Staff Reductions? Maybe, But How Best To Proceed?

I came across a blog entitled "Ignore Your People at Your Own Peril" by a Canadian blogger, Geoff Crane. It dealt with the problems caused by a hospital's reduction of nursing staff as a result of a non-collaborative staffing reduction on the part of management. Anyone can cut costs, and salaries & benefits are generally around 60% of a hospital's costs. No one wants to cut staff if they can help it, although the current fiscal state of many hospitals can make it unavoidable. But I agree with the author, adjustments in staffing must be done carefully. This would seem to be a no-brainer, but ill-conceived staffing cuts are not rare.

So, what's the approach to be taken? Foregive me if I'm preaching to the choir, but you've got to look at processes and responsibilities across all functions. Are there processes that can be streamlined or otherwise improved? What are the likely consequences of reducing staff in a particular department? I'm a big believer in metrics and benchmarks, They can give you a 10,000 foot look at areas of opportunity. So, bear with me as I bore through some numbers.

For example, if a hospital has 6 Full-Time Equivalent employees per adjusted patient day (a ratio of staffing compared to patient volume) and the benchmark for a hospital of equivalent size, geography, acuity, etc. is 4.7, chances are you have an opportunity to reduce staff somewhere in the facility. But where? Let's look at a single department next. Say environmental services expends 3 hours per 1,000 square feet versus a benchmark of 2. OK, maybe this an area for further exploration. Now, we get to the important part. What do the housekeepers do, and how do they do it, compared to the benchmark you're measuring against? For example, if your hospital has housekeepers changing bed linens while another hospital uses nurse aides you're not comparing apples to apples.

I don't want to run on forever here, so let me get to the key points. Involve as many functional area leaders as possible in evaluating opportunities for staff reductions. Start with metrics, benchmarks, key performance indicators or whatever, as a starting point. But examine processes carefully to identify where the reductions should occur.