Overview
Mountain States Health Alliance (MSHA) is a not-for-profit healthcare system based in Johnson City, Tennessee. The MSHA system includes 21 primary/preventive care centers and 13 outpatient sites providing care to residents in 28 counties in Kentucky, North Carolina, Tennessee and Virginia.
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Situation
In 2007 the MSHA Nursing Leaders set out on a mission to improve their process of managing nursing labor, a common issue facing most health care organizations. Chief among their concerns were the inefficient allocation of nursing resources, the rising costs of nursing labor and the inability to effectively communicate staffing needs across the enterprise.
At that time, staffing responsibilities were held by individual hospitals, each with its own variation of a staffing office. Within some hospitals, each department functioned independently. This created a fragmented and inconsistent approach to staffing, turning nursing managers into staffing managers, decreasing productivity and creating financial inefficiencies. When surveyed, roughly half of nursing managers reported feeling that staffing activities demanded too much of their time.
Compounding the negative effects that result from this "silo" approach, was the lack of an effective channel to communicate with staff, both at the hospital and enterprise level. In times of shortage, nursing staff would report being contacted by several different managers to fill the same need. At the macro level, there was no way to efficiently share resources among hospitals. One location could find itself cancelling core staff while another would be struggling to fill their needs, resorting to overtime and bonus pay.
Solution
In November of 2007, after a lengthy RFP process, MSHA partnered with Avantas, choosing to revolutionize their approach to staffing. Their method was to integrate and centralize their processes across the enterprise using Avantas' proprietary software, Smart Square. MSHA discovered that Smart Square was the only product suited to meet its goals of reducing nursing labor costs and implementing a more efficient scheduling and staffing process.
"What sold us on Smart Square," said Sharron Grindstaff, Corporate Director of Central Staffing Services, "was the fact that Avantas is not just a ‘software company', Avantas is a healthcare company." Smart Square is the ideal tool to manage labor costs, as it anticipates future needs, determined by the Avantas Predictive Model. Paired with this, MSHA implemented i-Choice, the Avantas shift and incentive management tool. i-Choice continuously weighs census predictions against available staff and automatically posts open shifts in Smart Square. Incentives, within ranges set by MSHA, fluctuate in parallel with patient need, keeping the expense in line with a targeted overall rate. The popularity of this staffing tool has greatly diminished the need to make staffing calls, and has lowered the stress levels of nursing leaders, filling holes in the schedule up to thirty days before the start of the shift.
"The breakthrough moment for us," Grindstaff said, "was when a staff member called the staffing office to ask if i-Choice was working properly, since no available shifts were posted. Our Staffing Rep had to explain that yes, i-Choice was working perfectly, all the holes in the schedule had been filled!"
The staffing culture required for MSHA to achieve their desired future state necessitated the move to a Central Staffing Office. Smart Square is the perfect companion for this model, as it requires very few individuals to efficiently administer a small or large health system. The Staffing Analysis tool within Smart Square provides a system level view with the ability to drill down to individual units all on the same, easy to read page. This flexibility to view the system at the micro and macro level has made possible the addition of a source of contingency staff able to work across the system. By simply looking at their computer screen, viewing real-time acuity information, staffing analysts have the necessary information to communicate with nursing leaders and staff to deploy the right person to the right place at the right time.
"The thing we like most about Smart Square is the support we get from Avantas."
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"Smart Square really is a system-wide tool," said MSHA System Administrator, Debbie McInturff. "It is literally a 180 degree difference from the way staffing was. The coordination between staffers has greatly benefited the system."
During times when staff is not immediately available to fill openings, call rosters can be generated listing all available staff specifically qualified to work on the unit(s) in need, and with click-to-dial and other advanced telephony features, staffing communication is expedited in a swift and orderly manner.
"The recruitment features in Smart Square and the automated dialing and messaging features really save our staffers and nurse managers a lot of time," McInturff said. "They are able to pull up staff that can work where we might have a shortage and see their notes from previous recruitment efforts, their upcoming schedules and preferences all on one screen."
"Avantas is not just a 'software company', Avantas is a healthcare company."
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This sort of flexibility has given MSHA the peace of mind to begin to focus less on 'in-the-moment' staffing and more on proactive staffing, which is easily visualized with the help of the Avantas Predictive Model. In fact, the intuitive nature and logic of Smart Square has enabled the MSHA staffing office to run virtually paperless, creating an efficient and environmentally conscious, at-your-fingertips approach to managing people resources.
"I honestly cannot stress enough the positive changes we have experienced since partnering with Avantas and bringing on Smart Square," Grindstaff said. "But the thing we like most about Smart Square is the team support we get from Avantas. They are literally the best company I have ever worked with."
Smart Square and Avantas Work Strategies are pieces of the puzzle helping MSHA reach their desired future state. What holds those pieces together is the courage and commitment to drive meaningful change. These attributes are alive and well at Mountain States Health Alliance.
About Avantas
Avantas is an Omaha, Nebraska-based company recognized for its proven best-practice work strategies for the health industry. Majority owner, Alegent Health also serves as the test environment for Avantas products and services. Blending state-of-the-art technology and sound business processes, Avantas Work Strategies create a precise balance of labor supply to patient demand across the client enterprise, regardless of size or geographic location.
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