Managing PRN Costs
Despite continued efforts of Health & Human Services organizations to reduce labor costs, the challenges of today’s workforce often complicate this objective. Many organizations are struggling with long recruiting cycles, high turnover, and an aging workforce. These factors make it difficult to balance staffing levels and costs. In this environment, many organizations are utilizing pools of PRNs, or on-call staff, to bridge staffing gaps.
Do you really need PRNs?
In some situations, creating and managing PRN staffing models is a necessity. However, it is important to conduct an analysis of your organization’s labor levels and practices to establish appropriate usage rates for premium staff. Organizations need to identify ideal versus actual staffing costs and analyze the gaps to ensure that your organization is using PRN staff as a necessary asset to provide care and not as a Band-Aid to fix known, or unknown issues.
One of the main reasons that PRN staff is utilized is to offset or eliminate overtime costs that are incurred by existing employees. Therefore, it is important to review overtime levels across the organization and confirm the reasoning behind it. Is the department really short staffed or is their time being inflated due to low oversight?
PRN Management
Sometimes organizations “schedule” overtime, which can be a clear sign that the department is short-staffed and unable to cover its current shifts. Other times, this can be an oversight from the scheduling managers because they do not have enough visibility into their workforce to see when employees are in or approaching overtime. More commonly, overtime stems from staffing emergencies like call-offs, no-shows, or terminations. Many organizations, especially 24-7 facilities, must be fully staffed at all times in order to maintain compliance with regulations and meet the client demand, which is where PRNs come into play.
Staffing emergency situations is generally where organizations need the most improvement. In these situations, scheduling managers need to prioritize calls to those people who are not projected to be in overtime, which requires visibility into workforce analytics. Scheduling managers also need the organizational visibility to see cross-departmental information about employees in order to evenly distribute shifts to broader groups of people, instead of always calling “go-tos.”
Technology for PRN Utilization
PRN utilization is often nearly impossible to predict, which makes proactive models difficult to create, and budgeting even more of a challenge. However, with robust reporting capabilities, historical PRN utilization trends can be analyzed to provide a benchmark level of utilization on a month-to-month basis that allows scheduling managers to be more prepared. Additionally, with the right tools, scheduling managers can monitor demand at the facility and review schedules to spot problem areas and opportunities where they can proactively eliminate or add shifts with more notice.
Organizations looking to maintain sustainable PRN models should consider automation to enable them to handle these challenges and control labor costs by minimizing unnecessary overtime and managing staffing more efficiently. Technologies that provide organization-wide information and analytics are critical to ensuring that executives and managers make timely and informed decisions. Having visibility into the staffing needs of the entire organization will enable you to flexibly move staff and place qualified PRNs in the departments that need them the most, resulting in better shift coverage and lower labor costs overall.
As the Health & Human Services industry continues to experience workforce challenges, the need for PRN staff is not likely to diminish anytime soon. Vacancy rates are rising and the time it takes to fill positions is not improving. While PRN utilization is necessary, organizations should focus on creating consistency in scheduling processes, increasing cross-departmental visibility, and using automation to reduce the amount of time trying to fill staffing gaps. Meanwhile, it is important to begin implementing strategies that aim to increase employee engagement and retention to strive for more balanced staffing models in the coming years.
This DATIS Blog was written by MJ Craig, DATIS, on October 20th, 2016 and may not be re-posted without permission.
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