Thursday, May 12, 2022

 The Death of Hospital Labor Consulting

People often ask us "How can workforce consulting help a challenged hospital workforce?" The question makes sense if you understand traditional labor consulting. That old labor model: Handing managers benchmarks as budgets; proving to them that they aren't functioning at an optimal level; and adding a leather-bound book of staffing grids and tired strategies to cut positions. Many labor consultants have spent their entire careers in that model. It's all they know.

But today hospitals are facing new workforce challenges, and the old way no longer works, if it ever really did, because today we have... 

  • An aging workforce 
  • The pandemic driving clinicians away from the bedside 
  • Competition for workers not only from other healthcare organizations but other industries 
  • A failing education system attracting fewer applicants into healthcare careers 
  • A younger workforce with changing values demanding more work life balance 
  • And an ever increasing demand for healthcare

But there is another tradition, not labor consulting, but Workforce optimization. That model grew from;

  • Quality Improvement
  • Change Management
  • Organizational Development and
  • Industrial Engineering 

And it is entirely different. It's Workforce Optimization. Today we have a new name that is a better description: Business Optimization, Labor and Throughput.


In this model we suggest a holistic look at the business, improving the net margin per patient and the total margin of the service line while improving all service and quality metrics to best practice levels.

How to do this quickly? Teamwork.

This is a model that reduces the patient, physician and staff leakage happening every day invisibly in most hospitals. 

This is a model that recovers and grows billable incremental volume and the hospital's margin: Recovering leakage lost because of patient, physician and staff frustration waiting in multiple lines, waiting on the phone, waiting for results, waiting in pain for days for their treatment.

  • We suggest capturing all the patients you are losing today, and their margin,  lost from leakage due to inefficient processes, without adding any labor cost

  • Eliminating waste, reducing delays, realigning job responsibilities so skilled workers are working to the top of their license on all shifts
  • Working in conjunction with HR to attract and educate new colleagues
  • Working in conjunction with case management and patient access to optimize patient throughput, improving quality and patient satisfaction

In this learning organization of high touch, high engagement and high efficiency folks come in earlier in their career, to be trained up, educated, invested in, participating in a longer career ladder with a broader range of skills, that starts with assistance to other professionals and becomes professional;  This is how the hospital rebuilds career-spanning relationships with their associates. This also reduces labor disruption.

The new model, which a good BOLT facilitator can help build, starts with multi-disciplinary teams with multiple levels of management and associates working together every week from a dashboard and work analyses. 

The team sees their numbers: cost, quality, benchmarks, length of stay by DRG, position control, vacancies, recruiting turnaround time, overtime, margin, patient satisfaction, staff and physician engagement scores, throughput, coverage; productivity; even skill level by shift. Colleagues receive full educational and analytic support by their consulting partners. Because all these pieces are interrelated.  They fit together.  And an informed workforce can accomplish far more than an ignorant one. Now the leadership team is engaging the full power of the workforce.

Better margin, mission, morale and margin (did I mention margin?) develop faster and sustain for years. Because they are built on better collaboration and alignment by growing a stronger team with all hands on deck.

Written by Spence Tepper and Dirk Pattee