The aftermath of COVID has created the perfect storm in healthcare staffing that is continuing to expose the shortcomings of staffing in a non-centralized environment. When COVID first hit, organizations saw higher volumes in critical care. Since elective surgeries were paused and people avoided healthcare as much as possible, the challenge was understanding how to supplement critical care units with med-surg or surgical resources.

Organizations using a unit-based or siloed staffing strategy struggled with a lack of enterprise-level transparency. That constrained their ability to see how they could balance their staffing across two extremes: areas with exceedingly high needs vs. areas with a much lower needs, where resources were even being sent home.

Staffing challenges have not subsided, even as demands of COVID have fluctuated. Instead, many healthcare organizations are now facing the perfect storm of extremely high caregiver turnover, burnt out staff who are calling in sick more frequently, and a very high volume of patients who avoided healthcare, are now sicker and require a higher level of care.

Surviving, and even thriving, during this storm requires taking a centralized staffing approach that enables the sharing of valuable staffing resources across units, and even facilities. Full staffing transparency across the enterprise – a very broad and deep view into the workforce needs of the organization as a whole – is critical to addressing these post-COVID challenges.

The success of this much-needed centralized approach hinges on embracing technology that enables a central staffing office (aka the operational air traffic controllers) to effectively oversee daily enterprise-wide staffing needs and deploy all available resources effectively. In addition, predictive analytics need to be used to understand and plan for future staffing needs effectively.

Whether you used the methodology during the height of the pandemic or not, the advantages of centralized staffing can benefit your health system as you navigate current nursing shortages. This blog post shares some important considerations that can help you make a successful transition to a centralized approach and fully leverage the team in the central staffing office (CSO).

What is centralized staffing?

Centralized staffing is a holistic, enterprise-wide approach to staffing. Some health systems use a fully centralized methodology while others find it’s more effective for them to use a hybrid approach, where some staffing functions are centralized and others are done at the unit level.

When evaluating how a centralized approach fits with your organization’s structure and culture, consider the following questions:

  • Will schedules be created and published by the CSO or by each individual unit? Thinking through the best way to create schedules can help you identify whether it makes sense for each unit to create their own schedules or have a CSO manage the schedule creation process.
  • Who is responsible for finding resources to fill staffing gaps after the schedule is posted? Is each unit accountable for finding staff to fill the holes or is the CSO responsible for the open shift management process? Our clients have found the most success with having their CSO fill any staffing gaps that occur after the schedule has been posted.
  • Who schedules and deploys float staff? Is the float pool unit-specific, facility-specific or regional? This is another staffing task that is often handled best by the CSO.
  • Are staffing and scheduling policies, such as weekend/holiday rules, minimum hours commitments, premium pay and self-scheduling processes, consistent across the entire organization? Standardized processes and policies make it easier to utilize a centralized approach to staffing because all staff are treated equitably and know what to expect regardless of which unit they are assigned to.

The benefits of centralized staffing

When staffing is centralized, the CSO can serve as an ‘air traffic controller.’ Because enterprise-wide staffing data and processes are consolidated within a single team of staffing experts, the CSO is equipped with a comprehensive perspective that enables better staffing decisions that have a positive impact on both individual units and the organization as a whole.

  • Optimize available resources – With the responsibility for deploying staffing resources based on needs and availability under the purview of the CSO, much of the staffing chaos that typically occurs at the start of each shift can be eliminated. Data-driven decisions can be made and acted upon quickly and accurately.
  • Understand future needs – When the CSO has the ability to predict staffing needs in advance and match those needs with available staff, they can fill staffing gaps with the most appropriate resources. And, those open shift management decisions can be made with confidence days in in advance, reducing the need for last-minute adjustments.
  • Less administrative burden on unit leaders – Staffing and scheduling can be a time-consuming task for unit leaders. When a team of staffing experts in the CSO is efficiently managing scheduling and open shift management, unit leaders have more time to spend with their staff and patients.

Three critical keys to success

Centralized staffing works best when processes are well-defined and everyone understands what their role in the process is.  Here are some strategies that our clients have found to be important to the success of their centralized staffing methodology:

  • Collaboration – While the CSO serves as the ‘air traffic controllers,’ having involvement and buy-in from each unit and the front-line nurses is crucial. When the entire team works together to resolve staffing issues, unit leaders gain trust in the process. They recognize that even though they will sometimes need to share staff from their unit, they will also get additional staffing resources when they need them.
  • Staffing office is strategic – Staffing is often thought of as a tactical function. Although some aspects of staffing and scheduling are task-oriented, the CSO should also view staffing from a strategic vantage point. With enterprise-wide staffing data at their fingertips, the team in the CSO is positioned to be problem-solvers. They can balance staff across the enterprise, deploy staffing resources quickly and provide informed guidance for dealing with staffing shortages.
  • Enterprise-wide approach – In order to optimize staffing resources, unit managers, nursing leaders and the staffing office need to balance meeting the needs of each individual unit with staffing effectively across the entire organization. Our most successful clients work to minimize floating while also recognizing that floating staff amongst units can be an extremely valuable strategy for mitigating understaffing challenges. That’s why we provide tools that make floating less frustrating for nurses while also ensuring the consistent delivery of high-quality patient care.

Ready to transition to centralized staffing?

Centralized staffing is an integral part of a successful staffing methodology. To see how a centralized approach fits into a successful predictive staffing strategy, check out our white paper, “Overcoming Staffing Challenges with Predictive Analytics: Health System Success Stories.”


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