How Your Facility Can Best Cope With Fluctuating Staff Needs

David Coppins, CEO, IntelyCare

Staffing in senior care facilities was already an issue before the COVID-19 pandemic. But, with more staff leaving the industry, senior care facility staff are stretched thinner than ever. Fluctuating staffing needs makes covering shifts even more challenging, and with resident safety and wellbeing on the line, it’s essential that facilities find ways to cope as their staffing needs change, even day-to-day.

The Challenges of Changing Staffing Needs

Multiple factors affect fluctuating staff needs. David Coppins, CEO of IntelyCare, explains that staffing need changes are typically prompted by an increase in census or when staff call out of shifts. “The challenge is that for the nurses and other aides who are working, the workload is too big. They’re overworked,” he explains.

“Anyone can handle that for a few shifts here and there, and even in the early days of COVID-19 when we had that we’re in this together feeling, you can kind of make that work. But, it’s really damaging to the folks who always have to be working in that way.”

Last-minute staffing changes can necessitate that nurses unexpectedly work longer shifts. Since nurses can’t leave their post without another nurse on duty, if that second nurse calls out, the first nurse might be required to stay and work a double shift.

Too many short-staffed shifts lead to burnout and increased staff turnover, which worsens the staffing challenges the facility faces. “It’s a vicious cycle. If you’re short staffed, it leads to people quitting, and then you’re short staffed more,” says Coppins.

Short-staffed shifts can also lead to an increased risk of mistakes. Medication errors, overlooked symptoms or changes in residents, and failure to properly document resident notes are all mistakes that can arise when nurses are overworked and covering for other staff responsibilities. Unfortunately, these errors can reduce resident safety and satisfaction, and can be frustrating for all of the staff.

Staffing Mistakes to Avoid

Certain common errors can make it more difficult for facilities to get the staff they need for each shift. When schedulers don’t receive the training they need, it’s difficult for them to succeed and mistakes and oversights can affect all of the staff. “There’s so much that a scheduler needs to learn over a period of time, and turning over your schedulers is massively disruptive,” says Coppins. It’s essential to ensure schedulers receive detailed training and have a thorough understanding of the facility’s scheduling needs and challenges.

Some facilities fail to plan far enough in advance for seasonality and vacation staffing needs. Often, by the time they realize they need to bring on additional staff, it’s too close to a holiday to successfully fill those shifts, even when using third-party staffing.

Some facilities rely on too many staffing agencies; Coppins knows of one facility that uses 12 different agencies. “In these times, facilities feel desperate and may feel like they need to go to many agencies to get their staffing needs filled,” says Coppins. “But juggling people from different agencies is extremely complicated. If agencies know that you’re working with that many other agencies, no one feels like they need to be committed to you, either. You’re not getting the best of the agency.”

Further exacerbating the problem is that some facilities view contingent staffing or third-party staffing as a necessary evil. “They’d rather not have them at all, so they don’t really treat them as partners in solving the goal of being fully staffed,” Coppins explains. “The facility will end up waiting until the last minute to request staff, and then they pay high rates out of desperation, when they could have probably filled their shifts more completely if they took more time.”

Coppins notes that it’s important for senior care facilities to view third-party, contingent, and agency staffing not as a necessary evil, but as potential partnerships. “If you use them in a smart way, then at the end of the day, you’ll reduce your costs and your own workforce will be happier because they’re not called on in the last minute to fill shifts.”

Solutions to the Most Common Senior Care Staffing Challenges

Technology plays an essential role in staffing today, and it’s important for facilities to learn to embrace that technology. Coppins references an IntelyCare survey that revealed that between 35 and 40% of facilities are still using pen and paper or spreadsheets to schedule their own staff. “There’s a lot of value in using scheduling software,” he says. “It gives you a more organized point of view and helps to optimize staffing needs, instead of just the simple rotation that you might be able to get out of a spreadsheet.”

Technology also streamlines a facility’s ability to communicate with its staff. Without communication technology, schedulers may resort to posting open shifts on bulletin boards or walking down hallways to try to ask staff to fill open shifts. Texting allows for a faster connection, but text limits mean that schedulers can only reach out to 20 staff at a time, which slows the process.

“We created a texting platform so facilities can enter open shifts and then reach their staff through text,” says Coppins. “It supports back-and-forth conversations and is remarkably effective at getting more shifts filled with your own staff. It’s free, too, because it’s part of our staffing business. I think technology can truly make a big difference in maximizing and optimizing your own staff. At IntelyCare, we use many algorithms that can help to fill the shift better than the average agency can. We have fill rates that are three times better, as a result.”

In addition to using technology to support staffing needs, Coppins highlights the importance of hiring a scheduler who is experienced, smart, resourceful, and ideal for the position. Facilities will see greater value and results when they hire an experienced scheduler, but it’s also important to pay that person well.

He also notes how important it is to value employees. “We have hundreds of nurses and nurse aides coming to IntelyCare every week. They’re coming from a system that doesn’t give them schedule flexibility, that doesn’t listen to them and appreciate the work that they’re doing, and that doesn’t recognize them through fair wages for the value they’re creating.”

Coppins explains that while focus tends to be placed on wages, that’s not the largest factor that’s driving people out of the senior care workforce. “It’s more the first part – that scheduling is very inflexible. Caregivers and nurses live complicated lives, and it’s hard to work around that. They need the ability to manage their own schedule.”

Wages do play an important role in one particular instance: When facilities need to fill shifts at the last minute. “If someone has a day off, they probably want to keep that day off,” says Coppins. “It can be hard to find someone last-minute, which is why you need a go-to list of clinicians who can drop everything. You have to pay them a higher differential over their normal pay, or give them the next holiday off, but you have to be prepared to negotiate.”

IntelyCare maintains a group of IntelyPros on its last-minute heroes list. They have flexibility, and they’re often willing to drop everything to go work for a high pay raise. “I’d recommend any facility determine if they have people on their staff who can become their go-to list when they need someone who can take on shifts at the last minute.”

Navigating changing staff needs is challenging, but there are many tools available to senior care facilities to help them successfully fill shifts. Facilities may need to change their approaches, implement new procedures, and partner with staffing tools and agencies, but the result will be a happier workforce and residents who receive the quality, attentive care they deserve.

Paige Cerulli

Paige Cerulli is a contributing writer to i Advance Senior Care.