Budget & Risk Management in Healthcare Rostering

We all know that the health system is under pressure from all directions and a significant part of that comes down to finding ways to deliver healthcare to meet the expectations of the communities they serve within the very real budget constraints and the prescribed frameworks of compliance and safety.

With unlimited money and an unlimited supply of staff, it would be way easier, but that’s not how it works. Everyone in healthcare knows that things are tight.

Who does it impact?

Most people working in healthcare see and experience the impact of the problem, but the underlying drivers and solutions are not always as obvious because they are complex and require a system-wide understanding and plan to address them.

This is an incredibly difficult thing to achieve with the diversity of perspectives and priorities that co-exist with functional divisions and structures within hospitals and the internal competition for scarce resources.

Often what happens when there is a lack of cohesion is that someone makes an executive decision to implement a process or a system that on the surface may seem to make a difference but in reality, does not address the underlying challenges so the problems persist.

And here is why:

The biggest cost in healthcare is the people.

The ongoing operational budgets are not blown out in big chunks of thousands or millions of dollars like they could be in a Capital project.

The healthcare budget is blown in tiny increments hour by hour, call-back by call-back and shift by shift.

The ability to reduce annual leave balances that sit on the balance sheet and eat into operating budgets will stay big while there are no meaningful plans, tools and resources to manage them. And the tool to do that is not an expensive piece of reporting and tracking software dressed up as a leave management solution

Whether the hospital is compliant with the Awards or not has very little to with the HRIS or HR Department.

The ability to meet the obligations regarding patient experience and outcomes in contracts with funders has very little to do with what the contract says and more to do with the number of people and the mix of skills they have when a patient turns up.

The person actually spending the money, managing the leave, ensuring compliance, and managing the resources to meet patient demand is the person managing the rosters. And they do not get given the right tools to help them do it.

And what happens, in reality, is that these people carry the burden of budget, risk, compliance, patient outcome and all of the staff related issues from fatigue to training requirements.

And no matter what the memo says about budget constraints or reduction of leave balances, they have to make the choices and address the priorities with the professional diligence that puts staff and patients first.

The memos about budgets and leave reduction do not come with written permission and instruction to reduce staff levels and increase waiting times for patients, stress levels for staff or permission to override the Awards.

A Timetable is not a Roster

That’s a lot of responsibility for the NUM, Doctor, unit administrator or Medical Workforce Unit to manage on an excel spreadsheet, whiteboard or with a timetable programme mistakenly called a roster system.

Just to be clear what I mean by that, what most people think of as a roster is actually nothing more than a timetable.  A roster system is something that takes into account all of the variables (skills, finance, compliance, availability, risk, rules, workflows etc) and a timetable is just a report that says who should be at work.  One is a system, the other is a report

SLIDE 8- Transformation

The ability to transform the healthcare system sits in the hands of the people managing the roster at the frontline and the power to enable it to happen sits at the top end of management.

So if the people with the ability have no power and the people with the power have no ability then the wider system is in a perpetual stalemate situation with very little meaningful progress. The massive filter of “translators” in the middle called the hospital or health system is often so encultured with entrenched beliefs and behaviours that it makes it difficult to get traction. It’s nobody’s fault because everyone is in healthcare shares the same purpose, it’s just difficult to see how to change it when you’re in the middle of it and it feels like a labyrinth.

The most amazing thing is that you already have all of the ingredients you need to make a difference and you do not need to change your underlying drivers, people, processes, or systems.

And you already have really smart staff with the desire and ability to make it happen if they have the right tools to help them do it. Everyone is on the same page and wants the same thing.

You just need Core Schedule to bring it together seamlessly and unlock the data to enable transparent and appropriate rostering that frees up resources and improves performance at all levels.

Streamlining the process

You don’t need always need a complicated answer to a complicated problem. Sometimes you just need people to understand exactly how complicated it is and see a clear path through it without diminishing it.

There are very few real roster systems on the market and there are plenty of timetables in drag pretending to be, but no other system does or can do what Core Schedule does.

It is because we understand the complexity of the whole health system that we built a tool that is easily tailored to be completely fit for purpose for each individual roster in any unit, no matter how different they are from each other.

Breaking down silos (Big Picture)

At the same time, we also ensure the needs of others are met – such as the Finance Manager who needs to run forecasts and identify trends, or the HR department ensuring overall Award compliance, or Switchboard knowing who is on call at any given moment in any department.

The reality is with Core Schedule you can transform your healthcare system without disrupting it.

You can make a massive difference to really big challenges in your organisation if you have the tools to manage the details. As the old saying goes – “look after the pennies and the dollars will take care of themselves”.