Proper staffing is an important component of emergency department efficiency. EDs that aren’t appropriately staffed may find it difficult to provide the high-quality and timely care patients seek and deserve.
Determining when and how to utilize your staff for maximum efficiency and cost effectiveness can prove challenging. Patient volume fluctuates and the effects can be difficult to predict even when taking historical data and real-time analytics into account. Additionally, the strengths and weaknesses of your staff must be considered when scheduling, as should the possibility of outside events beyond your control. When it comes to staffing, preparation is everything.
But how can ED leaders conclude whether or not their ED is properly staffed in the first place?
When working with EDs, I look at four indicators first to assess if staffing issues are present. These signs can be very telling when it comes to staffing and scheduling, and whether your team is being utilized in the most efficient and cost-effective manner.
1. Patient throughput time
The first place to look to determine whether or not your ED is properly staffed is your patient throughput times. If they are above the national or state averages or are steadily rising from month to month, staffing issues may be the reason why.
Throughput times may increase for a variety of reasons, so it’s important to analyze other factors to determine which ones may be contributing to the rise. An increase could be related to an inefficient patient flow process; poor communication among staff and other departments; or a combination of factors that should be addressed with a tailored action plan.
2. Leaving without out being seen (LWBS) rate
Just like high patient throughput times, increased LWBS rates are a key indicator that your ED isn’t properly staff. Patients will leave if their concerns aren’t addressed in a timely manner. How your ED is staffed — specifically at triage — plays a crucial role in making sure all patients are seen.
3. Patient satisfaction
If patient satisfaction scores are lower than expected, your schedule may be the reason why. While patient satisfaction scores aren’t the most telling of indicators when it comes to staffing issues your ED may be facing, they are important to consider. Communication and pain management are key drivers of patient satisfaction. However, staffing may be an underlying cause behind these and other issues leaving your patients unsatisfied. If the staff is in a pinch for time, it can take longer for them to get patients the pain management solutions they need in a timely manner. And, a harried staff can make clear, empathetic communication challenging.
4. Staff morale
ED staff members are under a considerable amount of stress even when an ED is appropriately staffed. If you notice that your turnover rate is on the rise or that there is a general sense of dissatisfaction among your staff, take a look at your schedule. Morale is closely related to the three indicators discussed above — patient satisfaction especially. If patients aren’t satisfied, your staff won’t be either. A solution may lie in a few tweaks to the staff schedule.
The most effective way to properly staff an ED is by first analyzing the strengths and weaknesses of your staff members and creating the schedule accordingly. Although, the natural inclination for many ED leaders facing issues related to staffing is to increase the number of staff on duty and on-call during a given shift. However, this strategy can be expensive and it doesn’t always address underlying issues like playing the right staff in the right positions.
If you believe your ED isn’t properly staffed, Donovan & Partners can assess the reasons why and create an action plan that maximizes efficiency while keeping your bottom line in mind. Contact Donovan & Partners today at cmd@constancedonovan.com or 651-260-9918. I'd be happy to do a personalized assessment of your ED and provide actionable solutions. For more information on the services we offer, visit our website.
SOURCE:
Collins, Martha: “Staffing an ED Appropriately and Efficiently.”