Tackling the Temp Problem

June 24, 2011
by Dawndra Jones-Hornsby   Back in 2003, The University of Pittsburgh Medical Center (UPMC) used temporary nursing staff in part to meet schedule

by Dawndra Jones-Hornsby

Back in 2003, The University of Pittsburgh Medical Center (UPMC) used temporary nursing staff in part to meet schedule and skill needs, but found that rates were continually increasing from nursing shortages and unique skill requirements. The leading healthcare system in western Pennsylvania with 19 hospitals and other care sites across 29 counties, UPMC wanted to continue to avoid using traveling nurses, but couldn't ignore the temporary nursing shortages and ever-increasing rates.

Getting Centralized

With each facility in the UPMC system responsible for managing its own staffing needs, processes were greatly decentralized. We lacked insight into how each facility was managing its various contingent labor initiatives, including multiple rate agreements with more than 20 outside staffing vendors. Often, sister facilities competed for the same temporary staff, which drove up rates and led to tremendous inefficiency. Processes such as invoicing and payment were decentralized and complicated by unique requisition requirements at each facility dictated by varying job titles and shifts.

With each facility relying on manual, often error-prone processes involving phone, fax, email and verbal conversations with temporary staff and outside agencies, UPMC faced further risks in terms of compliance. We found it challenging to manage the time and payment requirements of our contingent workers, and our methods for checking worker qualifications and licenses were redundant and time consuming. In addition, if a temporary nurse was let go because of too many medical errors, the nurse could potentially be staffed at another hospital or even the same facility through a different staffing provider.

To control costs and ensure compliance, our team decided that we needed to standardize all processes related to sourcing, monitoring and paying temporary staff. We sought an automated, centralized way to address our unique requirements, which include ensuring candidates hold the appropriate updated certifications, while also supporting varying work shifts. To fully automate processes, we also needed flexible ways to input time records and deliver round-the-clock alert notifications for immediate position fulfillment requests.

After a rigorous selection process, we selected IQNavigator, a company that provides Web-based services procurement software solutions. In addition to handling all the requirements noted above, the application has also simplified our invoicing and scheduling processes and created one unified system for managing all temporary staff across the organization. Using the solution, we were able to standardize rates across the enterprise and provide the detailed level of reporting we needed to review and monitor performance.

The fix

Our new system gives us the ability to pool our requisitions and respond to temporary labor needs more quickly. We've achieved better rates by consolidating our procurement procedures, negotiating as a single entity, and as a result reducing and locking in rates.

We now receive a single consolidated invoice each month with approved time and rates for all temporary staff. We are able to view these invoices to any level of detail, creating visibility for our staffing requirements by month, week, day, shift or position as needed across the organization. It's saving us a significant amount of time and headaches and allows us to gain more real-time visibility into our internal nursing demand.

We have also greatly improved our sourcing of temporary nurses, implementing a tiered approach in which the system automatically notifies our preferred providers of requisitions. If the position is still unfilled 72 hours prior to the available shift, the system automatically notifies all second-tier providers. The software checks qualifications and licenses, and selects which candidates provide the best fit for specific job requirements and shifts.

Because IQNavigator's technology is provided as a hosted Web service, there was no need for installation on UPMC's network, no need to configure servers, and no additional work for our IT staff. All our staff needed was an Internet connection and a browser to begin using the system, which was fully configured and operational with our processes and data in six weeks.

Once the system was up and running across the UPMC network, the IQNavigator team worked closely with UPMC to help train our employees. Functionality has been enhanced with quarterly software updates, including capabilities we've requested to improve our operations.

As a result of this program, we estimated savings of 11 percent for overall temporary nursing costs and have achieved significant internal process savings as well. We have much better visibility into our spending, demand for nurses, and the performance and quality of each staffing supplier. Finally, UPMC has a way to make sure that all compliance standards are met across the organization, from processes and procedures to certification checks.

Dawndra Jones-Hornsby R.N., BSN, is director of vital staffing, at the University of Pittsburgh Medical Center.

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