Billings Clinic Staffs Equitably During COVID-19 and Magnet Journey
Provides flexibility to customize schedules and shifts to meet changing patient volumes and care needs, even during a pandemic
Creates balanced patient assignments based on patient intensity, for equitable workload distribution across each unit and throughout the organization
Supports nurse self-scheduling and shared decision making in line with Magnet-designated guidelines designed to sustain nurse satisfaction and quality patient care
As Montana’s largest healthcare system, Billings Clinic serves residents of Montana, Wyoming, and the western Dakotas at its 304-bed hospital and Level II trauma center and through its regional partnerships with 13 critical access hospitals and an outpatient clinic. Billings Clinic, which has 15,000 employees, was Montana’s first Magnet®-designated healthcare organization recognized for nursing excellence. The Magnet Recognition Program® also optimizes job satisfaction, resulting in lower nurse attrition and an improved patient experience.
As COVID-19 cases started spreading across the U.S., Billings Clinic’s leadership team prepared for an expected surge of patients as it also engaged in the organization’s Magnet redesignation process. Because it had been using UKG® solutions to enable nurses to self-schedule and to ensure equitable distribution of patient workload based on intensity of care levels, Billings Clinic felt it was better positioned than most healthcare organizations of its size to handle the staffing demands of the pandemic.
The organization used its UKG for Healthcare scheduling solution to staff its COVID-19 triage unit and also added new units to the solution, including one just for travelers. Nurse managers had the information and flexibility they needed to build unique schedules and make informed staffing decisions shift by shift.
Newly skilled nurses floated to different units, and units shared patient care resources. The hospital’s inpatient cancer unit took stepdown patients from the cardiovascular unit, which then took overflow patients from the ICU. Each unit adjusted its workload rationale guidelines to account for new patients that nurses were caring for. UKG Workload Manager for Healthcare played a key role in balancing patient assignments based on the intensity of patient care needed ― and on clinical data ― as well as according to staff skills.
The solution’s workload-based staffing functionality enables unit nurse managers to determine appropriate nurse-to-patient ratios based on clinical data. While some nurses were used to caring for five patients at a time, patients’ increased intensity of care levels during the pandemic made caring for just three patients extremely demanding.
“We also used data on our one-to-one sitters, which we track through the scheduling area,” shared Danielle Mahon, Healthcare Informaticist. “All of my nurse managers know how to run reports in the scheduling solution to see their productivity and how their one-to-one hours are impacting their productivity.” Having real-time visibility into hours per patient day helps units stay within budget.
“Acuity-based staffing is imperative to meeting our goals and making sure we have the right staff and number of staff for the right types of patients. And we’re able to give nurses a flexible schedule while making sure we have what we need to meet our patient needs.”
As a Magnet-designated hospital, Billings Clinic is committed to empowering its nurses through self-scheduling and shared decision making, a focus that has served it well during the pandemic in retaining nurses, maintaining their satisfaction, and delivering quality patient care.
“Magnet is firm on nurses having a say in their schedules,” noted Mahon. “Dimensions allows us to do that. During a Magnet site visit, all nurses in the self-scheduling units were able to speak to how they can request their PTO and put in their schedules.”
UKG Scheduling and UKG Workload Manager for Healthcare solutions have supported Billings Clinic in meeting Magnet goals for exemplary professional practice and ongoing improvement in knowledge and innovation. Able to manage their own schedules, nurses are more engaged and are less likely to call off. A positive work environment with balanced patient assignments and workload ― determined by data for each shift ― also supports quality patient care.
“Acuity-based staffing is imperative to meeting our goals and making sure we have the right staff and number of staff for the right types of patients,” said Mahon. “And we’re able to give nurses a flexible schedule while making sure we have what we need to meet our patient needs.”
During its Magnet redesignation process, Billings Clinic shared stories from its COVID-19 experience to illustrate how they were able to schedule and empower nurses to maintain their satisfaction and to deliver quality patient care. UKG for Healthcare data supported the ability of Billings Clinic to achieve operational excellence.
Approximately a year after Billings Clinic began its Magnet redesignation journey ― and experienced all the challenges of COVID-19 ― the organization was redesignated a Magnet hospital.