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Resident Centered Staffing™: 12-Hour Shift Approach

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Resident Centered Staffing™: 12-Hour Shift Approach. Oklahoma Association of Homes and Services for the Aging (OKAHSA) 15 th Annual Meeting, Educational Seminars & Exhibition March 10, 2010. Dan Gray, President. AGENDA. Staffing and Operations Employee Buy-In Implementation

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slide1

Resident Centered Staffing™:

12-Hour Shift Approach

Oklahoma Association of Homes

and Services for the Aging (OKAHSA)

15th Annual Meeting,

Educational Seminars & Exhibition

March 10, 2010

Dan Gray, President

agenda
AGENDA
  • Staffing and Operations
  • Employee Buy-In
  • Implementation
  • Resolving Challenges
best practice 12 hour shifts
BEST PRACTICE12-HOUR SHIFTS
  • Minimizes number of shift changes
  • Eliminates shift overlap for CNAs
  • Provides the same number of staff
  • Provides consistency of staff
  • Prefers full-time staff
staffing
STAFFING
  • In order to have 3-day weekend on Friday, Saturday, and Sunday, pay period cannot end on Thursday or Sunday
  • Weekend differential can be eliminated
  • Shift differential is paid only on night shift (7p to 7a)
staffing1
STAFFING
  • Use day shift staff pattern for Day 12 and night shift staff pattern for Night 12
  • Team approach allows reduction of nurse management (e.g., Unit Manager or House Supervisors)
slide8

OPERATIONS

OVERTIME

  • Must be based on over 40 hours not 8 over 80
  • Overtime versus idle time
    • One idle hour = wages and benefits—all nonproductive
    • Overtime assumes productive work
    • Overtime can be more cost-effective
  • Most nursing home staff day and evening shifts the same—overstaffing between 7p and 11p
operations facility benefits
OPERATIONSFACILITY BENEFITS
  • Reporting to the same people at the beginning and end of shifts
  • Residents served by the same nursing staff increases consistency of care
  • CNAs and nurses are on the same team and have the same days off, which reduces call-offs due to peer pressure
operations facility benefits1
OPERATIONSFACILITY BENEFITS
  • Improved recruitment
  • More staff to feed evening meals and return residents to bed
  • Less shift-to-shift complaints—problems are easier to resolve with only two shifts
  • Less wasted time for reporting with only two shifts—units are quieter at 3p
operations facility benefits2
OPERATIONSFACILITY BENEFITS
  • Scheduling is simple—just fill in names each month and adjust for vacations and/or holidays
  • Less complaints
    • Working long stretches
    • Too many weekends—12-hour shifts gives off every other weekend (Fri/Sat/Sun)
employee buy in time off
EMPLOYEE BUY-INTIME-OFF
  • More days off in a two-week pay period (e.g., 7 days versus 4 days)
  • Never work more than 3 days without 2 days off—3 day stretch is only once every two weeks
  • Employees have a long weekend (Fri/Sat/Sun) every other week
employee buy in increase control
EMPLOYEE BUY-ININCREASE CONTROL
  • Can plan their schedules since the days off are known in advance
  • Only need to use 24 hours of PTO to be off for 7 days at a time
  • Feels more like working part-time with full-time benefits
employee buy in less expense
EMPLOYEE BUY-INLESS EXPENSE
  • Transportation
  • Laundry (Uniforms)
  • Child care
employee buy in improved resident care
EMPLOYEE BUY-INIMPROVED RESIDENT CARE
  • Consistent full time staff
  • Residents receive care from the same 4 CNAs and 4 nurses
  • Increases productive hours of care due to elimination of shift change
implementation challenges
IMPLEMENTATIONCHALLENGES
  • High absenteeism (> than 2% call offs)
  • Work force with second jobs
  • Work force relying on public transportation
  • Child care
  • Older staff
  • Heavy medication pass at 9p
implementation challenges possible solutions
IMPLEMENTATIONCHALLENGES-POSSIBLE SOLUTIONS
  • Explore together how to support the process of implementation in such a way that would benefit all
  • Could staff interact and plan together for implementation in their facilities?
  • Could staff work out the schedule themselves?
  • Develop or contract child care services to cover 12-hour Day shift
questions
QUESTIONS

1501 Greer Lane

Signal Mountain, TN 37377

423.517.0567 ▪ 423.517.0568 Fax

[email protected]

www.consulting-cds.com

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