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Minimum Staffing v. Minimal Staffing

Many healthcare leaders believe that the term “minimum staffing” is the result of performance improvement initiatives aimed at doing more with less. It is actually a critical component of any department’s operations and should be considered in all productivity strategies and staffing-based decisions.

Minimum staffing levels indicate the number of manhours across each job code category in a department, regardless of patient census or workload, necessary to operate safely and efficiently. These “tipping points” consider essential staffing ratios, quality, and staff/patient satisfaction. This concept is not meant to lean staffing out as a cost-savings effort or minimize FTEs within a department. Instead, a focus on minimum staffing ensures the appropriate resources are always in place to produce the best outcomes.

With the holidays fast approaching, it is important for leadership to identify minimum staffing within their areas of responsibility (if they have not done so already) to determine how to properly schedule staff to maintain effective operations. The first step is examining historical volume trends to determine the expected demand for services leading up to, during, and immediately after each major holiday. Typically, procedural areas and outpatient services see a decline in volume as most patients opt to share their time off with family and friends, pushing back their visits. However, the holidays can lead to an increased risk for household accidents and other unexpected dangers, resulting in a surge in the utilization of emergency services. Whatever the case may be, hospital management should use data to anticipate needs and plan staff accordingly.

Once leaders know what the workload should look like, the next step is reviewing PTO requests and identifying which staff are required to match it successfully. For most support areas that do not flex staff relative to the census, it is easier for managers to schedule a “skeleton crew” that can maintain necessary functions and allow for the majority of staff to utilize benefit time. It is even common for these departments, in some instances, to shut down entirely for a day or two with the manager on-call to address any immediate needs. In patient care areas where minimum staffing requirements are typically higher, staff often rotate through holiday coverage and are compensated through holiday pay and/or overtime rates.

Knowing the minimum staffing levels eliminates the need for “what-if” scheduling, which can be even more costly to an organization and dissatisfying to employees during the holiday season. Establish a plan early and communicate it to the staff, asking for their valuable feedback. It is the staff that ultimately make or break the holiday schedules, include them in the process!

To learn more about minimum staffing best practices for your department, service line, or organization as a whole, please reach out directly at [email protected]

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