1. It's no secret that scheduling software applications can dramatically improve a hospital's staffing situation. However, software won't solve the nursing shortage. It bothers me to say that. I'm a huge believer in technology but sadly, it will not solve all of our problems. Even though the economy has given us the illusion that the shortage of healthcare professionals has decreased, this is only a temporary situation (no pun intended). All analysis suggests the shortage will only continue to get worse. According to the Bureau of Labor, at 23%, the demand for nursing will be much greater than the average for all other occupations between 2006 and 2016. So no matter how efficient the software, if there's no staff to manage - there's no staff - and working with temporary labor is still necessary.
2. Deploying a solution to better manage your internal staff while ignoring the management of staffing agencies won't solve your hospital's staffing problem. Hospitals need a solution that will manage all of their staffing - both permanent and temporary.
3. The article includes some popular generalizations about the use of healthcare agency staff such as: using agency requires more organization and effort and that it "can sometimes lead to resentment among the permanent staff, who question why their hospital is willing to pay twice as much to agency nurses to fill open shifts as it pays to its own loyal staff."

Healthcare Vendor Management Systems ensure that the process for managing agency staff is simple and effective. Implementing such a system means that the same, if not less, effort than managing internal staff is required. In addition, nurses do not get paid 2x as much if they work for an agency. The mark up on pay rates to agency staff does not equate to being 2x the cost of internal staff (especially if you factor in other benefits for internal staff) and this money is not all paid to the nurse. Further, there is an implication in this statement that the mark up is unnecessary. The mark up exists to provide quality staff, often under short notice and goes to cover the business costs of properly recruiting, screening, hiring and placing these professionals.

The solution is to more effectively utilize staffing agencies - not work toward eliminating them. Attempting to eliminate agencies can actually end up being more costly to hospitals in the long run due to increased staff overtime, burnout/turnover and higher management costs due to a lack of efficient processes if/when using agency staff is necessary. Additionally, until the nursing shortage is over it's not feasible for every hospital to fully eliminate their agency usage. Therefore, a better goal is to focus on more effective agency management - not elimination.

In the past I've written about several reasons to use agency staff so I won't repeat myself here. I'll only close by saying that focusing on things such as improved orientation, better credential compliance management and process automation with a comprehensive workforce management system is a more effective solution for hospitals in regard to addressing their concerns with agency staff.

Top Healthcare Staffing Stories of 2009 and Predictions for 2010

Over the next few weeks both of my sons have birthdays and I plan on spending some down time with my family for the holidays. Therefore, this will be my last post until the new year.

I thought I'd use this post to highlight some of the big events that affected the healthcare staffing industry in 2009 as well as make a few predictions about the industry for 2010. (is it 'twenty-ten' or 'two thousand ten'?)

What the healthcare staffing industry looked like in 2009:

Major downturn in spending on healthcare temporary staff.

The biggest news in 2009 for the healthcare staffing industry was undoubtedly about the downturn in the economy. My second blog post ever was on the reasons hospitals were spending less on healthcare agency staff. The down turn in the economy even made people start asking the question: "is there still a nursing shortage?" From there, leading economists confirmed that not only was the economy bad but that it will take awhile for it to improve and return the healthcare staffing industry to pre-2009 levels. And finally, the Staffing Industry Analysts informed us that the nurse travel industry decreased by 44% this year and we saw this downturn reflected in the revenue loss reported by major public healthcare staffing companies.

Widespread adoption of healthcare vendor management.

In 2009 hospitals gave a big vote of confidence to vendor management as the preferred model for agency management. VMS has matured in the industry and delivered on its promise of saving hospitals both time and money on their staffing costs.

How healthcare reform will affect healthcare staffing.

The topic of how healthcare reform will affect healthcare staffing couldn't be avoided. Many debates about the pros and cons of healthcare reform occurred on my blog and many of us had the privilege of hearing former Senator Tom Daschle's view on healthcare reform at the healthcare staffing industry conference. AMN even produced results from a poll suggesting that hospital CEO's feel healthcare reform will benefit the healthcare staffing industry.

Technology VMS companies struggle.

Even though some healthcare vendor management technology companies thrived in 2009 as hospitals increased their adoption of VMS, many companies did not fair so well. A few healthcare VMS technology companies had to close their doors this year while some VMS companies struggled to pay their staffing agency partners. Additionally, some VMS companies found acquisition to be the best way to survive the turbulent year.

Increased use of social media.

2009 was the year that many hospitals and staffing agencies began to use social media. Many hospitals, such as Providence St. Vincents in Portland Oregon who found success with their 'pink glove dance video' that went viral, took full advantage of these tools. Some hospitals are still behind when it comes to social media while several hospitals are finding success with tools such as Twitter. Both healthcare staffing agencies and hospitals are now promoting and monitoring their brands online, as the online tools for brand promotion and management are starting to become more prevalent. I've even created some helpful tools for people to search for healthcare staffing industry information and follow companies in the healthcare staffing industry on Twitter.

As you can see, 2009 was a very eventful year for the healthcare staffing industry. So what will the next year bring?

My predictions for healthcare staffing in 2010:

More consolidation of staffing agencies and VMS companies.

After struggling through the economic downturn of the last 1.5 years many companies are now really feeling the effects. I see several staffing agencies closing their doors and many more acquisitions in 2010. I wouldn't be surprised if we even see some consolidation with some of the major players. In addition, I expect we'll see some more acquisitions of healthcare VMS companies.

Continued adoption of vendor management.

Hospitals will continue to choose vendor management for their agency management solution. As the rate of adoption continues to increase, I expect we'll see hospitals still choose vendor neutral healthcare vendor management companies over agency run managed service providers.

New technology players.

The industry has gotten a bit stale in terms of innovation and new technology options. In addition, we've seen a decent amount of consolidation of industry technology companies. Both of these facts suggest to me that new players will enter the market and hopefully they will bring with them some exciting and innovate technologies. As these players enter the healthcare staffing industry I expect we'll see more and more hospitals and healthcare staffing companies embracing technology to improve their staffing process. Stay tuned!

New marketing methods and opportunities.

As budgets tighten many hospitals and staffing agencies will look for more inexpensive and effective methods for marketing their services. Many more healthcare staffing organizations will turn to SEO/SEM and social media for company/brand promotion. 

The market will come back slowly. Kind of.

Even though there are some positive signs for the economy overall and there has been some slight improvements in the healthcare staffing industry I don't see anything that suggests we should get too excited. Earlier this week the Staffing Industry Analysts (SIA) hosted a webinar about the economic outlook for 2010. Their predictions suggested that every industry will improve in 2010 - except healthcare staffing. In fact, they are predicting an overall decline of -1%. Therefore, unfortunately, I believe 2010 will still be a year of struggle. There will be some positive bumps here and there but we won't start fully pulling out of this down turn until early/mid 2011.

What are your predictions for healthcare staffing in 2010? Please share them here if you have any.

I wish you all well - happy holidays - happy new year. See you in 2010!

How Much Can VMS Really Save You?

Recently, the Staffing Industry Analysts (SIA) put out a report on how much Vendor Management is saving companies that have adopted VMS as a management solution for contingent labor. According to the SIA "The results were based on findings from the 2009 Contingent Buyer Survey, conducted in September 2009, and reflect the opinions of buyer respondents from 171 large (1000+ employee) companies." Again, the report is only available to paying members of the SIA but I've listed some interesting findings from the report below.

What was most interesting to me about the report was how much the overall savings on contingent labor costs was underestimated by buyers that do not use VMS systems as an agency management solution.

According to the SIA report:

• Contingent workforce buyers who have not implemented VMS greatly underestimate the savings achieved by its adoption. Among such non-VMS users, the median projected savings from implementation was 5%--half the savings reported by those who had actually implemented VMS.
• Roughly a third of non-VMS users had “no idea” how much VMS would save; an additional 11% thought it would save neither time nor money, and 13% more thought it would save time but not money.
• The median estimated savings of contingent buyers working with a VMS model was 10%.
  
• Buyers reported that in the first year of implementation VMS saved a median of 10% of contingent workforce spend. However, buyer perception of savings varied widely, from 0% to over 25% savings.
  
• Almost all buyers—85% of them—thought VMS saved at least some significant percentage of spend (2% or more). About a quarter of buyers thought VMS saved 16% or more. Of the VMS users who did not think it saved money, almost all thought it saved time.

It's clear that the adoption of a vendor management model saves buyers of contingent labor both time and money. Depending on how it is implemented and the model chosen, the amount saved can vary.

Healthcare Staffing: Canadian Style

I spent the last couple of days in Canada and learned some interesting things.

1. Lots of people really do say "eh" and "a boat" (about)
2. It's really a lot colder that far North
3. Vancouver is a beautiful city and has tons of great restaurants
4. Green traffic lights blink for some reason
5. The walk sign (little white light man) is different than the one in the states

I also met with a Canadian based company that makes staffing software for hospitals and they gave me some interesting information on healthcare staffing in Canada such as:

• All hospital census is always at 100%. There are 0 vacancies. The theories as to why were everything from - there is a waiting list for care in Canada and no beds are ever empty to - there are too many, unnecessary for-profit healthcare delivery organizations in the states causing a consistent census gap, mismanagement and poor staffing.
• All hospitals employees are unionized and the same organizations that run the educational centers for healthcare professionals negotiate on behalf of the unions.
• All of the hospitals are not for profit and effectively owned by the government.
• Due to all of this, there is little to no market for healthcare staffing agencies in Canada even though there is still a shortage of healthcare professionals.
• When polled, consistently, the people of Canada approve of their healthcare system by 80+%
• The company I met with also makes payroll systems for countries all over the world and claimed that 1) the U.S. has the most complicated tax laws over any other country and that 2) no other country they work with has local or regional taxes.

This information is anecdotal, as it came from a handful of people. However, I'm interested in learning more about it so I'll be doing more research on it. If anyone else has information on any of this please let me know.

Hospital Acceptance of VMS and MSP Models Predicted to Continue Steady Growth

Earlier this year the Staffing Industry Analysts (SIA) put out a report suggesting that 50% of buyers (hospitals and health systems) in the healthcare staffing industry now manage their agency usage through a VMS or MSP model. In an earlier blog post I discussed this in more detail and showed that more hospitals are choosing a vendor neutral VMS technology solution than they are an agency led MSP model.

Yesterday, the SIA released another report suggesting that by 2011, 93% of healthcare buyers in the U.S. will be using a VMS or MSP. The numbers come from a survey they did of 171 healthcare buyers. The survey results also suggested that the breakdown of these accepted offerings will be:

• 55% MSP
• 42% VMS

According to my estimates of hospitals using a VMS or MSP model, the 50% current adoption is probably pretty close to accurate. This adoption of VMS by hospitals is up 24% from last year according to the SIA. The SIA is partially basing their prediction of a jump to 93% in 2011 based on a similar growth pattern from the previous two years. However, I don't think this jump is accurate because I think there previous year (2008) estimate of 24% was much too low.

Further, in terms of the number of hospitals, the vendor neutral VMS technology model has been much more widely accepted than agency MSP offerings. Therefore, I don't see how in two years the MSP model will overtake the VMS model by 13%.

So, place your bets on who's crystal ball is clearer. We'll see what 2011 brings.

Side note: I would love to share the entire SIA report with you. However, the SIA does not allow for redistribution of their data and you can only access it if you're a corporate member. I won't say anything about this being an outdated business model or how much more success they would have and members they would earn if they allowed for a more free distribution of their data. At least, I won't say any more than that.

Leveraging Human Capital Supply Chains in Healthcare Staffing

Guest Post by: Tim Giehll - CEO, Bond Talent US and the co-author of “Human Capital Supply Chains."

The Healthcare staffing industry has always had its ups and downs over the past few years and with revolutionary healthcare legislation on the horizon, it is hard to know how to plan for the future.  Aside from the whole legislative uproar, we do know 3 important facts that the Healthcare staffing industry needs to prepare for, starting today:

1. As the Baby Boomer Generation eventually retires (even though the recession has delayed some retirement plans), there will be a lot more elderly people for the us (society) to take care. 
2. The “supply” of doctors and nurses will not be able to keep up with the “demands” of this retiring BB generation.
3. As we recruit and train more healthcare professionals, we also need to find new ways for the Healthcare industry to become MORE PRODUCTIVE!!  For all the talk about electronic medical records, that alone will NOT be enough to rebalance our “supply” of healthcare professionals with the “demand” for healthcare services.   

This is where the concept of  human capital supply chains comes into the picture to help save the day.  

Corporations have been building and optimizing manufacturing supply chains for over three decades. Companies like Dell and Wal-Mart are famous for leveraging supply chain management techniques and technologies to better streamline supply with demand. It’s time to refocus the Healthcare industry and apply the lessons learned from optimizing production lines to optimizing our Healthcare workforce and processes. Building a just-in-time human capital supply chain is a big commitment, but one with the potential for big cost savings.

But how do healthcare organizations get their arms around their total human capital spending and estimate the value of implementing a human capital supply chain? My new book, Human Capital Supply Chains, provides the practical steps of designing and implementing your own human capital supply chain. The book is structured as a “How To” handbook for implementing and managing the new processes, technologies and organizational roles that are required to create a successful human capital supply chain. As we learned in manufacturing, establishing and managing a supply chain not only reduces costs in the short-term, but the long-term tuning of the supply chain can result in strategic advantages, advantages that will define the most successful companies across industries in the years to come.

Tim Giehll is the CEO of Bond Talent US and the co-author of “Human Capital Supply Chains” with The Code Works CEO Sara Moss. Tim lives in the Minneapolis are and can be contacted at tgiehll@eempact.com.

 

Perks or Practice Environment? Shift Seen in What Nurses Value Most

More and more hospitals are figuring out that the work environment is a key attribute to retaining top healthcare professional talent. Pay and benefits are a huge motivator, but a good work environment focused on providing quality patient care and treating healthcare professionals properly is perhaps the best motivator for long term retention.

In recent times, we’ve seen a shift to them focusing on the work environment rather than financial incentives,” said Joni Sperry, employment manager at Southwest General Health Center in Middleburg Heights, Ohio. The financial incentives help get the nurses here, but that’s not what keeps them here.

Offering healthcare professionals greater flexibility over their work schedules and allowing them to participate in the day to day operational decision making is also a great way to create a productive work environment for retaining key staff.

This article from nursezone.com speaks to the shift in what nurses and other clinical staff are looking for in their work environments.

Nurses press for patient limits - Framingham, MA - The MetroWest Daily News

Here's an article from the Metro News Daily on how Massachusetts nurses are tailing California in trying to legislate nurse to patient ratios. This has been a very controversial topic with arguments against nurse to patient ratios as well.

The proposed bill requires the state Department of Public Health to set nurse-to-patient ratio standards for each hospital department. Hospitals could later alter the ratios based on need. Many opponents of the bill cite costs of compliance with such standards.

...in order to meet the bill's ratio requirements, the cost of hiring and retaining enough nurses could cost at least $250 million in Massachusetts.

While those for the bill refer to patient care and safety, as well as better working conditions for healthcare staff.

"Hospitals can truly not continue their unsafe practices," Donna Kelly-Williams, Massachusetts Nursing Association president, said in testimony to the Joint Committee on Public Health. "There is no limit to the number of patients that I, as a nurse, can see. There is none."

Med Staff On-Call's Innovative Approach to Healthcare Staffing

Company: Med Staff On-Call

CEO: Denise A. Kent PhD(c), RN, APN - CEO

Location: Chicago, Illinois

Positioning is one of the hardest challenges facing healthcare staffing agencies. Comparatively, each agency goes through the same/similar processes for recruiting and placing healthcare professionals at hospitals. This makes it difficult for staffing companies to separate themselves from their competition, typically leaving them with only price or volume as their true differentiators.

Recently, however, I discovered a healthcare staffing agency that has a completely different spin on what it means to be a staffing company. Med Staff On-Call is a fully automated staffing agency that uses technology to change the way their business is run. From recruiting, to hiring, to receiving and filling job orders, Med Staff On-Call has found a way to stand out from the pack. The efficiencies created in their innovative model allow them to contain costs, present competitive rates to their clients and provide an overall better work experience for the healthcare professionals they employ.

Med Staff On-Call has three key aspects of their company that make them unique:

Quality - The Intellimatch™ technology process they’ve created drives the quality of the staff they provide by ensuring that the medical professionals they place are the most qualified for every position. This automated matching process improves satisfaction for their employees by factoring in availability, shift and facility preferences, and credentials when notifying staff of available shifts.

Efficiency – Med Staff On-Call’s web-based staffing solution is much more efficient than a traditional staffing agency. The process is completely automated eliminating phone calls, faxes and other manual tasks associated with a traditional staffing process. Instead, staff post their availability on Med Staff On-Call’s secure website and receive notifications of qualifying positions via text message or e-mail. Healthcare organizations are notified instantly of filled positions. In addition, Med Staff On-Call has interfaced their system with leading healthcare vendor management companies so that job orders are made instantly available in their system.

 

Competitive Rates – Med Staff On-Call is 100% driven by innovation, leveraging technology to streamline the staffing process for their hospitals and medical staff. Their technology allows them to lower their internal costs and pass that savings on to their hospital partners. Efficiencies derived from their technology platform allow them to focus on recruiting and retaining quality medical professionals.

Q&A with Med Staff On-Call’s CEO - Denise A. Kent PhD(c), RN, APN

How do healthcare professionals sign up for your service?

“Healthcare professionals sign up for our service on-line. They complete all of the necessary pre-employment requirements and submit their credentials electronically. We then have their credentials verified by a third party. Once the information for the healthcare professional is validated and approved they can access our job orders, add their availability and sign up for specific job alerts.”

How are candidates submitted for jobs?

“Most of our job requisitions come in through on-line portals such as healthcare vendor management systems. These jobs are sent directly to our software application through the interfaces we have built to these VMS systems. If a job matches the preferences and credential qualifications of a healthcare professional they are alerted via text message or email and can respond through the same mediums for the jobs they want. The confirmations are then sent directly to the hospital.”

Why did you decide to run your business this way?

“We never had any intention of being a traditional staffing agency that’s old school. We knew we could create a competitive advantage by delivering higher quality staff, faster and at a lower cost by leveraging technology. Additionally, we wanted to provide healthcare professionals with a better work experience by giving them direct access and more control over their schedules and job preferences. Technology was the logical direction to go in.”

Do you feel that vendor management companies help or hurt your business?

“They definitely help our business. The vendor neutral vendor management companies completely handle the burden of credentialing, billing and job acquisition with our clients. Their systems improve quality by requiring proper documentation and including features like on-line performance evaluations. Overall the efficiency is completely complementary to our model.”

Do hospitals ever have an issue with your model being 100% driven by technology?

“Our clients love how quickly we can meet their staffing requests. We also have a very thorough screening process for our staff. All of their credentials are verified by a third party and all this information is accessible via our system.”

Do you work with other modalities outside of nursing?

“Currently, our primary focus is staffing nurses and nursing assistants. However, we have begun placing allied staff including pharmacy, PT and OT professionals.”

Do you feel your model has helped you in this economy?

“No question it has helped us. Because of our technology we are able to keep our costs low and offer staff at a very competitive rate to our clients. This has made us the number one provider to some of the largest health systems in the country.”

Conclusion: Med Staff On-Call is offering some of the most innovative solutions in the market to both their hospital clients and the heatlhcare professionals they employ. Such innovations will continue to have a positive impact in changing the way business is done in the healthcare staffing industry.