By Spiros Paleologos

Canadian healthcare organizations continue to face numerous challenges, both internally and externally. They continually struggle to balance costs and quality of care, as demands surge but funding does not keep pace. They also need to successfully maintain an efficient and productive nursing corps while regularly attracting fresh talent. And attracting that quality talent is becoming an increasingly challenging task, given the ever-increasing workload, much of it administrative in nature.
These challenges are not mutually exclusive — and they’re not just a concern for HR leaders — as various studies have shown a direct correlation between employee engagement and improved quality of care.

Absenteeism and overtime: The flip side of employee engagement

In healthcare specifically, a 2016 study by the Canadian Federation of Nursing Unions revealed that absenteeism and overtime, a manifestation of disengagement, are a growing and alarming problem. According to the report, public sector health care nurses’ absenteeism rate is 8.7 per cet on average, up from 7.9 per cent in 2014. This rate of absenteeism is substantially higher than the average of all other occupations (5.7%). In fact, hours lost due to illness or disability is equivalent to the annual workload of almost 15,900 nurses. In other words, 28.8 million work hours must be found to replace those workers who are absent. Finally, the annual cost of absenteeism to the health care system is conservatively estimated at $989 million a year in 2016, assuming 49 working weeks in one year, compared to $841 million in 2014.

As absenteeism rates rise, so too does overtime. Aggregating both paid and unpaid overtime in 2016, public sector health care nurses worked an estimated 20.1 million hours annually, compared to 19.1 million hours worked in 2014. This number is equivalent to 11,100 full-time positions at an estimated cost of $788 million attributable to paid overtime, plus $180 million of unpaid overtime borne by nurses.

This data is supported by the Coleman Parkes Research, which found that, in healthcare:
• 52% of respondents find managing absenteeism to be a truly challenging experience
• 73% cite increased employee absence as a core disruption impacting their work
• 73% say unplanned absences are their biggest workforce management challenge

While the absenteeism problem in Canadian healthcare needs to be addressed at its root cause, the good news is that relatively small, incremental changes can reap big rewards in the short term and help inform broader, deeper changes over time.

Many organizations turn to Human Capital Management (HCM) and workforce management (WFM) technology to automate activities such as data collection, forecasting, budgeting, and scheduling. At their core, these tools alleviate the administrative burden across the organization, deliver actionable insights to senior management, and allow employees to have greater visibility and control over their work and schedules.

By deploying such tools, performance and competency improve by avoiding non-productive and time-wasting processes that could negatively impact an establishment’s budget. The transparency enabled by automated schedules made visible to all fosters greater employee engagement.

Organizations need to evaluate current (and future) systems with three key stakeholders in mind: executives, front line managers, and employees.

Executives: Is the bottom line enough?
Fifty-eight per cent of employees think their CEO is focused on finances rather than employees. This may seem a rather harsh evaluation of a position whose purpose is to focus on business performance, yet it’s fair to say it may be difficult to juggle staff concerns while keeping an eye on the bottom line.

Modern WFM technologies can help alleviate some of this pressure. Analytic dashboards can provide greater insight into real-time costs, production, and forecasting of business outcomes across the entire organization. This data helps executives proactively address situations before they negatively impact results, while also offering a window on some of the issues facing employees.

Unfortunately, this level of executive involvement with WFM is still rare, with only five per cent of organizations in Canada today operating at this level. While organizations continue to use manual processes and/or outdated technologies, it may make it difficult for senior executives to have more direct involvement in fostering employee engagement.

Front line managers: Caught in the middle?
Often the intermediaries between senior management and employees, it’s not unusual for nurse managers to find themselves in the middle between executives’ demands and nurses’ needs.

WFM technologies can give managers instant access to insight and analysis enabling them to proactively address critical business issues and challenges before short and long-term goals are compromised. Additionally, WFM can help to ensure proper staffing levels and support to meet and manage patient demand and executive expectations.
Current data shows only 20 per cent of organizations are operationally efficient, with outdated systems and technology again being one of the main stumbling blocks.

Employees: handle with care
The majority of employees strive to be recognized as an asset to their organization, but can often be hampered by tedious administrative tasks. Respondents to the ‘$88 Billion Question’ survey cited two key factors that would increase employee engagement: More empowerment in their role and more visibility and flexibility in scheduling.
Automating scheduling and basic time and attendance processes such as timesheets, electronic approvals, and conditional workflows can significantly lower administrative effort and costs, and increase efficiencies. Hospitals using workforce management solutions report reductions in agency fees of up to 50 per cent, and in overtime of up to 30 per cent. But this is merely the first step. Organizations can then focus on integrating more complex workforce procedures into the organization’s clinical, financial or production systems. Benefits include:
• Deeper insight into employees’ performance and productivity by management;
• Automation of burdensome tasks for employees (such as scheduling), allowing them to focus on value-add tasks that help deliver results and exceptional patient care,
• Enhanced communication with employees for greater transparency.
The end result is more employee empowerment, with a stronger determination to deliver on tasks and goals.

The journey in three steps
It’s easy to say organizations need to evaluate the current state of their WFM processes, but in reality it’s a multi-stage journey that, despite its complexity, can be achieved by following these three steps:
1) Begin with the ‘low-hanging’ fruit and automate tactical procedures, such as timesheets, schedules and business rules;
2) Once that foundation has been set, begin integrating with other business systems for deeper insights into performance and impact on the quality of care; and,
3) Shift to a level of analytic capability that provides:
a. Ability to identify trends and patterns across an organization’s most important metrics
b. Exposure to underlying issues and opportunities to improve productivity and quality of service
c. Transparency so employees and managers alike are better equipped to make data-driven decisions on key issues impacting performance and operational outcomes
By following these steps, while constantly keeping in mind the needs of executives, management and employees, organizations can begin to reap the full benefits of WFM that will help them realize an unprecedented level of workforce engagement.

Spiros Paleologos is the Vice President and General Manager for Kronos Canada. During his 20 years of leadership, Spiros has grown Kronos Canada to be the leading provider of Workforce Management solutions in Canada.