UNLOCKING WORKFORCE DATA TO IMPROVE STAFFING
Additionally, trust board visibility of workforce intelligence can support strategic decision-making, workforce planning, and performance management, such as establishing their headroom requirements.
- There is always lots of data, not all of which are easily presented or well understood – the huge amounts of data can overwhelm staff
- Data are not tailored in ways relevant to different types of staff: human resources, clinical staff, boards, ward managers
- Few, if any, departments claim responsibility for rostering data but as the information impacts all staffing groups in an NHS trust, clinical, human resources, and finance teams must all jointly own the data, with an identified accountable officer at board level
- The rostering data collected are not always used to monitor performance against key performance indicators (KPIs).
“THE USE OF ROSTERING TOOLS AND COMPLIANCE WITH KPI’S CAN BE A PROXY MEASURE OF GOOD OR POOR LEADERSHIP AT WARD LEVEL, GOOD ROSTERING IS IMPORTANT ON SO MANY LEVELS, FOR WARD STAFF SATISFACTION, SAFE STAFFING, TEMPORARY STAFFING MANAGEMENT, ALL OF WHICH ULTIMATELY IMPACT ON PATIENT EXPERIENCE AND EVEN OUTCOMES”
THE NURSE’S VIEW
“It is essential that provider organisations have ward to board reporting and that board members know, through e-rostering performance and KPI compliance, how well they are utilising their workforce. It’s amazing how many hospitals have an e-rostering system but have no idea how efficient it is or how well it is used, yet staff will be the organisations most expensive resource and the greatest asset.
- Roster Template/Budget Variation – Linking roster templates and the available shifts to service plan and budgeted establishment for each service. This will ensure financial controls are built into the roster design which will facilitate conversations about productivity. This should include having structures and hierarchies that align to organisational accountability.
- Net hours – The sum of all contracted hours over worked minus the sum of all unused contracted hours. This should include identifying those staff with no duties assigned.
- Roster Approval – Approval should be appropriate to service need, with six weeks being the recognised minimum for the two tier approval process. This approval should also focus on the quality of the approved roster from a clinical, quality and financial perspective. With poorly compliant rosters being rejected against agreed criteria.
- Headroom – Total unavailability is made up of annual leave, study leave, sickness, parenting leave, working day and other leave. This can be considered prospectively for planned rosters (checked during roster approval) and retrospectively for the worked rota to understand the impact on service delivery; the two may look very different.
- Missing Skills or Charge Cover – Confirming appropriate leadership and skills for each shift is key when writing good clinical quality rosters.
- Duties with warnings – Service configured warnings that ensure safety and fairness for both staff and patients.
- Additional duties over funded establishment – All additional work should be recorded on the roster with justification (e.g. enhanced care).
- Temporary Staffing – Number of temporary staff requests against the total temporary hours worked, and unfilled hours worked broken down by bank and agency staff. Temporary staffing usage should be tied back to substantive unavailability on the roster (e.g. Total hours of vacancy, sickness and special leave are equal to the total time request for temporary fill).
- Supervisory Time Utilisation – Ensuring senior clinical leaders have time to manage and lead in their clinical environment. A % of released time against planned is a good example of this.
- Temporary Staffing Lead Time – Maximising lead time for temporary staffing bookings will help to effectively fill shifts available for temporary staffing usage, minimising the need to use agency when not needed.
- Intelligent Temporary Staff Modelling – Identifying expected temporary staff reliance based on known roster factors will support appropriate allocation of temporary workforce. Especially at key (high cost/high impact) times. This can also help inform organisational strategy towards agency management.
- Turnover – Identification of substantive starters and leavers and modelling this into expected operational shortfall as well as helping to highlight cultural problems.
- Cost per patient day (CPPD) – which can be worked out at trust and individual ward level which is available on the Model Hospital Dashboard
- Shift/Leave Requests – The proportion of shift or leave requested on the electronic rostering system is a good indicator of system embedding and is an enabler for cultural change when used effectively.
- Fixed Working Patterns – the degree of fixed (set days) or flexible (available/unavailable) working patterns should support and enable staff to work but not limit a particular service.
- Auto-roster – the degree of roster automation in the writing process will minimise the administrative burden creating fair and safe rosters.
- Clinical Safety Rating – Staffing related clinical safety rating and a staff RAG (Red, Amber, Green)
- Care hours per patient day for substantive, bank and agency staff
- Number of rosters approved with the potential for failure in provision of basic care, known as red flag events
- Red flag patient safety events such as delay in administration of pain relief, falls, pressure ulcers
- Matrons undertaking regular patient acuity inter-rater reliability audits for each ward
East Cheshire harnesses its workforce data
- Excellence in rostering practice
- Sound governance assurance for staff inductions
- Quality assurance process for temporary workers
- E-job planning and e-leave management
- Effective workforce analytics.