It is no secret that the COVID-19 pandemic made a profound impact on the healthcare industry, especially its workforce. Healthcare systems across the country struggled with addressing critical staffing needs in key operational departments, which contributed to employee burnout and dissatisfaction. Something had to be done to address the employee shortages and alleviate the burden it was causing on existing colleagues.
At Hartford HealthCare, we developed a Regional Operations Command Center to combat these vacancies and ensure adequate staffing and support to various departments during the height of the pandemic. However, we understood that this was not a sustainable solution as we slowly returned to pre-pandemic operations. We began looking ahead to see how we could increase staffing as part of a long-term strategy. Our focus turned to developing an internal staffing agency to focus on the departments of Food and Nutrition (dietary), Environmental Services (housekeeping) and Transport. To give you an idea of what we were up against, these departments saw a turnover rate of about 35% nationally. Here’s a breakdown of how we operationally addressed this issue with what we call a general operations associate.
Development
We needed a budget-neutral solution that would address the problem at hand. The team evaluated roles that had similar salary ranges and skills that could be transferrable between departments. Strong collaborative planning between operations leaders and department heads spearheaded the development. We also needed to find an incentive for employees to be cross-trained in multiple departments.
Job Description Development
A generic job description was developed to encompass the three departments, incorporating job codes from Environmental Services, Food and Nutrition and Transport. The work in Environmental Services includes cleaning and disinfecting inpatient rooms, the Emergency Department, operating rooms and public areas. In Food and Nutrition, the duties include taking patient orders, food prep, delivering patient trays, and a variety of different roles within the cafeteria and catering operations. When a general operations associate is working in transport, their key duties include transporting patients through the hospital as well as assisting in discharging patients. A partnership with Talent Acquisition/Human Resources was pivotal in the development of the operational structure.
Compensation Development
Leaders partnered with Hartford HealthCare’s experts from Human Resources and compensation to define adequate salary ranges. It was determined early in the discussions that the wage had to be competitive to attract top talent and provide an opportunity to those seeking healthcare careers. An additional component of pay was evaluated and agreed upon based on skill sets and flexibility to work in multiple departments.
Training and Continuing Education
To develop a team of productive staff, the three departments outlined their standard onboarding processes. A risk assessment was completed, and a defined number of working hours was established for each department with a subject matter expert overseeing monthly evaluation of performance. This provided management and staff with confidence that the individual was performing at the highest level. Departmental competencies and ongoing supervision from both the department and the internal staffing agency were critical to long-term sustainability and success.
Implementation
Our general operations associate role was admittedly met with resistance due to concerns with the competency of staff and the long-term sustainability of the budget-neutral position. Additionally, the HHC system had a heightened awareness around financial performance due to the impacts of COVID-19. Therefore, the role in the internal staffing agency was created without adding unbudgeted full-time employees. Once executive leadership approved the GOA role, positions were opened at acute care facilities within HHC and we saw an immediate influx of candidates. The manager of the internal staffing agency partnered with departmental leaders to conduct interviews and onboard candidates who fit within the HHC culture.
Outcomes
The immediate impact of the general operations associate brought relief to departments, especially covering off-shifts, evenings and weekends. Since go-live in August 2022, the internal staffing agency on average has covered over 1,100 hours a month, which if left unfilled would have resulted in vacancies or overtime. As a result, departments reduced their overtime spend by 13.5% after implementation. Departments also saw a significant reduction in call-outs due to staff burnout. As a result, our employee engagement survey participation increased by 22% and the overall employee satisfaction mean score increased since inception by .04%.
Feedback
The feedback from leadership has been extremely favorable. The managers of Food and Nutrition at The Hospital of Central Connecticut and MidState Medical Center had this to say about the use of general operations associates:
- The Hospital of Central Connecticut
“The general operations associates have been a huge help filling holes in our schedule and taken an immense burden of our full-time and part-time staff. Without them, I would’ve had to work as an hourly associate or continue to put burden on the limited staff we had to pick up extra shifts and hours.”
- MidState Medical Center
“As far as our department is concerned, the general operations associates have been life savers.”
Next Steps
A continued focus on competency and sustainability will highlight the advancement of the general operations associate. Efforts are underway to develop a similar model in the clinical space, which includes pharmacy, nursing and lab.
Garrett C. Havican, FACHE, is president, Hartford Healthcare Central Region. Rev. Kristoffer Popovitch is senior director, Operations, Hartford Healthcare Central Region. Robert M. Weiss is regional business operations manager, Hartford Healthcare Central Region. If you’re interested in learning more or have any questions about the general operations associate role, please reach out to Robert.Weiss@hhchealth.org.