The Importance of Proper Position Control


According to a recent article, the turnover rate in the healthcare industry has increased by 5% across all job categories over the last decade. With the impacts of the COVID-19 pandemic on the operations of hospitals and health systems, it is safe to assume that these rates will continue to rise. Considering how time-consuming and costly recruitment efforts can be, especially given the ever-shrinking candidate pool that presently exists, it is critical that healthcare leaders appropriately manage the employees that they do have. Ensuring that staffing levels are in line with patient/volume demands so that no one feels undervalued or overworked is more important than ever. Gone are the days of “throwing bodies” at a problem because hiring more people is no longer sustainable!

One of the most effective ways of keeping labor costs down while achieving more efficient operations and improved clinical outcomes is through a well-established job requisition approval process led by a designated Position Control Committee. Having this structure in place can alleviate the stress of recruitment by ensuring that only necessary positions are being filled based on relevant quality, patient satisfaction, and productivity metrics. It can also have a significant impact on employee retention because it instills a culture of accountability and performance measurement, minimizing the need for downsizing and layoffs.

Here are some successful strategies that we have implemented with our clients to aid in the proper development of Position Control Committees and requisition approval processes in their organizations:

  • The purpose of the Position Control Committee should be to:
    • Balance organizational goals relative to labor, quality, service, and performance
    • Control labor costs commensurate with volumes
    • Assure that VPs/department leaders receive approval in a timely way to fill positions that will otherwise require overtime or agency staff to fill
    • Identify possible opportunities for shifting FTEs from one function to another, rather than hiring new staff
  • Membership should consist of:
    • Representation from all facets including, but not limited to Administration (CEO), Operations (COO), Finance (CFO and/or Controller), and Human Resources (VP of HR and/or Director of HR)
    • A Committee Chair appointed among selected members
  • The procedure followed should include:
    • Regularly scheduled bi-weekly or monthly Position Control Committee meetings
    • Submission of all requisitions to be considered to the HR Department, with all required approvals, at least three days before the scheduled Position Control Committee meeting
    • Assessment of performance relative to productivity standards for all areas requesting new or replacement positions to be approved
      • Review departmental productivity reports showing the FTE variances for budgeted FTEs, actual FTEs, and recommended FTEs
        • In cases where negative FTE variances exist, the VP and/or department leader will need to present a plan to return the department’s performance to budget and/or offset salary and fringe costs with unbudgeted revenue
      • Review recent quality and patient satisfaction reports relevant to the departments seeking position approval
    • Presentation of the positions seeking approval by the appropriate VP or department leader in order to provide justification
    • Deliberation at the conclusion of all presentations by the Position Control Committee with decisions made by the following day
    • Periodic review currently posted positions by the Position Control Committee to determine if recruitment should continue to be pursued
      • Posted positions may be removed from the list of approved positions at the discretion of the Position Control Committee
    • Expedited processes for those requisitions requiring urgent consideration

ALTIUS provides the direction and tools needed to achieve elevated performance. Adopting a strong position control and job requisition approval process ensures the proper alignment of resources with fiscal and operational goals. If you would like to discuss how we can assist in improving your current processes, contact us today!

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