Healthcare Staffing: Telemonitoring Nurse

• Mass General Brigham revised it's mission, developing goals for quality and cost-effectiveness in patient care, especially for diabetes, heart attack, stroke, and colorectal cancer through technology.

• Managers had to staff, planning for job requirements like telemonitoring nurses, and determining the number needed.

• Jobs were organized and designed by identifying tasks, responsibilities, authority, and qualifications.

• The telemonitoring nurse job was responsible for monitoring vital signs via telehealth, responding to anomalies, and guiding patients through heart education.

• Managers then needed to recruit applicants and select candidates based on specific criteria.

• Careful selection of telemonitoring nurses was crucial as some prefer bedside care over monitor-based work.

• The final step involved preparing job offers with compensation, starting dates, and other essential information.

• The staffing function helps progress toward patient care goals.

• Healthcare organization (HCO) managers are required to obtain and retain people to do the work to achieve the HCO's goals.

• Staffing is the third of the five fundamental management functions, defined as securing and retaining staff.

• Previous planning and organizing considers workers, jobs, positions and staff.

• Chapters 7 and 8 explain how management staff their organizations through a variety of management roles i.e monitors, entrepreneurs, disturbance handlers, resource allocators and negotiators.

• Effective staffing is essential for HCOS's strategic success,

• Healthcare is a service performed by people: staff, workers, employees, associates, teammates, and human resources

• Even with advanced equipment, people are needed operate them and management itself requires personnel and thus managers must excel at staffing

• Many organizations state employees are their "greatest asset"

• Many HCOs however have struggles obtaining and retaining employees

• Chapters 7 and 8 identify the staffing process and examines concerns

• There are seven staffing processes, explained in depth, the first three in this chapter focus on obtaining workers, where as next chapter focuses on retention

• Chapters 7 and 8 will assist people to prepare for staff management

• The staffing of some HCOs includes jobs performed by physicians and other licensed independent practitioners (e.g., dentists, podiatrists, and nurse practitioners, the application of the staffing process does not cover physicians

Staffing Processes

• The management staffing function entails 7 processes i.e. (French 2007; Fried 2021; McConnell 2018; Newman and Fottler 2021):
• Planning for staff: forecasting future workforce and planning to obtain and retain staff
• Designing jobs and work: determining tasks, qualifications, supervision, conditions, rules, and schedules.Determining work
• Hiring staff: recruiting and selecting, potentially reassigning existing workers through promotion or transfer
• Developing staff: helping employees gain new knowledge, skills, attitudes, behaviors, and competencies for current and future jobs.
• Appraising performance: evaluating workers' job performance and discussing evaluations.
• Compensating staff: determining and giving wages, salaries, incentives, benefits, and rewards.
• Protecting staff: ensuring safe work conditions, worker's rights, well being are all protected, and manager are considerate of opinions.
• The first 3 staffing processes helps one get in the door for work, latter 4 maintain staff.
• The seven staffing processes all interrelate and effect each other
• This work includes, staff diversity, equity, and inclusion; centralized, decentralized and outsourced staffing; and laws and regulations

COVID-19

• The COVID-19 pandemic has severely affected staffing in HCOs, through changing mandates, guidelines, and rules
• Frontline healthcare workers in the US experienced;
• 62% increased stress and worry and primary worry for family members.
• 56% trouble sleeping
  • 56% hospital over capacity for critical patient ICU beds
  • 34% of worker's experienced PPE shortages
• employers falling short on giving additional pay for high risk situations
  - 55% burned out and 70% for 18-29 age group
• Exhausted workers are retiring early and resigning from external healthcare
• Land (2021) explains HCO leader's neglect of healthcare worker health, COVID-19 pandemic accelerated the issues, affecting entire workforce.

Workforce Diversity, Equity, and Inclusion

• Diversity includes differences that encompass internal dimensions as gender, race, ethnicity, and external dimension such as religion, nationality (Boston College Office for Institutional Diversity 2022).
• A diverse workforce improves organization performance, population health, patient experience, community relationships with the patient's ethnic group.
• HCOS open to diverse workforces are receiving larger supply of labor to hire.
• Higher ethnic and cultural diversity is 35 percent more likely to perform then industry averages.
• A wider range of ideas and innovations broadens outlook for management and decision makers towards diversity
• Diversity creates conflict, avoidance of coworkers, less teamwork, biased decisions, illegal actions, and other negative outcomes if diversity is not valued
• Health diversity equity, and inclusion are all aided by The Institute for Diversity and Health Equity (IFDHE),

Inclusion

• Inclusion involves ensuring HCOs maintain fairness and justice with equity, includes gender, racial, age towards all characteristics.
• Inclusion actively engages diversity, which each person value respects and supports to create fulfillment an participation
• It is important for organizations to become more diverse, equitable, and inclusive, by using tools, methods and processes

Generations

• US demographics have increased workforce diversity based on age and generation (baby boomers, Generation X, millennials (Generation Y), and Generation Z and possibly traditionalists
• Generations have important differences in opinions and lifestyle and is important to adapt to staffing
• There is not a one size fits all compensation plan or work schedule plan with diverse generations of workers

Centralized, Decentralized, and Outsourced Staffing

• Top managers need to decide if staffing will be 100% internally or potentially outsourced to external companies
• Centralized human resources (HR) staffing specialists as well as decentralized line managers throughout each organization
• Large staffing performs tasks to advice, tools, systems for procedures
• Line managers are partially responsible for staffing
• Centralized HR department makes staffing for all managers to use throughout the HCO like;
  • onboarding program
  • social media approach to recruit
  • performance evaluation rubric
• AI tools and information systems further supported information
• An HR tools can
  • identify approved positions
  • track applicants
  • measuring DEI
  • manage compensation
  • identifies when appraisals are due - tracks employee safety problems
• Centralized HR gives HCOS methods, systems needed

Laws and Regulations

Greatly dictates how managers recruit, interview etc based on laws, court decisions and regulations and licensing.

• Governments may pass laws to strenthen / weaken enforcements or change labor / state laws
• Managers should train and stay educating themselves about the legal aspects of staffing consulting and the HCO

Planning for Staff

• First staffing process involves recalling strategic planning an mission and implementation plans

1. Forecast future required staff
2. Plan how to obtain and retain workforce That should be a breakdown of total workers, skilled workers and their role in the the strategic vision Factors to consider are as follows;
   • Worker expected turn over
   • Retirments
   • Resignations
   • Promotions
   • Transfers and other transititions There are disruptive complications in the forecast as COVID-19 alters;

• How jobs will be performed
  • Virtual vs in person
  • Task done using robots vs workers Second, managers need to plan out how to retain and obtain workers through a "SWOT analysis" Strength Weakness, oppurtunies and threats to examine the following
  • Competitive wages funds, diverse workforce
  • changes to labor laws, availability, demands, labor enrollment changes vs diversity
  • COVID impacts on workforce etc To better retain staff consider their following concerns;
  • Offer more local clinicals from local colleges
  • Improve hiring procedure
  • which benefits help maintain current generations

Staffing may involve - job designing and centralization - Decenterlize hiring - compassionate supervisors - revissals to do self evaluations - revising policy for paid days - diversity celebrations

• There is AI is available to manage 100s to 1000s of employers

Desigining Jobs and Work

• Involving determining tasks and activities must be done and how job should be assigned to positions.

Job analysis

• Job analysis breaks down job descriptions to identify tasks and behaviors and relationship
• Managers assess if job is flexible or adaptable
• Flexible approaches are needed often "other duties assigned" is a description
• HR staff analyze jobs using several methods including written and observation
• Job descriptions indicate the name and tasks, including (in varying detail) and potential qualifications.
• Managers, supervisions and HR all must communicate to effectively analysis for each
• Descriptions
  • plan how many jobs are needed of with the necessary requirements
  • write announcements of job openings
  • assess applications perform and ability
  • train and further advance all staff involved Incorrect analysis and information leads to job dissatisfaction and lawsuits, failures to accommodate trends requires accurate job analysis

Work Rules and Schedules

• Managers help create work rules for predictability, civility and balance the needs of the companies and employees
• Rules must stay adapting to current needs and regulations
• Managers create work schedules and balance employer and patient needs and use Al tools,
• They should still communicate with workers regarding work life and balances, work schedule should be open to flexibility
• Employees may work 5 8-hour days, or 4 10-hour days a week
• HCOs may be required to remote sites

Hiring Staff

• After job design managers want to find people to fulfill staff needs with a diverse array of status
• HCO may have multiple hiring agency at their disposal, however this chapter looks at the most common, i.e. placing the employee on the payroll and potentially outsourcing work like staff recruiting.
• The process is defined as talent acquisition, including ;
  • recruiting applicants -selecting applicants
  • making offers and accepting them
    • occasionally reassigning workers

Recruiting

• Managers ensure that the HCO is appealing, compatible teammates, inclusive settings
• Managers and HR must authorize recruitment for specific positions and if a decline/ freeze is needed.
• HR staff or recruitment firms often perform this processes, specialized recruited for larger HCO
• Internal recruitment from within works to provide the most compatible hires, as oppose to the external route. It allows use to HR boards/networking and is a method for internal transfer/ promotion
• External includes job fairs and professional conferences with HCOs.
• Can also leverage social media networking to e-cruit
• A pool of candidates is needed, with a diverse understanding and potential for new ideas, all while meeting the HCO goals
• Job announcement are needed for all applicants, including location and requirements for the job and organization

Selecting

• A long and short effect is placed on HCOS as a result of selection so great considerations is needed.
• Bad performance creates staff tension and turnover
• Vacant jobs involve the departments managers and immediate supervisors and HR and must all comply with the HCOS
• HR must review compliance to provide appropriate tools
• Selection criteria is based on the initial qualifications, skills, and competencies that are described on the descriptions of descriptions on the job descriptions
• HCOS almost always include if their criteria is meet and will they fit properly in current organization values
• The potential is based on applicant qualifications, skill based.
• HCO is required to not deter or violate hiring from diversity based selection in the recruitment process.