Children’s Nebraska, is the state’s only full-service pediatric healthcare facility and provides expertise in more than 50 pediatric specialties to children across a five-state region and beyond. Children’s Nebraska delivers patient services at its 225-bed hospital and 11 outreach clinics, and employs approximately 4,000 people.
Challenges
Although Children’s Nebraska has been a longtime user of UKG® workforce management solutions, it still used some manual processes, including tracking incentive pay on spreadsheets, an error-prone practice. The organization also tracked accruals in its ERP system, a process also open to errors. With support for its longtime UKG solution ending, Children’s Nebraska decided to migrate to a new UKG workforce management solution with expanded functionality.
Solutions
Approximately 3,800 employees at Children’s Nebraska use the upgraded UKG solution, including all nonexempt employees and contract travelers. In addition to using UKG timekeeping and accruals modules, the organization is utilizing UKG advanced scheduling and clinical scheduling extensions modules.
Schedules for clinical staff are created using the advanced scheduling module, before this information migrates into the scheduling extensions solution, along with patient acuity data from the organization’s Epic electronic medical health record system. Modeling of volumes is done in the scheduling extensions solution, as is forecasting staffing needs based on the volumes.
The UKG solution also interfaces with an employee pay solution, which gives employees daily access to their earned pay before scheduled paydays.
“The UKG solution is well worth it and has all kinds of potential and possibilities, depending on the time and effort you want to put into it”
Business Operations-Patient Care Services
Results
Adding the advanced scheduling solution has enabled Children’s Nebraska to move from every unit scheduling staff to a centralized staffing office scheduling nursing units, emergency services, and surgical services staff. The initial plan was for four people in this office to schedule staff 24/7, but the office determined that only two people are needed to complete scheduling over four days. The current model is a collaboration between the Staffing Office, House Supervisors, and Charge RNs.
“With a better workflow than what we had anticipated with the staffing office, and supervisors taking on some of these duties, it’s facilitated our huddles in running more smoothly and improved the allocation of resources,” said Carol Quiroz, Manager, Business Operations-Patient Care Services at Children’s Nebraska.
During scheduled twice-daily and as-needed huddles on inpatient nursing floors, house supervisors pull up UKG Clinical Scheduling Extentions solution to review data with team members on current patient census and acuity, forecasts for census levels later in the day, and staff scheduled for each shift, enabling the team to equitably distribute staff to balance patient-care workloads and support quality patient care.
“It’s helped us identify unit turnover rates and to make better decisions, as far as staffing resources that are needed and which type of staffing resources are needed,” Quiroz explained. “There’s a lot of efficiencies in the scheduling solution and balancing schedules, so we can more effectively use our current resources.”
With the ongoing nursing shortage, the organization has been using a substantial number of traveling nurses, who are entered into the UKG Advanced Scheduling and Clinical Scheduling Extensions solution. This streamlines scheduling available staff to meet patient census and expected workloads as well as generating invoices to outside agencies for travelers’ time. Use of the tool has facilitated a focused effort on reduction in traveling nurses resulting in a $12 million dollar savings within 7 months over the last fiscal year.
Children’s Nebraska runs reports from the UKG solution to gain insight into a range of workforce-related areas, including overtime usage and float percentages for the flex team and each unit, as well as to conduct payroll audits before processing. Also, adding incentive pay codes directly onto the timecard and building incentives shifts into select schedule timeframes have improved the incentive pay process.
“The UKG solution has allowed us to identify FTE creep, over- and under-hours, and employees not taking lunches,” said Quiroz. “It also shows whether employees are working to their full FTE or way below it, so when we’re short of resources, we can make sure we’re using all the resources we have available and also that we’re not abusing extra hours.” Use of UKG tools at Children’s Nebraska has resulted in an estimated $100,000 per year on employee’s meal break incremental costs. In addition, ensuring that employees are taking their lunch break also results in less fatigue and better wellbeing.
Children’s Nebraska also runs quarterly reports to determine how well budget and staffing allocations align with actual patient population acuity levels and staffing usage. Using Epic scores and assigning them an acuity level helps the organization determine what the high, medium, and low patient acuity averages should be set at.
“We’ll do some modeling before we change this, but we use this information to do this, so we equitably distribute our resources,” said Quiroz. “Volume indicators for different types of statistics kept by departments on inpatient nursing floors also help us identify where we might be having more ventilator patients, chemo patients, and other types of patients.”
In addition to improving clinical decision-making, the upgraded UKG solution is improving the employee experience by empowering and engaging staff. Employees have access to the solution on their mobile devices to check their schedules, swap shifts, request time off, and make timecard corrections ― from anywhere. Managers also use the mobile functionality to review and approve timecards, missed-punch submissions, and time-off requests.
“Our nursing staff is so dependent on their schedules and knowing when they’re going to work, having access to this information at their fingertips is super critical,” said Joshua Kluver, Business Systems Analyst II, Information Technology at Children’s Nebraska. “Their having this freedom through mobile access allows employees to kind of control their own destiny.”
The organization continues to assess the benefits that Children’s Nebraska has realized by migrating to its new UKG solution, Kluver said, “Making this leap was the best thing we could have done.” In the future, he said they want to further optimize their scheduling solution to ensure they are taking full advantage of all functionality.
“The UKG solution is well worth it and has all kinds of potential and possibilities, depending on the time and effort you want to put into it,” added Quiroz. “You could put minimal effort into it and get a lot back from the system or you could optimize your efforts and get even more back. If you put the time in, it’s going to be well worth it.”