Disclosures. Relevant Financial Relationship(s): List or Nothing to Disclose. Off Label Usage: List or Nothing to Disclose 12/9/2016
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1 Staffing to Workload Joy Gomez December 12, 2016 Disclosures Relevant Financial Relationship(s): List or Nothing to Disclose Off Label Usage: List or Nothing to Disclose 1
2 Objectives Discuss data driven methods to capture workload. Develop staffing models to align laboratory staffing with workload demand. Improve FTE productivity by aligning staffing with the workload demand to reduce turnaround times. What staffing issues do we have? 2
3 Align Staffing with Workload Scheduled Scheduled Staff Hours Staff Hours vs. Required Required Workload Workload Hours Hours Hours Hours Scheduled Staff Hours Required Workload Hours 0 0 Mon Mon Tue Wed Tue Thu Wed Fri Thu Mon Fri Tue Wed Thu Fri Demand / Staffing Schedule - Relationship Improve staff utilization Improved Quality (improved turnaround times) 3
4 Outcomes of Staffing to Workload 1. Improve staff utilization 2. Calculate optimum staffing 3. Reduce overtime 4. Reduce the need to hire FTE 5. Increase capacity 6. Improve turnaround times / improve patient satisfaction Value Equation Utilization & Quality 4
5 Reasons for Change Internal reasons: Fluctuation of test volumes - rising for some and declining for other tests Limited space to accommodate growth Shortage of qualified staff High service level expectations of patients and clients External reasons: Fierce Competition Tests prices are set and controlled by market Offering affordable healthcare to everyone Required data for Staffing to Workload Demand Time per unit of work performed Staffing Schedule 5
6 Case Study 1 Case Study 1 Process Flow Accessioning Testing Analysis Reporting 6
7 Case Study 1 Work Distribution Work Available in Accessioning Sun Mon Tue Wed Thu Fri Sat Total Percent to Total Work Available for Analysis Sun % Mon % Tue 9 9 2% Wed % Thu % Fri % Sat % Case Study 1 Schedule Distribution Scheduled FTE Percent to Total Sun 8 4% Mon 46 22% Tue 46 22% Wed 45 22% Thu 39 19% Fri 24 11% Sat 1 0% 7
8 Case Study 1 Staffing Analysis Work Distribution vs. Schedule Distribution Sun Mon Tue Wed Thu Fri Sat Work Distribution 18% 18% 2% 6% 19% 20% 18% Schedule Distribution 4% 22% 22% 22% 19% 11% 0% 25% Work Distribution Schedule Distribution 20% 15% 10% 5% 0% Sun Mon Tue Wed Thu Fri Sat Case Study 2 8
9 Apheresis Unit Case Study 2 Key Terms Volume Projections Variable Time Fixed Time Apheresis Unit Case Study 2 Volume Projections Test Volume Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 9
10 Apheresis Unit Case Study 2 Volume Projections 2016 Test / Procedures Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Mobilizer HPC Collections Leukapheresis Donor Research/Dendritic Plasma Exchange Liposorber (LDL) Platelet apheresis Leukapheresis Photopheresis Red Cell Exchange Total Apheresis Unit Case Study 2 Variable Time + Fixed Time = Total Time 10
11 Apheresis Unit Case Study 2 Timings Test / Procedure Time per (minutes) Mobilizer 154 HPC Collections 466 Leukapheresis Donor Collections 279 Research/Dendritic 466 Plasma Exchange 172 Liposorber (LDL) 407 Plateletapheresis 316 Leukapheresis 316 Photopheresis 217 Red Cell Exchange 193 Apheresis Unit Variable Time Calculations (minutes) Volume x Time per test 120 x 154 = Case Study Test / Procedures Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Mobilizer HPC Collections Leukapheresis Donor Research/Dendritic Plasma Exchange Liposorber (LDL) Total Hours / Average days per month / 8 hours per day Platelet apheresis Leukapheresis Photopheresis Red Cell Exchange Total Minutes Total Hours Total FTE
12 Apheresis Unit Case Study 2 Fixed Time Calculations (minutes) Task Minutes FTE Daily setup Daily wrap-up Equip maintenance / Inventory Front Desk Phone calls / Gift Mgmt Total 1.87 Apheresis Unit Case Study 2 FTE Calculations 2016 Jan Feb Mar Apr May June Jun Aug Sep Oct Nov Dec Variable FTE Fixed FTE Tot FTE PTO Total
13 Apheresis Unit Case Study 2 Staffing Analysis FTE Average Staffing Projections Actual Staffing Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Case Study 3 13
14 Blood Donor Services Case Study 3 Process Flow Registration PE Blood Draw Blood Donor Services Case Study 3 Data Collection Volume distribution 6:00 AM 7:00 AM 8:00 AM 9:00 AM 10:00 AM 11:00 AM 12:00 PM 1:00 PM 2:00 PM 3:00 PM 4:00 PM 5:00 PM Total % Monday March 2 nd % Tuesday March 3 rd % Wednesday March 4 th % Thursday March 5 th % Friday March 6 th % 14
15 Blood Donor Services Case Study 3 FTE Calculation Registration (Front Desk / Inv / etc.) Fixed time (936 minutes/day) + PE (10.5 minutes) + Variable time (34.5 minutes) Blood Draw (24 minutes) + PTO Fixed time (792 minutes/day) Blood Donor Services Case Study 3 Volume Distribution 6:00 AM 7:00 AM 8:00 AM 9:00 AM 10:00 AM 11:00 AM Volume x Time per procedure (2 x 34.5 minutes = 69 minutes) 69 minutes / 60 minutes/fte = 1.2 FTE 12:00 PM 1:00 PM 2:00 PM 3:00 PM 4:00 PM 5:00 PM Monday March 2 nd minutes / 12 / minutes/fte 22 4 = 1.30 FTE 6:00 AM 7:00 AM 8:00 AM 9:00 AM 10:00 AM 11:00 AM 12:00 PM 1:00 PM 2:00 PM 3:00 PM 4:00 PM 5:00 PM Variable (PE/BD) minutes / 12 / 60 minutes/fte = 1.1 FTE Fixed (Front Desk/ParEx) PTO Total
16 Blood Donor Services Case Study 3 Staffing Analysis 20.0 Monday 15.0 FTE :00 AM 7:00 AM 8:00 AM 9:00 AM 10:00 AM 11:00 AM 12:00 PM 1:00 PM 2:00 PM 3:00 PM 4:00 PM Variable (PE/BD) Fixed (Front Desk/ParEx) PTO Current Staffing 5:00 PM Blood Donor Services Case Study 3 FTE Monday FTE Tuesday FTE Wednesday FTE Thursday Friday FTE
17 Blood Donor Services Case Study 3 Hours distribution by Day of Week Hours Monday Tuesday Wednesday Thursday Friday Variable (PE/BD) Fixed (Front Desk/ParEx) PTO Case Study 4 17
18 Transfusion Lab Process Flow - 24/7 operation Case Study 4 Bench A Bench B Bench C Order Entry Component Prep Crossmatch Testing (NEO) Medical Dispatch Surgical Dispatch Time per Process Test / Task Test/Task Medical Dispatch RETURN 0.04 Time per Medical Dispatch MED COOLER 0.07 Process Test / Task Test/Task Medical Dispatch DISPATCH 0.04 Crossmatch ABID 1 Medical Dispatch READBACK Crossmatch ABOFW Time per Medical Dispatch DOUBLE BUBBLE Crossmatch NABO Process Test / Task Test/Task Medical Dispatch PHONE Time per 0.03 Crossmatch Order Entry CPP Time per RHIGSAMP 0.03 Process 0.05 Medical Dispatch Test HAEMOBANK / Task ITC Test/Task 0.33 Process Test / Crossmatch Task Test/Task ROSETTE 0.5 Order Entry CRYO Surgical 0.05 Medical Dispatch Dispatch HAEMOBANK OR ISSUE DOM Component Prep CRYO Crossmatch PS 0.02 TXRN 0.5 Order Entry FFP Surgical 0.05 Medical Dispatch Dispatch OR RETURN ISSUE Component Prep DIVIDE Crossmatch 0.35 UNIDABORH Order Entry GRN Surgical 0.05 Dispatch SURG COOLER 0.07 Component Prep FFP Crossmatch PS 0.02 UNIDABYS 0.45 Order Entry IATR Surgical 0.05 Dispatch RETURN SURG COOLER 0.04 Component Prep IRRAD Crossmatch 0.13 UNIDARC Order Entry PLT Surgical 0.08 Dispatch RETURN MED COOLER 0.04 Component Prep NEO DIVIDE Crossmatch 0.5 XME 0.03 Order Entry RBC Surgical 0.05 Dispatch Time COOLER per MGMT 0.05 Component Prep Process PLT Crossmatch PS 0.02 Test / XMPEG Task Test/Task 0.7 Order Entry SPECIMEN 0.06 Component Prep Testing PLT QC (NEO) ABYG 0.08 Component Prep SYRINGE Testing (NEO) 0.14 NEO SAMP 0.03 Component Prep THAW 0.06 Transfusion Lab Process Flow - 24/7 operation Case Study 4 Bench A Bench B Bench C Order Entry Component Prep Crossmatch Testing (NEO) Medical Dispatch Surgical Dispatch Process Test / Task Time per Test/Task Component Prep CRYO PS 0.02 Component Prep DIVIDE 0.35 Component Prep FFP PS 0.02 Component Prep IRRAD 0.13 Component Prep NEO DIVIDE 0.5 Component Prep PLT PS 0.02 Component Prep PLT QC Component Prep SYRINGE 0.14 Component Prep THAW 0.06 Monday Time Volume 12:00 AM 0 1:00 Monday AM 0 Time 2:00 AM Volume 0 12:00 3:00 AM AM 0 1 1:00 AM 4:00 AM 0 3 2:00 AM 5:00 AM 0 0 3:00 AM 6:00 AM 1 5 4:00 AM 7:00 AM :00 AM 8:00 AM :00 AM 5 9:00 AM 23 7:00 AM 18 10:00 AM 7 8:00 AM 20 11:00 AM 9:00 AM :00 PM 10:00 AM :00 1:00 AM PM :00 PM 7 1:00 PM 5 Tuesday Time Volume 12:00 AM 1 Tuesday 1:00 AM 0 Time 2:00 AM Volume 1 12:00 3:00 AM AM 1 2 1:00 AM 4:00 AM :00 AM 5:00 AM 1 0 3:00 AM 6:00 AM :00 AM 7:00 AM :00 AM 8:00 AM :00 AM 25 9:00 AM 22 7:00 AM 18 10:00 AM 17 8:00 AM 14 11:00 AM 9:00 AM :00 PM 10:00 AM :00 1:00 AM PM :00 PM 3 1:00 PM 2 Wednesday Time Volume 12:00 AM 3 Wednesday 1:00 AM 1 Time 2:00 AM Volume 0 12:00 3:00 AM AM 3 1 1:00 AM 4:00 AM :00 AM 5:00 AM :00 AM 6:00 AM 1 5 4:00 AM 7:00 AM :00 AM 8:00 AM :00 AM 5 9:00 AM 11 7:00 AM 24 10:00 AM 11 8:00 AM 14 11:00 AM 9:00 AM :00 PM 10:00 AM :00 1:00 AM PM :00 PM 7 1:00 PM 15 18
19 Transfusion Lab Case Study 4 Staffing Schedule Bench A Bench B Bench C 12:00 AM :00 AM :00 AM :00 AM :00 AM :00 AM :00 AM :00 AM :00 AM :00 AM :00 AM :00 AM :00 PM :00 PM :00 PM :00 PM :00 PM :00 PM Transfusion Lab Case Study Bench A Bench B Bench C Surgical Dispatch Order Entry NEO Medical Dispatch FIXED EFFORT Crossmatch Component Prep Schedule Total 0 12:00:00 AM 12:30:00 AM 1:00:00 AM 1:30:00 AM 2:00:00 AM 2:30:00 AM 3:00:00 AM 3:30:00 AM 4:00:00 AM 4:30:00 AM 5:00:00 AM 5:30:00 AM 6:00:00 AM 6:30:00 AM 7:00:00 AM 7:30:00 AM 8:00:00 AM 8:30:00 AM 9:00:00 AM 9:30:00 AM 10:00:00 AM 10:30:00 AM 11:00:00 AM 11:30:00 AM 12:00:00 PM 12:30:00 PM 1:00:00 PM 1:30:00 PM 2:00:00 PM 2:30:00 PM 3:00:00 PM 3:30:00 PM 4:00:00 PM 4:30:00 PM 5:00:00 PM 5:30:00 PM 6:00:00 PM 6:30:00 PM 7:00:00 PM 7:30:00 PM 8:00:00 PM 8:30:00 PM 9:00:00 PM 9:30:00 PM 10:00:00 PM 10:30:00 PM 11:00:00 PM 11:30:00 PM Monday TRANSFUSION LAB RMH 19
20 Staffing to Workload Recap Questions & Discussion 20
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