Nebraska Medicine, Omaha, NE
Laurie Winkelbauer, Ellie Stull, Ann Yager
Background: Our cancer service line provides infusion services for oncology patients at three locations. The numbers of chairs vary by location from 10 to 30. Each location has a nurse manager. Staff are hired for specific locations. Hours of operation differ at each location, depending on patient needs. With increasing pressure to streamline operations and maintain productivity, along with challenges of RN vacancies and growing volumes, efforts were needed to coordinate staffing between locations to ensure best utilization of resources. Methods: The leadership team met to identify opportunities for improvement and develop an action plan. Issues identified included: Locations worked in silos to manage staffing issues and patient volumes. Decisions were made without consideration of the other locations; Staff were reluctant to float; Lack of consistent communication and comradery among managers/leads; Critical decisions were made inconsistently by staff; Lack of communication to senior management and physician leadership when capacity and staffing situations were occurring. Strategies were proposed to address the issues. Phone huddles with leadership from all locations are held daily to discuss staffing, patient scheduling and concerns. A tool was developed to assist with decision making related to staffing and patient scheduling. A “One Team” approach was implemented for staffing with the expectation that staff would float to cover staffing needs at the other locations. Processes were standardized across all units to ensure staff feel competent when floating. Results: Several positive outcomes have been noted since changes were implemented 10 months ago. Staff are more willing to float and have bought into the “One Team” concept. Cross coverage of staffing vacancies occurs daily, allowing for better and more cost effective utilization of staff across locations. Decisions to block schedules are made by managers using the developed tool. There is improved awareness of critical staffing and capacity issues by senior leadership and physician leaders. Conclusions: Implementing a One Team staffing approach to cover three infusion center locations increases staff productivity and allows for fluctuations in patient volumes.
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