Lecture 4

Report
 Presentations
 Dec 1st, 4pm-8pm, Chapman 140
 One presentation, two evaluations
 Final Exam




Monday Nov 24th, 12:30-4pm, Chapman 100
Review in class Nov 19th – if needed can meet Sunday 23rd.
One side of one sheet of paper, hand written
On the computer
 Book Report
 November 19
 Final homework due date?
Staffing, Productivity and Labor
Management
Staffing and Productivity
 Goals
 To understand some of the key terms in workload management
 Know the relationship between staffing, and scheduling
 Understand the meaning of productivity in health care
organizations
 Develop and describe commonly used productivity ratios
Productivity/Labor Management
 Part of the role of management is to manage operating





expenses
Largest expense in operations is labor
Ignore your labor costs and you’ll be gone pretty quickly
Also must maintain high quality care
Pay attention to patient and staff satisfaction
Making that happen daily is the tough part of this business
HCA Operating Costs $11 Billion in
Salary, Wages and Benefits
$25
Operating Costs
$20
All Other Operating
$15
Dollars
(in Billions)
Supply Expense
Corp
Shared Services
$10
$5
Admin
SWB
Operations
makes up
makes up
55.4%
90.3%
of Total
Operating
Expense
of
Salaries, Wages
& Benefits
Operating Expense
SWB
Clinical
makes up
83.6%
of
Operations'
SWB
$0
Operations - SWB
Overview
• Productivity
 A measure of how efficiently a system uses resources to produce the desired
output.
• Labor Management
 All the systems, processes, and initiatives designed to support, measure, and
influence productivity.
• Productivity is the rate at which we operate as a business,
whereas labor management is the art of controlling that rate.
Workload Management
Staffing
Scheduling
Reallocation
Patient Satisfaction
Staff Utilization
Productivity
Costs
Staff Satisfaction
Workload Management
 Staffing
 Decide on the appropriate number of full time employees to be
hired in each skill class
 Longer term– tactical
 Scheduling
 Establishes when each staff will be on or off duty and on which
shifts they will work
 Often per pay period
 Reallocation
 Fine tunes the previous decisions. Shift-by-shift decisions.
Fundamentals of Labor Management
Components of Labor Management
Overview
Monitoring &
Controlling
Scheduling &
Staffing
Flexible Position Control
(FPC)
Developing Standards
9
• Step 1: Rate of productivity is established and expressed in
terms of standards and targets
Fundamentals of Labor Management
Components of Labor Management
Overview
Monitoring &
Controlling
Scheduling &
Staffing
Flexible Position Control
(FPC)
Developing Standards
10
•Step 2: The standard is applied to determine the potential
range of labor needs; the foundation for hiring.
Fundamentals of Labor Management
Components of Labor Management
Overview
Monitoring &
Controlling
Scheduling &
Staffing
Flexible Position Control
(FPC)
Developing Standards
11
•Step 3: Using the boundaries set by FPC, create staff schedules
and make real-time staffing adjustments.
Fundamentals of Labor Management
Components of Labor Management
Overview
Monitoring &
Controlling
Scheduling &
Staffing
Flexible Position Control
(FPC)
Developing Standards
12
• Step 4: Develop systems and processes to provide feedback on
resource utilization, leading to improvement
Labor Management Module One:
Terminology
&& Concepts
Monitoring
Components of Labor Management
Controlling
13
Scheduling &
Staffing
Flexible Position Control
(FPC)
Developing Standards
• Step 1: Rate of productivity is established and expressed in
terms of standards and targets
Foundational
Terminology & Concepts
Terminology & Concepts
Productive, Non-Productive, and Paid Hours
Hours Category
Productive
(worked)
Non-Productive
(non-worked)
Paid
(Total of Productive & NonProductive)
Definition
Hours Included
Hours actually worked by the
worker
• Regular worked hours
• Overtime
• Orientation
• Education & Training
• Contract Labor
Hours paid to the employee that
are NOT worked
•Vacation & Sick time (PTO)
• Holidays
• Leaves of Absence (using PTO or Paid
Leave)
• Bereavement
• Jury Duty
Sum of Productive & NonProductive. Typically budgets focus Represents hours of every type
on Paid hours.
14
Hours
 Application:
If a department has 500 regular hours, 100 overtime hours, 100 contract hours, 100
orientation hours, 100 PTO hours and 100 continuing ed. hours,
How many are productive hours?
How many are non-productive hours?
How many are paid hours?
Full Time Equivalents (FTEs)
 1 FTE = person(s) who is paid at 80 hours per pay period
 8 hours/day x 5 days/week x 52weeks/year = 2080
 Is not equivalent to just one person- can be several people
 FTE = hours per week
40 hours
- or -
FTE = hours per pay period
80 hours
Careful…
One FTE is not necessarily equal
to One Employee:
• Janet worked 20 hours this week
• Carlos worked 40 hours this week
• Paula worked 36 hours this week
3 employees, but only 2.4 FTEs!
Hours worked
20+40+36
=
= 2.4 FTEs
Hours in period
40
16
Productive, Non-Productive, and Paid Hours
Hours Category
Productive
(worked)
Non-Productive
(non-worked)
Paid
(Total of Productive & NonProductive)
Department Pay Period Example
Hours
FTEs
Worked: 1560
Overtime: 30
Contract: 160
Education: 34
TOTAL:
1784 Productive Hours
1784
80
= 22.3 ProductiveFTEs
Paid Time Off: 192
Jury Duty:
16
TOTAL: 208 Non-Productive
Hours
208
80
=2.6 Non-Productive FTEs
Productive Hours:
1784
Non-Productive Hours: 208
Paid (Total) Hours: 1992
=
1992
80
24.9 Paid FTEs
17
Establishing Standards
 Work standard – the predetermined allocation of time available
for a unit of service to maintain an appropriate level of quality
 The unit of service varies – could be measured as patient days or
procedural
Description
Standard
Nursing care hours per patient day (med-surg)
4.5
Nursing care hours per patient day (coronary
ICU)
12.0
Physical Therapists hours per patient treatment
0.5
Technician hours per CT scan
0.4
Establishing Standards
 Historically Standards were based on overall census of the facility.
 Easy to calculate
 Misses much variation across departments
 Today there are more sophisticated techniques which are
calculated at the department level and adjust for the acuity of the
patient.
 Steps
1.
2.
3.
Establish patient classification and acuity system
Develop time standards to reflect the time necessary to care for
each patient using the classification system
Convert total coverage needed into appropriate number of fulltime equivalents (FTE).
Patient Acuity Systems
 Hospitals rely on departmental acuity adjusted census to
establish work standards
 More accurate
 An 85 year old male in ICU vs. minor surgical procedure
 Population entering hospital is sicker today than 10 years ago.
Trend likely to continue
 Coupled with decreased reimbursement and increased emphasis
on cost control
 Requires more fine tuning to maintain quality
Patient Acuity Systems
 Patient Acuity Systems or Patient classification systems are
used routinely in Nursing
 Joint Commission Standard
 “Define, implement, and maintain a system for determining patient
requirements for nursing care on the basis of demonstrated patient needs,
appropriate nursing intervention, and priority for care.”
Staffing Determination
 Once acuity is measured, we then convert to time level required
and then needed FTEs
 First step is a careful identification and documentation of activities
in the department
 Flow and process charts
 Fixed and variable activities
 Second step is assessing time required to perform tasks
 Estimate
 Historical averages (aggregate level)
 Logging
 Adjust for utilization
 Utilization rate is generally not 100%
 Controllable – vacation, avoidable delays, etc.
 Uncontrollable -- sick leave, physicians, etc.
Some Examples
 See Staffing Examples Spreadsheet
Determination of FTEs for Nurse
Staffing
1.
Minutes of required care
Minutes of care = (average census) * (average required minutes per
patient)
2.
Unadjusted FTEs
Unadjusted FTEs = (Total minutes of care)/(Minutes available to work
per nurse per day)
3.
Core Level FTEs
Core Level FTEs = (Total Minutes of Care)/(utilization
standard)*Available work minutes)
See example on Excel Spreadsheet
Productivity
 Here we want to understand the meaning of productivity in




the context of healthcare
How do we measure?
problems with measuring
Relationship between productivity and quality
Some examples
Definitions and Measurements
 In its simplest form productivity is defined as output over
input:
Pr oductivity
Output
Input
 Alternatively Hours Per Patient Day:
TotalHours
HPPD
PatientDays
 Or in the outpatient setting:
HPPV 
HoursWorke d
PatientVis its
Definitions and Measurements
 Nurses in unit A worked a total of 25 hours to a treat a
patient who stayed five days. Nurses in unit B worked 16
hours to treat a patient who stayed four days. Which unit is
more productive?
25
HPPDA 
5
5
16
HPPDB 
4
4
Terminology & Concepts
Units of Service (UoS)
 Productivity can be measured at the individual, department, or facility
level. Because of this, we measure the output in ways that are different
but make sense for that level, department, etc. We refer to these workload
measures as Units of Service (UoS).
28
Department UoS
Departments perform varying functions, so UoS differs among departments.
•
•
A patient day is the equivalent of one patient in one bed for 24 hours, so two patients each staying for three days
would be a total of six patient days. The basis for measuring work in nursing units is patient days.
The Nursing Unit Statistic also accounts for discharges, transfers, and observations (note that 12 hours of
observations counts as one patient day). This calculation is performed for you, but it’s important to understand
the factors it includes:
Patient Days +
(Discharges + Transfers)
2
+
Observation hours
12
Department
29
UoS
Surgery
OR minutes
Non-Invasive Vascular Lab
Procedures
Lab
Billable Tests
Occupational Therapy
¼ hour increments of therapy
Dietary/Cafeteria
Adjusted Patient Days (APD)
Emergency Department
Patient Visits
What about outpatients? How are they
counted?
 Using Gross Revenue as a proxy indicator for facility output,
the Outpatient Factor is calculated to adjust for this
Outpatient Revenue =
$3,020,000
Inpatient Revenue =
+ $11,185,200
Total Patient Revenue= $14,205,200
 =
  
 
=
$14,205,200
=1.27
$11,185,200
 So adding 27% more to inpatient volume will account for the
outpatient activity
Adjusted Volume
Concept
Answers the
question of….
Formula
Adjusted
Average
Daily Census
(AADC)
Adjusted
Patient Days
(APD)
Adjusted
Admissions
(AA)
Average Daily
Census
(ADC)
What’s the total
output in patient
days, if we could
count
outpatients in
terms of
inpatients?
What is the number
of patients we
treated, if we could
count OP in terms
of IP?
On average, how
many inpatients do
we have on any
given day?
On average,
how many
patients do we
have at any
given moment,
adjusting for
outpatients?
Inpatient admissions
Inpatient Days
x OP factor
# of days in period
Average Daily
Census
x OP factor
Inpatient Days
x OP factor
Terminology & Concepts
How is productivity measured at the hospital level?
 EEOB = Equivalent Employees per adjusted Occupied Bed
 Use of AADC reflects length of stay (LOS)
 Also referred to as “FTEs per AADC”, EPOB
 MH/AA
 SWB/AA and SWB/APD
32
Can use
either Paid or
Prod
Paid FTEs
AADC
Terminology & Concepts
How is productivity measured at the hospital level?
 EEOB = Equivalent Employees per adjusted Occupied Bed
Can use
either Paid or
Prod
Total Manhours
 MH/AA = Man Hours per Adjusted Admission
Adj Adm
 To convert FTEs into Manhours, multiply FTEs
by the number of hours in the time period of study
 SWB/AA and SWB/APD
33
Terminology & Concepts
How is productivity measured at the hospital level?
 EEOB = Equivalent Employees per adjusted Occupied Bed
 MH/AA = Man Hours per Adjusted Admission
 SWB/AA = Salaries, Wages & Benefits per Adjusted Admission
 SWB/APD = Salaries, Wages & Benefits per Adjusted Patient Day
 Expressed in terms of dollars instead of hours
SWB (in $)
Adj Adm
34
SWB (in $)
Adj Pt Day
Benchmarking
 Productivity is a relative measure
 Compare to similar unit or the same unit over time
 These comparisons over time are referred to as historical
benchmarking
 Alternatively best practices across organizations can be
established and the unit’s numbers are compared to these
 On a day-to-day level, departments are compared to what is
budgeted
Developing Standards
Setting Standards for Productivity
 The productivity standard is the
ratio of hours and UoS specific
to a department. It is applied to
actual data to determine if a
department is effectively using
resources.
 Where does my standard come
from?
 Historical Actual Data
 Benchmark
 Facility Budget
 Facility Management
Experience
36
Monitoring
&
Controlling
Scheduling &
Staffing
Flexible Position Control
(FPC)
Developing Standards
Developing Standards
Applying Standards to Hours and FTEs
 The standard is the basic ratio used in conjunction with UoS (volume) to calculate
target hours which are then converted to FTEs
Concept
Example
Budget UoS
x
Standard
=
Budget Hours
200 UoS
x
0.25
=
50 Hours
Actual UoS
x
Standard
=
Target Hours
220 UoS
x
0.25
=
55 Hours
Target Hours
-
Actual Hours
=
Hours Variance
55 Hours
-
54 Hours
=
1.0 Hour
37
Case Mix and Quality
 Previous examples assumed:
 Homogeneous outputs
 Constant quality
 In practice outputs and inputs are hard to measure
 Two nursing units with the same staffing levels each treat thirty
patients in a day. Equally productive?
 Suppose one unit is ICU, the other med/surg. Clearly ICU is more
productive given numbers above once we account for case mix.
 Even if case mix were constant, one unit may be providing better
quality.
 Thus in theory productivity measures should account for both case
mix and quality (although historical quality has been largely
ignored --- until now)
Adjustments for Inputs
 Skill Mix Adjustment
 We can use the wage (or salary) to weigh the hours of personnel
of different skill levels.
 Suppose RNs = $35, LPN=$28, Aides =$17.5
 WRN=35/35=1
 WLPN=25/35=0.8
 Waide=17.5/35=0.5
 That is one hour of an aide’s time is worth a half hour of RN
time.
Adjustments for inputs
 Adjusted hours:
AdjustedHours  WiXi
 Where Wi = the weight for skill level i
 Xi is the hours worked by skill level i
 Adjusted hours per patient day:
AdjustedHours
AdjustedHoursPerPatientDay 
PatientDays
Example
 Given the weights above (RN=1, LPN=.8, Aide=.5),
calculate the adjusted hours per patient day for unit A and B
Measurement
Unit A
Unit B
Annual Patient
Days
14,000
10,000
Annual Hours
Worked
210,000
180,000
Percent RN
100
45
Percent LPN
0
35
Percent Aide
0
25
Example
 Adjusted HoursB= 1(180,000 x .45) + .8(180,000 x .35) +
.5(180,000 x .25) = 146,700
 Adjusted Hours Per Patient Day:
 Unit A: = 210,000/14,000 = 15.0 Hours
 Unit B: = 146,700/10,000 = 14.7 Hours
 Note that if we used unadjusted HPPD we would reach the
opposite conclusion
Adjustment for Inputs
 Standardized Cost of labor
 Alternatively we can construct the numerator using the total
costs of labor
 Labor Cost = Σcixi
 Ci=the wage for skill level i
 Xi is the hours worked for skill level i
 SWB/AA and SWB/APD
Adjustments for Outputs
 The above measures do not consider case mix, so they are useful
primarily when comparing similar patients in similar settings or
for use in a departmental budget, but not across specialties or
hospital types.
 Patient classification systems categorize patients daily into several
categories of acuity.
 This allows the construction of a case mix index:
Casemixindexj  WiPij
where Pij= percent of patients for acuity category i in unit j, and
Wi is the weight for the ith acuity category
Example: Calculate the adjusted hours per
acuity-adjusted patient day
Measurement
Unit A
Unit B
Annual Patient Days
14,000
10,000
Annual Hours Worked
210,000
180,000
Percent RN
100
45
Percent LPN
0
35
Percent Aide
0
25
Acuity I
.5 direct hours per
patient day
15%
15%
Acuity II
1.5 direct hours
25%
30%
Acuity III
4.0 direct hours
35%
40%
Acuity IV
6.0 direct hours
25%
15%
Components of Labor Management
Fundamentals of Labor Management
Monitoring &
Controlling
Scheduling &
Staffing
Flexible Position Control
(FPC)
Developing Standards
46
•Step 2: The standard is applied to determine the potential
range of labor needs; the foundation for hiring.
Flexible Position Control (FPC)
The Need for Staffing Flexibility
Workload
Volume
Traditional Staffing Model
Understaffed
Understaffed
Overstaffed
Workload
Volume
Core Staffing Model
Flex staff up to
meet workload
demand
47
Average
FTEs
Flex staff up to
meet workload
demand
Core
FTEs
Flexible Position Control (FPC)
FPC as a hiring plan
 It is your hiring plan. Based on volume and your productivity standard, FPC
calculates FTE needs at Core, Average, and Peak.
Peak
Avg
Core
 It is desirable to fill your Core positions with all your Full Time and then some
Part Time and PRN to guarantee hours. Total FT employees should never exceed
Core values.
 Use Part-Time and PRN to “staff up” to meet Average and Peak levels.
 PRN is a nursing term: Pro re nata, Latin for “as needed”
48
Components of Labor Management
Fundamentals of Labor Management
Monitoring &
Controlling
Scheduling &
Staffing
Flexible Position Control
(FPC)
Developing Standards
49
•Step 3: Using the boundaries set by FPC, create staff schedules
and make real-time staffing adjustments.
Scheduling & Staffing
Making Daily Adjustments
 Daily Staffing fine-tunes the schedule to ensure that your department
meets target.
Call-off Order
• Daily Staffing Process
(accept volunteers at any point)
– Forecast workload for the upcoming shift(s)
– Convert into the amount of staffing required
– Adjust staffing levels (ensuring proper number and
mix of staff)
1) Agency and Traveling staff
2) PRN then Part time then Full time
staff in OT or other premium pay
status
3) Temporary Status Staff
4) PRN Staff
5) Part time staff in regular pay status
6) Full time staff in regular pay status
• Staffing Grids and Matrices
– Converts demand to needed staff automatically based on department
standard (Productive Hours per UoS)
50
Units of Service
Low
Peak
15
17
18
20
21
23
Mgr
1
1
1
Day Shift
RN
2
3
3
LPN
0
1
1
Evening Shift
Mgr
RN
LPN
0
2
1
0
3
1
0
3
1
Mgr
0
0
0
Night Shift
RN
2
2
2
LPN
1
2
2
Monitoring & Controlling
Components of Labor Management
Monitoring &
Controlling
51
Scheduling &
Staffing
Flexible Position Control
(FPC)
Developing Standards
• Step 4: Develop systems and processes to provide feedback on
resource utilization, leading to improvement
Monitoring & Controlling
Useful Tools & Reports
Labor Management Resources
Data Systems
PLUS
KRONOS
Daily Trend Report
52
Manager Self
Serve Module
Base Peer Group
Comparison
Daily Staffing
Summary
Bi-weekly
Utilization Trend
Report
Benchmark
People
Kronos Daily Trend
Report
ADC/CMI Peer
Group Comparison
Input/Daily Edits
Attribute Survey
Report
Personnel Action
Request (PAR)
Division
Management
Engineer (“ME”)
Responsible for
productivity at
division level,
including
development of
standards,
maintenance of
FPC, and
training/support
on tools
Monitoring & Controlling
Benchmarking – Definition of quartiles
 Quartiles are established to categorize performance levels within a
population
5
4.5
4
75th percentile
3.5
Hours per Unit of Service
– Assume each dot is a
department
– Lower Hours per UoS
indicates better
productivity performance
3
2.5
50th percentile
2
25th percentile
1.5
1
0.5
53
0
Best percentile
Summary
• Create and interpret PLUS reports
• Habitually conduct daily edits
• Appreciate the power of benchmarking
• Create a schedule using varying shifts
• Know when and how to flex staff
• Minimize use of Overtime and Contract Labor
• Differentiate between “Core” and “Peak”
• Use FPC in PLUS as your hiring plan
• Submit requests
• Comprehend basic units of productivity
• Know how standards are determined
• Understand how standards are used
54
Monitoring &
Controlling
Scheduling &
Staffing
Flexible Position Control
(FPC)
Developing Standards




Quality Metrics

Clinical Process and Outcome Measures









HCAHPS
ED
OP Test & Treatment
OPS

Risk Management

Risk Metric Summary

Claim Summary

Risk-Reduction Program
Operational Improvement

Patient Safety / Infection Prevention






55
AMI, HF, PN (parenteral nutrition), SCIP (Surgical Care
Improvement Project), Stroke,
VTE (venous thromboembolism)
Mortality & Complication Index
CABG / Stent Mortality & Complications
30-day Readmission Rate
Patient Experience Results


HAC (hospital acquired condition)
VAPS (ventilator associated pneumonia)
CLABSI (central line administered blood stream infection)
Falls
Pt and Medication Scan Rate
Flu-Shot Tracking

ED

ED Arrival to Bed

ED Arrival to Leave

LPT/LPMSE Rate

ED Hold Hours
Surgical Services

OR Dashboard

Surgical Services Playbook Progress
Basic labor definitions
& Calculations
Unit of Service (UOS)
Facility #1
Dpt #
Dpt. Description
___
Clinical Dept Total
August _ _, 2013 MTD Actual
Wkd.
MH/Stat
UOS
Pd.
MH/Stat
OT %
Salaries/
Contract %
UOS
#VALUE!
#VALUE!
Medical-Surgical
37
7.22
8.69
6.8%
13.8%
211.35
Medical-Surgical
41
7.28
8.22
5.5%
13.6%
203.09
Medical-Surgical
21
7.61
8.71
6.1%
1.3%
194.22
Obstetrics & Gynecology
19
6.97
8.93
2.0%
5.4%
212.21
Newborn Nursery - Level I
9
3.09
3.09
13.7%
0.0%
105.97
Progressive Care/Telemetry
22
9.96
11.40
8.1%
6.0%
272.59
Progressive Care/Telemetry
34
8.59
10.10
8.3%
7.6%
259.40
Medical Intensive Care
13
14.24
15.98
3.2%
12.3%
464.96
Surgical Intensive Care
16
15.44
18.12
5.5%
8.0%
601.63
Cardiovascular ICU
26
9.87
11.35
8.1%
0.3%
264.32
A quantity by which workload can be measured— aka
Statistic
Units of Service

Nursing Departments
Patient and Observation Days

Dialysis Treatment Center
Dialysis Treatments

Respiratory Therapy
Relative Value Units

Delivery Room
Deliveries

Operating Room
Minutes of Surgery

Outpatient Surgery
Visits

OR Sterile Processing
Minutes of Surgery

Cath Lab
Billed Procedures

Post Anesthesia Care
Minutes of Recovery

Emergency Department
Visits

Endoscopy
Billed Procedures

Laboratory
Billed Tests

Non-invasive Cardiology
Billed Procedures

Vascular Lab
Billed Procedures

TOTAL IMAGING
Billed Procedures

Cancer Treatment Center
Billed Procedures

Pharmacy
Billed Doses

Physical Rehab
Relative Value Units
Units of Service

Administration General
Total Patient and Observation Days

Nursing Administration
Total Patient and Observation Days

Case Management
Total Patient and Observation Days

In-service Education
Total Patient and Observation Days

Plant Ops & Maintenance
Total Patient and Observation Days

Biomedical Engineering
Total Patient and Observation Days

Security Services
Total Patient and Observation Days

General Accounting
Total Patient and Observation Days

Business Development/Marketing
Total Patient and Observation Days

Infection Control
Total Patient and Observation Days

Quality Management
Total Patient and Observation Days

Housekeeping
Cleanable Square Footage

Transportation Services
Adjusted Patient Days

Central Supply/Materials Management
Adjusted Patient Days

Community Health/Outreach
Adjusted Patient Days

Administration Medical Staff
Adjusted Patient Days

Information Services
Adjusted Patient Days

Communications/PBX
Adjusted Patient Days

Research Clinical Trials
Adjusted Patient Days
Units of Service

Admitting & Registration
Registrations

Medical Records
Registrations

Dietary Services
Meal Equivalents

Pastoral Care
Calendar Days

Volunteers
Calendar Days

Human Resources/Employee Benefits
Employed FTEs

Patient Accounting
Accounts Open/Worked

Transcription
Lines Transcribed
WHAT DOES “PER STAT” MEAN?
Review the various metrics on the Labor Variance Rpt
Worked Manhours per Stat
Daily Labor Variance Report
Facility #1
Dpt #
Dpt. Description
___
Clinical Dept Total
August _ _, 2013 MTD Actual
Wkd.
MH/Stat
UOS
Pd.
MH/Stat
OT %
Contract %
#VALUE!
Salaries/
UOS
#VALUE!
Medical-Surgical
37
7.22
8.69
6.8%
13.8%
211.35
Medical-Surgical
41
7.28
8.22
5.5%
13.6%
203.09
Medical-Surgical
21
7.61
8.71
6.1%
1.3%
194.22
Obstetrics & Gynecology
19
6.97
8.93
2.0%
5.4%
212.21
Newborn Nursery - Level I
9
3.09
3.09
13.7%
0.0%
105.97
Progressive Care/Telemetry
22
9.96
11.40
8.1%
6.0%
272.59
Progressive Care/Telemetry
34
8.59
10.10
8.3%
7.6%
259.40
Medical Intensive Care
13
14.24
15.98
3.2%
12.3%
464.96
Surgical Intensive Care
16
15.44
18.12
5.5%
8.0%
601.63
Cardiovascular ICU
26
9.87
11.35
8.1%
0.3%
264.32
Number of Worked Hours per Statistic—aka Worked
Hours Per UOS / Stat
Worked Hours per Stat
 Worked Hours per Stat =
Total Worked Hours/Total Units of Service
 Application:
If a department has 1000 Worked Hours with a total of 100
Patient Days, what is the Worked Hours per Stat?
If a department has a Worked Hours per Stat budget of 10.00
with a total of 10 Patients, how many Staffing Hours does the
department have?
Paid Manhours per Stat
Facility #1
Dpt #
Dpt. Description
___
Clinical Dept Total
August _ _, 2013 MTD Actual
Wkd.
MH/Stat
UOS
Pd.
MH/Stat
OT %
Salaries/
Contract %
UOS
#VALUE!
#VALUE!
Medical-Surgical
37
7.22
8.69
6.8%
13.8%
211.35
Medical-Surgical
41
7.28
8.22
5.5%
13.6%
203.09
Medical-Surgical
21
7.61
8.71
6.1%
1.3%
194.22
Obstetrics & Gynecology
19
6.97
8.93
2.0%
5.4%
212.21
Newborn Nursery - Level I
9
3.09
3.09
13.7%
0.0%
105.97
Progressive Care/Telemetry
22
9.96
11.40
8.1%
6.0%
272.59
Progressive Care/Telemetry
34
8.59
10.10
8.3%
7.6%
259.40
Medical Intensive Care
13
14.24
15.98
3.2%
12.3%
464.96
Surgical Intensive Care
16
15.44
18.12
5.5%
8.0%
601.63
Cardiovascular ICU
26
9.87
11.35
8.1%
0.3%
264.32
Number of Paid Hours per Statistic—aka Manhours
Per UOS / Stat
OT %
Facility #1
Dpt #
Dpt. Description
851
Clinical Dept Total
August _ _, 2013 MTD Actual
Wkd.
MH/Stat
UOS
Pd.
MH/Stat
OT %
Salaries/
Contract %
UOS
#VALUE!
#VALUE!
Medical-Surgical
37
7.22
8.69
6.8%
13.8%
211.35
Medical-Surgical
41
7.28
8.22
5.5%
13.6%
203.09
Medical-Surgical
21
7.61
8.71
6.1%
1.3%
194.22
Obstetrics & Gynecology
19
6.97
8.93
2.0%
5.4%
212.21
Newborn Nursery - Level I
9
3.09
3.09
13.7%
0.0%
105.97
Progressive Care/Telemetry
22
9.96
11.40
8.1%
6.0%
272.59
Progressive Care/Telemetry
34
8.59
10.10
8.3%
7.6%
259.40
Medical Intensive Care
13
14.24
15.98
3.2%
12.3%
464.96
Surgical Intensive Care
16
15.44
18.12
5.5%
8.0%
601.63
Cardiovascular ICU
26
9.87
11.35
8.1%
0.3%
264.32
% of Total Paid Hours that are Overtime
Contract
%
Facility #1
Dpt #
Dpt. Description
___
Clinical Dept Total
August _ _, 2013 MTD Actual
Wkd.
MH/Stat
UOS
Pd.
MH/Stat
OT %
Salaries/
Contract %
UOS
#VALUE!
#VALUE!
Medical-Surgical
37
7.22
8.69
6.8%
13.8%
211.35
Medical-Surgical
41
7.28
8.22
5.5%
13.6%
203.09
Medical-Surgical
21
7.61
8.71
6.1%
1.3%
194.22
Obstetrics & Gynecology
19
6.97
8.93
2.0%
5.4%
212.21
Newborn Nursery - Level I
9
3.09
3.09
13.7%
0.0%
105.97
Progressive Care/Telemetry
22
9.96
11.40
8.1%
6.0%
272.59
Progressive Care/Telemetry
34
8.59
10.10
8.3%
7.6%
259.40
Medical Intensive Care
13
14.24
15.98
3.2%
12.3%
464.96
Surgical Intensive Care
16
15.44
18.12
5.5%
8.0%
601.63
Cardiovascular ICU
26
9.87
11.35
8.1%
0.3%
264.32
% of Total Paid Hours that are Contract
Salaries
per
Unit
of
Service
Facility #1
August _ _, 2013 MTD Actual
Dpt #
Dpt. Description
___
Clinical Dept Total
Wkd.
MH/Stat
UOS
Pd.
MH/Stat
OT %
Salaries/
Contract %
UOS
#VALUE!
#VALUE!
Medical-Surgical
37
7.22
8.69
6.8%
13.8%
211.35
Medical-Surgical
41
7.28
8.22
5.5%
13.6%
203.09
Medical-Surgical
21
7.61
8.71
6.1%
1.3%
194.22
Obstetrics & Gynecology
19
6.97
8.93
2.0%
5.4%
212.21
Newborn Nursery - Level I
9
3.09
3.09
13.7%
0.0%
105.97
Progressive Care/Telemetry
22
9.96
11.40
8.1%
6.0%
272.59
Progressive Care/Telemetry
34
8.59
10.10
8.3%
7.6%
259.40
Medical Intensive Care
13
14.24
15.98
3.2%
12.3%
464.96
Surgical Intensive Care
16
15.44
18.12
5.5%
8.0%
601.63
Cardiovascular ICU
26
9.87
11.35
8.1%
0.3%
264.32
Total Salary Cost per Unit of Service—aka Salary
Cost Per UOS / Stat
Salary Cost per UOS
 Salary Cost per UOS =
Total Salary Cost/Total Units of Service
If a department has $100,000 in Salary Cost with a total of
1000 Patient Days, what is the Salary Cost per UOS?
Budget
Information
Hospital
Dpt #
Dpt. Description
___
Clinical Dept Total
August 2013 Budget
Wkd.
MH/Stat
UOS
Pd.
MH/Stat
OT %
271,433.36
3.23
Salaries/
Contract %
UOS
569.01
Medical-Surgical
29
7.66
9.20
5.5%
11.5%
233.52
Medical-Surgical
36
7.40
8.52
3.3%
12.3%
215.06
Medical-Surgical
20
7.70
8.74
6.3%
0.9%
197.37
Obstetrics & Gynecology
23
7.30
9.11
3.0%
0.0%
212.70
Newborn Nursery - Level I
14
4.67
6.57
7.2%
0.0%
187.50
Progressive Care/Telemetry
22
9.67
11.25
4.5%
8.2%
295.57
Progressive Care/Telemetry
43
9.12
10.34
7.7%
4.7%
257.24
Medical Intensive Care
15
14.80
16.98
0.0%
5.9%
506.32
Surgical Intensive Care
16
15.15
16.92
6.4%
6.9%
570.54
Cardiovascular ICU
27
10.00
11.62
7.9%
0.7%
306.63
The budget sets the standard
Department Variance
Hospital
Dpt #
Dpt. Description
___
Clinical Dept Total
DEPT VARIANCE [FAVORABLE/ (UNFAVORABLE)]
UOS (unf)
Wkd. FTEs
(unf)
OT FTEs
Pd. FTEs (unf)
(unf)
Contract
FTEs (unf)
50.14
47.59
(13.03)
(7.08)
Salaries/
UOS (unf)
Medical-Surgical
8
2.82
3.30
(0.73)
(1.25)
22.17
Medical-Surgical
5
0.85
2.17
(1.29)
(0.80)
11.97
Medical-Surgical
0
0.32
0.09
0.08
(0.14)
3.15
Obstetrics & Gynecology
(4)
1.08
0.60
0.28
(1.58)
0.49
Newborn Nursery - Level I
(4)
2.60
5.72
(0.33)
-
81.53
Progressive Care/Telemetry
(0)
(1.10)
(0.57)
(1.56)
0.96
22.98
Progressive Care/Telemetry
(8)
3.21
1.39
(0.33)
(1.73)
(2.16)
Medical Intensive Care
(2)
1.28
2.28
(1.18)
(2.32)
41.36
Surgical Intensive Care
0
(0.83)
(3.42)
0.50
(0.53)
(31.09)
Cardiovascular ICU
(1)
0.59
1.22
(0.09)
0.22
42.31
Salary & Wage Variance to
Target
Hospital
Dpt #
Dpt. Description
___
Clinical Dept Total
MTD
PRIOR WEEK: _ _/_ _/_ _
Proir Week SW
Var to Target
SW Var to Target
% Variance
(Based on
Prior Week
(Based on Salary Unfavorable $
From
Salary
% Variance
Cost/Stat Var)
Variance
Budget
Cost/Stat Var) From Budget
103,183.49
(37,955.80)
Medical-Surgical
12,282.36
0.00
12.13%
6,058.34
11.71%
Medical-Surgical
7,421.74
0.00
6.31%
4,459.76
8.36%
Medical-Surgical
973.59
0.00
1.63%
1,049.35
4.30%
Obstetrics & Gynecology
135.89
0.00
0.19%
(2,360.12)
-9.94%
Newborn Nursery - Level I
11,495.60
0.00
29.47%
9,280.74
87.76%
Progressive Care/Telemetry
7,470.05
0.00
7.72%
4,863.46
12.66%
Progressive Care/Telemetry
(1,112.70)
(1,112.70)
-0.68%
(2,536.43)
-4.79%
Medical Intensive Care
8,105.72
0.00
7.04%
(2,762.24)
-6.96%
Surgical Intensive Care
(7,586.26)
(7,586.26)
-5.51%
(5,798.53)
-10.41%
Cardiovascular ICU
16,331.29
0.00
13.04%
1,874.62
3.96%
Month-to-Date Salary Cost Variance
30,740.23
Unfavorable $ Variance
Hospital
Dpt #
Dpt. Description
___
Clinical Dept Total
MTD
PRIOR WEEK: _ _/_ _/_ _
Proir Week SW
Var to Target
SW Var to Target
% Variance
(Based on
Prior Week
(Based on Salary Unfavorable $
From
Salary
% Variance
Cost/Stat Var)
Variance
Budget
Cost/Stat Var) From Budget
103,183.49
(37,955.80)
30,740.23
Medical-Surgical
12,282.36
0.00
12.13%
6,058.34
11.71%
Medical-Surgical
7,421.74
0.00
6.31%
4,459.76
8.36%
Medical-Surgical
973.59
0.00
1.63%
1,049.35
4.30%
Obstetrics & Gynecology
135.89
0.00
0.19%
(2,360.12)
-9.94%
Newborn Nursery - Level I
11,495.60
0.00
29.47%
9,280.74
87.76%
Progressive Care/Telemetry
7,470.05
0.00
7.72%
4,863.46
12.66%
Progressive Care/Telemetry
(1,112.70)
(1,112.70)
-0.68%
(2,536.43)
-4.79%
Medical Intensive Care
8,105.72
0.00
7.04%
(2,762.24)
-6.96%
Surgical Intensive Care
(7,586.26)
(7,586.26)
-5.51%
(5,798.53)
-10.41%
Cardiovascular ICU
16,331.29
0.00
13.04%
1,874.62
3.96%
Departments with Negative Salary Variances
% Variance from Budget
Hospital
Dpt #
Dpt. Description
___
Clinical Dept Total
MTD
PRIOR WEEK: _ _/_ _/_ _
Proir Week SW
Var to Target
SW Var to Target
% Variance
(Based on
Prior Week
(Based on Salary Unfavorable $
From
Salary
% Variance
Cost/Stat Var)
Variance
Budget
Cost/Stat Var) From Budget
103,183.49
(37,955.80)
30,740.23
Medical-Surgical
12,282.36
0.00
12.13%
6,058.34
11.71%
Medical-Surgical
7,421.74
0.00
6.31%
4,459.76
8.36%
Medical-Surgical
973.59
0.00
1.63%
1,049.35
4.30%
Obstetrics & Gynecology
135.89
0.00
0.19%
(2,360.12)
-9.94%
Newborn Nursery - Level I
11,495.60
0.00
29.47%
9,280.74
87.76%
Progressive Care/Telemetry
7,470.05
0.00
7.72%
4,863.46
12.66%
Progressive Care/Telemetry
(1,112.70)
(1,112.70)
-0.68%
(2,536.43)
-4.79%
Medical Intensive Care
8,105.72
0.00
7.04%
(2,762.24)
-6.96%
Surgical Intensive Care
(7,586.26)
(7,586.26)
-5.51%
(5,798.53)
-10.41%
Cardiovascular ICU
16,331.29
0.00
13.04%
1,874.62
3.96%
% of Salary Cost Variance from Budget
Prior Week: Salary & Wage
Variance to Target
Hospital
Dpt #
Dpt. Description
___
Clinical Dept Total
MTD
PRIOR WEEK: _ _/_ _/_ _
Proir Week SW
Var to Target
SW Var to Target
% Variance
(Based on
Prior Week
(Based on Salary Unfavorable $
From
Salary
% Variance
Cost/Stat Var)
Variance
Budget
Cost/Stat Var) From Budget
103,183.49
(37,955.80)
30,740.23
Medical-Surgical
12,282.36
0.00
12.13%
6,058.34
11.71%
Medical-Surgical
7,421.74
0.00
6.31%
4,459.76
8.36%
Medical-Surgical
973.59
0.00
1.63%
1,049.35
4.30%
Obstetrics & Gynecology
135.89
0.00
0.19%
(2,360.12)
-9.94%
Newborn Nursery - Level I
11,495.60
0.00
29.47%
9,280.74
87.76%
Progressive Care/Telemetry
7,470.05
0.00
7.72%
4,863.46
12.66%
Progressive Care/Telemetry
(1,112.70)
(1,112.70)
-0.68%
(2,536.43)
-4.79%
Medical Intensive Care
8,105.72
0.00
7.04%
(2,762.24)
-6.96%
Surgical Intensive Care
(7,586.26)
(7,586.26)
-5.51%
(5,798.53)
-10.41%
Cardiovascular ICU
16,331.29
0.00
13.04%
1,874.62
3.96%
Prior Week: Month-to-Date Salary Cost Variance
Prior Week: % Variance from
Budget
Hospital
Dpt #
Dpt. Description
___
Clinical Dept Total
MTD
PRIOR WEEK: _ _/_ _/_ _
Proir Week SW
Var to Target
SW Var to Target
% Variance
(Based on
Prior Week
(Based on Salary Unfavorable $
From
Salary
% Variance
Cost/Stat Var)
Variance
Budget
Cost/Stat Var) From Budget
103,183.49
(37,955.80)
30,740.23
Medical-Surgical
12,282.36
0.00
12.13%
6,058.34
11.71%
Medical-Surgical
7,421.74
0.00
6.31%
4,459.76
8.36%
Medical-Surgical
973.59
0.00
1.63%
1,049.35
4.30%
Obstetrics & Gynecology
135.89
0.00
0.19%
(2,360.12)
-9.94%
Newborn Nursery - Level I
11,495.60
0.00
29.47%
9,280.74
87.76%
Progressive Care/Telemetry
7,470.05
0.00
7.72%
4,863.46
12.66%
Progressive Care/Telemetry
(1,112.70)
(1,112.70)
-0.68%
(2,536.43)
-4.79%
Medical Intensive Care
8,105.72
0.00
7.04%
(2,762.24)
-6.96%
Surgical Intensive Care
(7,586.26)
(7,586.26)
-5.51%
(5,798.53)
-10.41%
Cardiovascular ICU
16,331.29
0.00
13.04%
1,874.62
3.96%
Prior Week: % of Salary Cost Variance from Budget
Daily Productivity Trend
 Focused mainly on the management of actual hours
 Worked Hours
 Paid Hours
 Agency Hours
 Provides trended view of hours used during a given pay
period
 Allows one to see improvements or failures in labor resource
management from day to day
Daily Productivity Trend
UOS (Unit of Service)
Worked Hrs
Paid Hrs
Salary Cost Per Stat
Avgas Hrly Rate
Agency / Contract Hrs & %
Overtime Hrs & %
Orientation Hrs & %
Daily Productivity Trend
•Totals hours used for Pay Period
•Total hours used in prior Pay Period
•Total hours used month to date

similar documents