Debra Welk

In February of 2010, Immanuel Communities, a longtime leader in senior housing in Nebraska that includes assisted living retirement communities on five campuses, partnered with a healthcare labor management consulting and technology company in an effort to transform their approach to managing staff resources to enhance their ability to provide consistent, quality care.

To accomplish this, Immanuel Communities adopted workforce management best practices and technology solutions used by many leading organizations in the inpatient and acute care sector for nearly a decade, but until recently have not been found in assisted/senior living.

Initiatives Implemented

Immanuel Communities, with the help of their consulting and technology partner, Avantas, implemented HELMTM, a proprietary set of solutions that combines and embeds the science of workforce planning and operational best practices into a highly customizable healthcare scheduling and productivity solution. This strategy takes an enterprise approach to managing resources with the purpose of establishing:

  • A strategic approach to managing staff resources
  • A culture of transparency around staffing strategies
  • The right mix of core and contingency staff resources (to reduce reliance on agency and overtime utilization) 

These initiatives were implemented to accomplish four things:

  • Increase resident satisfaction
  • Uncover financial savings
  • Increase staff satisfaction among their 100 team members
  • Decrease time managers spend in staffing-related processes

Enterprise Labor Management

An enterprise approach to managing resources provides a 30,000-foot view of the collective communities, providing an effective way of identifying and filling staffing needs across all communities.

This strategy necessitates an organizational commitment to transparency, uniform policies and practices, and a willingness to coordinate staffing resources with a centralized resource management center (RMC). The RMC handles the majority of the administrative duties in addition to coordinating and deploying staff, removing cumbersome and time-consuming tasks from the shoulders of nurse managers, allowing them more time to care for residents and mentor staff.

Scheduling and Productivity Tools

The scheduling tool Immanuel Communities implemented, Smart Square, was developed initially for inpatient nursing units but has since been adapted to work effectively in virtually every type of environment, from senior living to ancillary departments within hospitals as well as outpatient medical groups/practices.

Unlike inpatient nursing units, where patient levels continually fluctuate and thus affect the number and types of staff needed on a shift-by-shift basis, senior living communities have a relatively steady number of residents and have fixed staffing needs. While senior living communities do not experience the same ebb and flow as inpatient nursing units, they benefit greatly from the same type of scheduling and business intelligence tools.

The scheduling tool allows Immanuel Communities’ staff to view their schedules online, submit paperless requests, and pick up open shifts from anywhere at anytime. Managers benefit from the 24/7 access as well. Managing trade and time-off requests take a fraction of the time they once did. The scheduling system shows the manager the submitted request and the outcome if the trade is approved. If the outcome would result in a hole in the schedule the manager can clearly see it and elect, if she chooses, to deny it. Otherwise, the open shift will be posted immediately for other qualified staff to pick up. Additionally, RMC personnel are automatically alerted of the upcoming open shift and can begin proactive recruitment to fill the need.  

Immanuel Communities’ managers had reported spending nearly 70% of their time in staffing-related activities. Since the implementation of the scheduling tool, this has been reduced to 30 minutes per week.

Continuity of Care = Resident Satisfaction

The leadership at Immanuel Communities understands that resident satisfaction is closely tied to consistent staffing.

In the past, Immanuel Communities would respond to holes in the schedule due to ill calls, FTE vacancy, etc., by utilizing agency staff. While this staffing source is reliable and provides appropriate care, they are not always aligned with a community’s culture and the residents at each location. Residents at assisted living communities and their families take comfort in knowing their care providers and are happiest when they are cared for by the staff members with whom they have a relationship.

The establishment of effective open shift management tools and proactive recruiting has allowed Immanuel Communities to reduce the amount of outside agency labor, saving $128,000 over three years. 

Controlling the Controllable in a Challenging Environment

The Affordable Care Act provides both benefits and challenges to long-term care and assisted living facilities. While the long-term repercussions will not be fully understood for some time, organizations must do what they can now to manage expenses and implement effective and sustainable plans to provide high quality care in a comforting and predictable environment. The implementation of tailored, best-practice workforce strategies and tools is one step that has proven highly impactful.

Debra Welk, above, is the vice president of healthcare services, Home Office, at Immanuel Communities. Jackie Larson, left, is the senior vice president of client services at Avantas.