Nurse self-scheduling is not a new concept. Dating back to the 1960s, self-scheduling largely failed due to the many challenges of implementing an equitable paper-and-pencil system. Today, however, technology makes self-scheduling easy. In fact, the method can be extended beyond the nursing population to other shift-based healthcare workers. And smart organizations that offer self-scheduling as a benefit to clinical staff may see their turnover rates—and associated expenses—trend downward in dramatic fashion.
Nurse turnover: bad for patients and for the bottom line
Within the value-based care model, every expense matters to healthcare systems operating on an ever-narrowing margin. And while nurse turnover may represent one of the largest controllable expenses within an ACO or other organization, a stunning 49% of healthcare organizations have no formal retention strategy for clinical staff, according to the 2016 National Healthcare Retention & RN Staffing Report produced by NSI Nursing Solutions, Inc.
The same report pegs the turnover cost of a bedside RN at $37,700 to $54,800 and estimates the average hospital can lose between $5.1 million and $8.1 million per year on nurse turnover alone. Of course, nurse turnover is not merely a financial matter. High turnover rates within the clinical staff population can negatively affect patient outcomes and the overall patient experience. It stands to reason, then, that you should take a forward-thinking approach to strategizing ways to reduce clinical turnover in order to provide high quality care and to soften the effect on the bottom line.
Enter self-scheduling as a recruitment and retention tool
When crafting a nurse recruitment and retention plan, you can look to self-scheduling as one way to improve staff morale and reduce turnover. Offering self-scheduling can give your organization an important competitive advantage in a marketplace where nursing positions outnumber nurses. What nurse wouldn’t find it attractive to be able to schedule shifts when they best suit him or her? And once a nurse is onboard, the ability to choose her own shifts to accommodate her lifestyle can be a powerful retention tool.
It’s easy to make the executive case for self-scheduling, too. You can point out that self-scheduling confers staff empowerment, and empowerment has been linked to increased staff morale that, in turn, correlates with low turnover. Connecting these dots leads to lower overhead costs for recruiting and retention—and likely improved patient outcomes through continuity of care, too.
But I remember when we tried this before, and…
If you’ve tried self-scheduling in the past using a paper-and-pencil or spreadsheet method, you might be skeptical about how it can work for your organization. That was the situation at Naval Hospital Camp Lejeune, where self-scheduling used to require a nurse to sign up on a piece of paper posted in the break room.
“If you weren’t working the day the schedule went up, you ran the risk of getting the least popular shifts,” said Scott Staup, RN, Labor & Delivery Nurse Manager. “To avoid that, you might have to come in on your day off and sign up. That could lead to some unhappy employees.”
Naval Hospital Camp Lejeune didn’t give up on nurse self-scheduling, though. Instead, it switched to a software solution that allows nurses to sign up for shifts from any device with an internet connection, including their phones and tablets, and says “everyone is a lot happier as a result.”
Expanding the concept to address turnover across the organization
Savvy CNOs will see the worth of self-scheduling to improve results within the value-based model. But why limit the rewards of the program to just the nursing population at your facility? Offering self-scheduling to other employee groups may entice high-turnover caregivers, such as CNAs, to remain in their positions longer, reducing the costs associated with hiring and training new staff. By extending self-scheduling to any shift-based worker group, you can position your organization as a model for how to reduce recruitment and retention costs and maybe even lower the overall cost of healthcare delivery in your community.