I am a new nurse manager to our newly restructured per diem pool.  Our staff have to cross two hospitals, which makes things difficult.  Does anyone else have this situation, and how do you distribute your resources to equitably meet both hospitals without one feeling shorted?

Hello Andrea.  We have several clients where staff cross between multiple campuses.  One suggestion would be to have a minimum requirement of hours in each hospital by selected staff so that you have a baseline group to pull from.

I recently developed a system float pool that travels between 2 facilities. The staff use BidShift to sign up at both facilities. They are supposed to work equally between the two. We've had some census problems that have made it difficult at one facility. The two staffing offices communicate at least twice a day to discuss needs. We remap people when we can. Not sure how you have set up your team.

We have pulled our staff out into a central pool, and distribute "in the moment" to the appropriate campus.  Our system sounds a bit like  yours in that one hospital is always busy, and the other is usually slower.  Our new process is going ok, but is not flawless and I would just like to hear of some other ideas.

For your system, if one hospital does not need the employee, do they go to the other hospital?

There are many ways to configure the Concerro product to help you optimize these resources. Below are a few of the more common themes we generally see (and recommend):

1) Be sure that all of your per diem resources schedule all of their time in Concerro. This ensures that all managers who are viewing their requested shifts can see every shift that was requested, awarded or awarded to others so that they can provide the optimum schedule. It also ensures that the recommended scheduling and overtime alerts functionality will be activated when someone exceeds those that have been configured in the system.

2) Profile your per diems to best meet the needs of your organization. For example, some multihospital systems have per diem/float pools at each site, each with their own individual cost centers, where others may only have a single cost center for their per diems that service each hospital. However you profile your per diems, it will be important to provide the appropriate system administrator permissions (your Concerro Executive Strategist can help you determine the best set up strategy and your Concerro Project or Client Services Manager can answer any configuration questions).

3) Determine the “behavior you want to drive” when deciding how to show shifts to your per diems.  Here are three common scenarios:

a) We have a per diem/float pool and all the staff belong to this department. I want them to each meet their commitment in their home department before being allowed to pick up shifts on individual units. Per Diem is profiled into the Float Pool cost center. Specific positions are created for this department (RN-Float Pool). Shifts are either restricted to this department via Shift Template (when you will only use this position for this purpose) or Minimum Requirements set when the position is built (if you might use this position for more than this purpose). Enough shifts are posted with this position so that all per diem staff from this department can meet their minimum requirement from these. Once they have done so, they can then begin to request shifts on individual units.

b) We have per diem staff that must see the shifts before anyone else can (maybe because of union contract). In this case, you can use any regular RN position and build a multiphase shift template, where one of the phases (usually the first one) is restricted to the appropriate per diem status(es).

c) We have a per diem/float pool and they must meet their requirement on their home unit first, but sometimes the home unit doesn’t have enough shifts or there isn’t a big enough housewide pool to warrant taking days out of the availability period to only show them to this group. In this case, you can open all shifts to all staff and control the award via operational process. Some organizations tell staff they will be awarding to their per diems first (which encourages the per diems to get in their early ), some also post an initial “subset” of shifts from which they want the per diems to choose from (weekends, nights, or other hard to fill if they are trying to “guide” their per diems to particular shifts), and then, once the per diems have met those commitments, open up the rest.

On the topic of “floating,” we recommend that it is never the “BidShift (Concerro)” person that floats, but that floating, as well as canceling off, be managed by cost/policy. So the order may be Agency, Overtime, Per Diem, Above budgeted FTE, Rotation.  In this instance, the overtime, per diem and a part timer working extra might all be Concerro folks in that scenario. The person who would go is the overtime person, not because they are the Concerro person,   but because by policy, the overtime person goes first. It takes Concerro out of the mix, which is important, because if it’s always the Concerro person who goes, staff stop signing up.

Of course, some organizations float their per diems first via policy (and this was going on before BidShift/Concerro came into the mix. Again, it’s not because of BidShift/Concerro, it’s because of operational policy.

Finally, if you are trying to ensure that your per diems have met their commitments in the appropriate hospital/unit, you can run the Employee Payroll Report for the particular date range and status, or simply go to the profile of the individual and choose “Click Here to View User’s Shifts,” choose the type of shifts you would like to see and enter the date range. You will quickly see what shifts (and where) this person requested, was awarded, or both (depending on what you asked to see). This can be printed out and shown to the employee if you need to have a conversation with them about their level of commitment.

Notes on Assignments Specific to Multi-hospital and Last Minute Assignment

Ensure commitment shifts to the appropriate hospital are assigned first – running the Unit Payroll Report within the first week of shifts opening up and restricting it to per diem status will show you whether staff has met their commitment to the appropriate area(s), allow you to check profiles of staff in question and give you a chance to follow up with staff or managers if this is not the case.

Ensure all shifts are in BidShift/Concerro – our most successful sites that assign just in time resources do so by assessing the unfilled shifts at the time of final deployment (usually 1-2 hours before shift start and then determine who, from their pool, will fill that shift. If a shift is not in BidShift/Concerro the team assumes there is not a need. The managers have the responsibility to ensure their shifts are accurate (unfilled needs are in there and shifts previously posted that are no longer needed have been inactivated). This allows the Staffing Office and/or supervisors to plan upcoming staffing without having to make or receive phone calls.

I agree with Diane hamm Vida's suggestion.  The per Diem staff could float between both facilities.  You could provide them access to which ever unit you need staffed, but only if they have already met thier Per diem commitments. 

Thanks, Nina. Additionally, it is really important to ensure that all per diems are meeting their commitments in the system for two main reasons:  1) If some managers are requiring per diems to put their time in Concerro and others are not, the manager of the employee cannot rely on the Employeee Commitment Report to hold their folks accountable (not to mention how confusing it is for the employee to have to remember which units are using the system and which are working around - plus their schedule is not accurate) and 2) Every shift that goes uncovered by committed hours not met is a shift that is probably going to overtime, agency or incentive (sometimes incentive and overtime)!

So it is critical to think through your strategies and then hold your managers accountable - executives set the expectations and promote the consistency, which breeds success and satisfaction for all.