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Improving Throughput Metrics with Reduced Labor Expenses

Nicholas Chmielewski and Kevin Browning

March 2021

A hospital emergency department within a recognized Magnet™ center of nursing excellence had exhibited longer-than-desired lengths of stay and a higher-than-desired worked hours per patient visit. A department performance improvement team was formed as part of a systemwide initiative to right-size the organization for optimum quality care at the most efficient cost and to focus on improving both length of stay and staffing practices.

The team transitioned the department from a fixed-budget staffing model to a staffing-to-demand model. Methods included both changes to permanent staffing plans and implementation of real-time staffing-to-demand tools. Comprehensive education on the methodological shift helped reduce the department’s staffing by 14.9 full-time equivalents, actualizing $3.35 million in annualized labor savings. The reduction in staffing was accomplished without unfavorably impacting the department’s left without being seen rate or key length-of-stay metrics. In addition, most patient-experience scores maintained a satisfaction at or greater than 90%. These improvements allowed the department to treat a higher volume of patients at lower cost.

This case study demonstrates that implementation of staffing-to-demand methodologies can be successful in reducing labor costs while maintaining, if not improving, key performance indicators including patient satisfaction.

Read the full paper in BRG Review.

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