Craig Kane

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The global pandemic has turned the world of healthcare delivery upside down. Hospitals and private clinics face significant revenue shortfalls with the disappearance of non-COVID-related procedures and surgeries—leading to layoffs, furloughs and pay cuts for the workforce. Meanwhile, the federal government has promised aid, but it may not be enough.

Yet, despite the gloomy outlook, the crisis as some would term this to be the Amazon Moment for healthcare—that is, an opportunity to digitally transform the entire industry. The pandemic has fundamentally changed the willingness of organizations to deliver healthcare services remotely. Provider-friendly regulatory changes such as relaxed licensure requirements and an overall expansion of covered services are laying the foundation for these changes to continue. Available, scalable technology makes further progress possible.

Looking forward, the strategic use of technology will become essential for healthcare organizations—and employing it to improve workforce management offers a natural starting point. Labor accounts for 50% of organizational expenses. What's more, workers play a pivotal role in the patient experience and quality of care. By doubling down on digital investments that transform the workplace, organizations improve their workforce management through the end of the crisis and build up their digital capabilities for a promising future.

Here are five digital investments in workforce management to consider as you navigate a genuinely new world of healthcare:

Redeployed clinical staff has quickly adapted to new environments, patients, procedures, and equipment. In the post-pandemic world, these learnings will translate into valuable training materials to prepare staff for future outbreaks. Learning experience platforms, tightly integrated with traditional learning management systems, can transform traditional job training and help staff during the regular flow of work. For instance, some leading platforms offer just-in-time, adaptive, and personalized training experiences that engage front-line workers. In addition, immersive learning platforms enable virtual, real-life training experiences at no risk to actual patients.

Stay-at-home orders combined with safety protocols aimed at stopping the virus spread have accelerated the adoption of telehealth—delivery organizations are seeing a 5x to 10x increase in telehealth usage. Organizations will likely continue to expand their telehealth capabilities, including implementing interactive chat-box features for helping patients self-triage and directing patients to the right resources. There's also the potential to integrate telehealth with electronic health record (EHR) workflows and video-based clinician visits. All of this can enable and improve multi-site staff management. On the virtual care front, organizations will adopt more remote monitoring and self-reporting technologies that allow clinicians to assess patient health from afar.

3. Data analytics and artificial intelligence

Numerous innovations are taking off at the intersection of advanced data analytics, artificial intelligence, and back-office and clinical operations. Some of the most useful applications include workforce and demand forecasting, candidate sourcing, employee assessment, and improving the recruiting and onboarding experience. On the clinical ops side, there's also been a significant uptick in the areas of image-based diagnostics, precision medicine, and population health, all of which can help alleviate the workload on staff and improve the quality of care.

Planning for fluctuations in demand and optimizing the healthcare workforce accordingly will continue to be a challenge in the future. Intelligent workforce planning and scheduling optimization tools can truly help organizations transform their workforce management efforts. In addition, applications that enable organizations to automatically address employee call outs, redistribute tasks, handle shift changes, and more are becoming key operational differentiators. Investments in these areas can lead to 15% to 20% improvements in labor budgets.

The pandemic has put growing pressure on job security and improving the employee experience. Focusing on the latter is critical. Consider that a one percentage point increase in staff engagement correlates with a half-point increase in patient satisfaction scores, which, in turn, influences value-based reimbursement programs. Employee experience platforms can help in many ways, from enabling open communication to offering tools for driving and measuring employee engagement and even providing self-service features such as shift management, payroll applications, and more.

The pandemic has opened up a significant opportunity also to transform an industry that’s long been reluctant to change. By investing in workforce-related digital innovation, organizations can build stronger connections with employees, create much-needed cost-savings through efficiencies, and ultimately enhance the patient experience in the process.

Craig Kane and Chris Paddison are partners in global strategy and management consulting firm, Kearney’s Health practice. Anshuman Jaiswal and Sachin Mahishi are principals in the firm’s Digital Transformation practice.

Articles

By doubling down on digital investments that transform the workplace, organizations improve their workforce management through the end of the crisis and build up their digital capabilities for a promising future.

Why Now is the Right Time to Double Down on Digital Workforce Management

The COVID-19 outbreak has magnified some key scheduling challenges in healthcare delivery systems such as overcrowded ERs, long patient wait times, overworked frontline staff, and hidden capacity. Scheduling challenges will continue in the post-pandemic world as providers rush to reschedule previously cancelled procedures. These challenges are common for all types of health services. In units serving walk-in patients, such as ERs, it is a struggle to forecast volume and serve demand while addressing individual staff needs. Scheduling appointments can be just as difficult. It only takes a few no-shows or late arrivals to throw a wrench in a planned schedule. The silver lining is that scheduling is not unique to the healthcare industry, and there is no need to build solutions from scratch in this digital age.

Fluctuating customer demand, late or no-show customers, and complicated shift schedules are challenges faced by retail operators from cinemas to stores to restaurants. The retail industry has improved forecast and optimization capabilities through machine learning, automation, and other digital solutions. A Big Box retailer drastically improved their demand forecasting by layering weather data with individual store demand to their benchmark after observing a decrease in foot traffic on rainy days, enabling optimized shift schedules and improved e-commerce operations. Large retail stores like Walmart and BestBuy are using staff self-scheduling applications to streamline scheduling and employee communication. These lessons learned and tools used by the retail industry can spark innovation and be adapted for the healthcare industry.

Five key capabilities to address healthcare scheduling  challenges

Despite the commonality, each health service delivery unit has its unique challenges across patient and staff, from scheduling planning to daily schedule operations. We identified five key capabilities that address these challenges – each with varying need for healthcare specific sophistication.

Accurate demand forecasting lays the foundation for schedule optimization. Important attributes to look for when evaluating solutions are the level of granularity for patient inflow, models that can place more weight on recent data to capture changes such as a new competitor nearby, ability to run various simulations based on inputs such as acuity, treatment needs, and ability to incorporate evolving targets and metrics. The technology is widely available – the challenge lies in aggregating accurate internal, external, structure and unstructured  data and building the machine learning models to spot complex relationship between the datasets for each unique operation.

Patient appointment scheduling is a game of Tetris. Successful appointment schedule optimization should smooth out demand variation, increase capacity to serve, and minimize the “domino” effect of late arrival and procedures running over schedule. Successful staffing schedule optimization needs to consider patient needs, certifications, skill levels, PTO, preferences, and overtime minimization, while balancing various regulations with schedule fairness, such as night shift rotation. State-of-the-art workforce scheduling tools have developed auto shift creation and assignment capabilities for retail customers – adding sophistication such as patient to staff ratio, machine learning and analytics for continuous improvement will be key. The optimization process should be user friendly; the recommended schedule should be executable without much disruption to patient care and clinical workflow by allowing for the right level of patient and staff preferences to balance with pure operational and financial metrics.

Self-scheduling empowers employees and patients to take ownership, commit to their shifts or appointment times, and reduces administrative effort. Staff features such as swap, open communication, and manager auto-approval largely streamline the process, while enabling accountability and accurate overclock tracking. Staff self-scheduling is best used as a complement to centralized shift assignment to balance between individual preferences and staffing need for the entire unit. Similarly, patient self-scheduling allows patients to schedule their appointments online using a website, app, or chatbots anytime without staff interaction. Patient self-scheduling is powerful when used with digital patient waitlists described below. Both are mature technologies in retail – user experience and interoperability with existing clinical and HR workflows and systems will be key to successful implementation.   

There are multiple intra-day solutions to go after depending the issue at stake. No-show solutions include personalized reminders and confirmation, digital waitlist for automatic mass notification to fill slots upon confirmed cancellation, as well as proactive recall capability that tracks and alerts patients who miss and those who are overdue for a routine visit, to ensure that they come back to receive care. Another idea to borrow from retail is virtual queues – self-service check-in that allows patients to wait at home and enables better tracking of patient volume real time to inform utilization and bottlenecks. Intelligent intra-day optimization engine can recommend schedule changes in time of underperformance – adjusting staffing hours, redistributing workload and patients, etc. Some of these technologies can be found outside; most still require healthcare specific solutioning that incorporates patient safety requirement, staffing regulations, clinical workflow, etc.

Metrics help track improvement and ensure implemented solutions have measurable benefits. When choosing metrics, it is important that they 1.) quantify what the organization really needs to know and 2.) align with and balance corporate priorities by ensuring the metrics are accurately measured and benchmarked against internal goals and competitor performance. Some factors that may be beneficial to track for your organization are patient time to service, resource utilization, real time budget performance, staff overclock and overtime. This will require a foundational data and analytical  infrastructure to collate operational metrics to enable front line staff to make sound decisions.

The digital age is here for Healthcare, including clinical scheduling operations. In-depth assessment of your future state need and goal will help you sift through the wide range of capabilities listed above and identify ones worth the investment. Your patients and staff might be reluctant to change – until you’ve proven how much these technologies have made their experience better and their jobs easier.

Craig Kane is a partner and Sachin Mahishi is a principal in the Digital Transformation practice of global strategy and management consulting firm, Kearney. 

Scheduling automation and optimization enables better patient experience, increases staff satisfaction, and improves workforce efficiency.

Author | Craig Kane

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