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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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Resident Centered Staffing™: 12-Hour Shift Approach

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Resident centered staffing 12 hour shift approach

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


4 critical areas of schedule change

4 critical areas OF SCHEDULE CHANGE


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


Best practice 12 hour shifts sample schedule

BEST PRACTICE12-HOUR SHIFTS-SAMPLE SCHEDULE


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)


Resident centered staffing 12 hour shift approach

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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