Nursing homes that prioritize building schedules around part-time workers can significantly improve consistency of care by potentially reducing how many nursing assistants care for each resident.
Adopting improved scheduling tactics can lessen the number of staff whom residents interact with by up to 30% a month, researchers at Carnegie Mellon and Cornell universities reported this week in Manufacturing & Service Operations Management.
Their study examined rosters from more than 15,000 shifts at three mid-Atlantic nursing homes. Co-authors Alan A. Scheller-Wolf and Vincent W. Slaugh found that facilities often routinely assigned full-time workers to the same unit, and then used part-time workers to fill gaps. But the researchers’ mathematical review determined that consistently assigning part-time workers and having some flexible full-time workers made for more consistent resident care.
“Flexibility among full-time workers helps because their higher work frequency tends to make a reassignment away from their home unit contribute less to inconsistency,” the authors wrote. Investigators noted that even if moved occasionally, the full-time staff could still likely work multiple shifts in a single unit over a relatively short period of time.
While consistency of care has long been associated with better outcomes in nursing homes, it has become an area of greater concern during the pandemic. Limiting the number of staff caring for any one resident can bolster infection control efforts; in cases involving part-time or contract workers who work at multiple healthcare facilities, it may also reduce the potential of infection from other nursing homes.
Consistency of care is also associated with the patient-centered care movement and resident dignity, and promoted in official messaging by the Centers for Medicare & Medicaid Services, the study noted.
“Our findings are relevant to the daily staffing practices of more than 15,600 nursing homes in the United States, especially for the more labor-intensive nursing assistant role, but also for nursing roles,” Scheller-Wolf, professor of operations management at Carnegie Mellon’s Tepper School of Business, said in a press release accompanying publication.
“We find that relatively simple changes in how facilities schedule workers can have a significant impact on consistency of care, which also should improve quality of care, and the satisfaction of residents, their families, and staff,” he added.
In the paper, Scheller-Wolf and Slaugh noted that nursing home managers who provided historical rosters said that staffing inconsistency ranked among the “most frequent complaints” from residents and their families.
“The insights from our analysis offer a simple, cost-free solution to improve quality of life for both residents and caregivers,” said Slaugh, assistant professor of operations management at Cornell’s S.C. Johnson College of Business. “Nursing homes that use more part-time and contract workers due to the labor shortage can use these insights to improve the experience of those workers.”
