Becker's Healthcare Host (00:01):

Hello everyone and welcome to today's webinar, increasing the Clinical Workforce Fill Rate with a focus on Operational excellence. On behalf of Becker's Healthcare, thank you for joining us. Before we begin, I'm going to walk through a few quick housekeeping instructions. We'll begin today's webinar with a presentation, and we'll have time at the end of the hour for a question and answer session. You could submit any questions you have throughout the webinar by typing them into the Q&A box you see on your screen. Today's session is being recorded and will be available after the event. You can use the same link you use to log into today's webinar to access the recording. If at any time you don't see your slides moving or are having trouble with the audio, try refreshing your browser. You can also submit any technical questions into the Q&A box, and we are happy to help at any time. I'm so excited to introduce our amazing speakers today. We are thrilled to be joined, joined by Nida Al-Ramahi, the Executive Director of Operations and System Nursing Services at the Center for Clinical Operations and Innovation Mercy and Lou Jug, Senior Product Manager at Trusted Health. Thank you both for being here today. I'm now going to pass the floor over to Nida to get us started.

Nida (01:15):

Thank you so much and welcome to our presentation today. We're very thrilled to have this discussion with all of you. A little bit about myself. I am a by background an MHA I have experience in strategy, operations, innovation, finance, and just really thrilled to be able to represent this work on behalf of many, many teams who spent countless hours getting us here. And Lou, I wanna pass you the ball to introduce yourself just a little bit.

Lou (01:44):

Thanks Nida. For everyone my name's Lou Jug. I have been at Trusted for quite some time. I lead our product efforts on our on-demand product. Very excited to be partnering with Mercy and a lot of the workforce transformation efforts that we've had and kind of compiling a lot of cool different areas of technology to achieve this goal. So thanks Nida.

Nida (02:05):

Alright, and before we begin, just a very special thanks to some key people on this slide. I felt very compelled to do this today. And I call out just a very specific person here, Betty Jo, who is truly an innovator ahead of her time. And without her, we wouldn't have been able to operationalize something so substantial and renowned that is truly transformative, not only within Mercy, but outside of Mercy across the industry. And, and with that, we thank you very much for your commitment and dedication to us. But again, some key names, Hrair, Veronica, Beth, Reese, Garrit Jony, Chase, Stephanie, Nathan, Jordan, and all of our Mercy CNOs and all of our mercy coworkers and Mimi who have really contributed in getting us to this point here today and continuously propelling forward. So many, many thanks to you all. We're grateful that we can represent this work, but without you, it wouldn't have been possible.

(02:58):

So, a bit about Mercy. We are across four states with 44 hospitals and over 900 physician practices and outpatient facilities. And with such a huge scope like this, we really sought to have a goal to have a unified clinical workforce that can go across all different care settings and to be able to leverage the strengths of them to deliver exceptional patient care. And so let's get into the pressures of the clinical workforce that really allowed us to innovate from this problem. And we know that there is a huge shortage across the workforce and across the industry. And there's no end in sight. We know in the next 10 years based off of some HRSA data that there will continue to be a, a shortage across that. And with that being said, we really need to think about this problem a little bit more intimately because it's not going away.

(03:58):

But we know through operational excellence we can truly overcome this issue. And for us at Mercy, operational Excellence is around ensuring that we have the right clinicians at the right spots, at the right time for the right price. And that we should develop things that make it very easy to do the right things and very challenging to do the wrong things. And for that, it equates to us in fill rate, which is our needs versus haves and through a very sophisticated scarcity economic model, which we'll talk about in more detail today. But these are very key thematic elements that have really driven not only our strategy, but in the way that we operationalize solutions based off of all of the friction in, in our environment today. So what does that strategy look like for us? And that is through a flexible workforce model. And so what do we mean by flexibility?

(04:50):

We always say we wanna give choice to people, but for us it's around being very thoughtful and intentional about the different ways in which we tap into our workforce layers, but also how we enable someone to stay with us at any points in time in their life. And so maximum flexibility and how and where you want to work. Having a multi-generational option for solutions in which people want to work in, and ensuring that there is consistency and clarity around the different types of coworkers. You can be here with us at Mercy and we've translated that into some very key things. And so we know we're not going to just focus on one layer. We have to look at layers in its entirety to increase our fill rate, but also to remove that friction out into the front line and deliver exceptional patient care. And so prior to this intervention, we had heavy reliance on our core staffing, which we know is not going to increase anytime soon.

(05:45):

Little reliability on our flexible staff layer, which we'll get into a little bit more detail around that. Very high reliance on our agency and our contingent labor workforce. And that's been translated into the now, which where we have a little bit decreased, but not that much of core staff, a significant increase in our flexible staff. And we'll talk about those layers momentarily. And reduction in reliance on our contingency labor and all of that, looking at these workforce layers in this way have really allowed us to bring more people to the bedside. So when we talk about specifics, what does that look like for our core staff, we introduced quite a bit of flexibility. When we take a look at the types of shift offerings, we offer 4, 6, 8, and 12 hour shifts. But that in and of itself is an introduction to a different way in working and a different time of working.

(06:38):

And for our regional and local float pools, we're really focused on ensuring that we created consistency and the way that we incentivize people to bringing them to the front line to fill those gaps. But again, making sure that they have the ability to fulfill their desires on where they wanna work, how they wanna work and when they wanna work. And then we introduced the gig workforce, which which is a zero F t e with one requirement of working 12 hours a month. But really they get to dictate a different type of way in which they can work, but also bring that exceptional cure to the bedside.

(07:11):

So how did we do this? Strategy is one thing, and that having the ability to translate that into action is another. And we did that through the enabling technology, via our partnership with Trusted Health, by creating Mercy Works on demand. And this technology is a very scalable and smart technology to connect all your different workforce layers in a meaningful way to drive people to the bedside, to deliver exceptional patient care, but also to reduce friction for our coworkers out to the front line and make it very seamless and automated. And we have over 93% of our clinicians right now in our health system participating into this, into this platform.

(07:50):

So I wanna summarize what I just discussed here with all of you today around how we're uniting our workforce layers and how we're being very thoughtful and intentional about the way in which we deploy, deploy them to the frontline. And again, it begins in our workforce layers of our core staff, which is comprised of our full-time, our part-time, our unit-based p r n type of coworker. And then introducing an increasing capacity to leverage our flex layer. So that includes your local flow pools, the regional flow pools, your gig per diem roles, and then it includes our agency. Agency is never going to go away, but we wanna minimize with in a way that's impactful to meeting the needs of our organization and of our patients. And so that includes your external and internal workforce and international agency programs. But the key piece here is that the technology is the connector between all of your workforce layers across all care settings within your operations.

(08:47):

And it does it in a way that's automated and fully embedded into your staffing and scheduling system to bring your needs into fruition and reduce that friction in getting people there and ensure that every unit is staffed safely in a meaningful way. But a key thing to highlight is that not only is this a way to help with staffing and scheduling, but it's very much a way to connect the dots about how we think about workforce management in its entirety. And that includes an automated way of bringing our nurse credentialing information into this platform. There is a whole dashboard in which we can manage nurse credentialing and licensure in a meaningful way and to, and, and into managing them appropriately and also bring people to the bedside by shift pickup and matching the right clinician to the right role at the right time in the right space.

(09:37):

 It is something that is very much multifaceted. So we see it as a comprehensive workload workforce management system. And that is something that continues to grow and brings quite a bit of value. So I get many questions around, well, how does this work about bringing people in at the right time at the right place? And it all begins back with your unit manager. Your key fundamental operating principles out into the front line is not going to change. You're still going to manage your staffing and scheduling system in the way that you typically and normally would. That is your central source of truth of information. And so those information and parameters are set into staffing and scheduling works on demand is the conduit to translate that information into shift priority and visibility. And it matches the right resources within your workforce layers that you've uploaded into this system.

(10:29):

So that could include and potentially be your gig roles, your part-time coworker, your your float pool or your core coworker. So be it. But to match the right amount of resources to the right places to drive people towards the areas of creative needs. And it is a continuous feed back and forth between these systems in an automated way to keep up with census changes in real time. So let's get into technology and, and highlight a little bit more in depth around how this works. For us, it was very important that we show our commitment to our coworkers here at Mercy by ensuring that they see the right amount of incentives in, in a very meaningful way and prioritizing them in, in the year of the core. And so the way that works is we've aggregated all of our different workforce layers into a singular labor pool that basically tells the system who is eligible, not eligible to work down all the way to the unit level. But those coupled with the parameters set in in our staffing and scheduling system is translated into the Mercy Works on demand app in a US feed via a p i empowerment. And we're gonna talk into more detail around how that works you to explain how does the pricing model work within

Lou (11:48):

Thanks Nida. As we've alluded to in multiple slides beforehand one of the key components of offering flexibility as part of this workforce strategy is determining the right shift incentive. That can be a complicated process and we'll talk about a little bit more later. But before we dive into like the nuts and bolts of how we've implemented dynamic pricing, I wanna kind of cover two core tenets of it. So the first is that facilities still have control over the incentive ranges that post. So while we are building this cool technology model of how to price shifts, facilities still have control to set guardrails for how the pricing model works. This can be useful when partnering with finance or with payroll, and it can also be quite useful in communicating out expectations with coworkers as well. From there, dynamic pricing within works on demand determines the market rate for every single shift.

(12:42):

So whether that's day of week, time of day and even shift length, we find the unique price within that range to achieve the desired result, which is ultimately higher fill rate. So how do we determine that market incentive rate? So simply put, we look at the pool of all available matches that you have in your system. So what is a match? A match is a coworker and a shift. That's what it's, so we look at every single match and determine the likelihood of that particular coworker picking up a particular shift. Okay? We're then able to build out what's called a candidate propensity matrix. Now, this sounds like a complicated term. In reality it is, what's the likelihood that someone's actually gonna pick up that shift? In this example, we have 16 matches for 10 open shifts, but really only eight of them are high propensity to actually pick up that shift.

(13:34):

So what this allows dynamic pricing to do is price higher. If the system has found that there are not enough people to fill that shift and there's high need, it also allows the system to slightly lower the shift if there is less need at that particular area. And we instead want to route folks to areas of higher need using that incentives. So if we wanna do a bit of a deep dive into how this works, so we call this predicting the optimal rate. So the model first determines what the current fill rate is on the unit and determines what we like to call a demand risk. Basically, what's your risk on the unit? How, how risky is it that we're not gonna have someone filling that shift? We then layer on that supply risk, which is how many candidates are actually wanting to pick up that shift.

(14:20):

We combine the two scores to determine the ideal rate. Now, while both scores are kind of in the mix, we always use demand as a priority because making sure that we're achieving our fill rate targets is a key priority. And as we've highlighted in the right side of the, of this slide, as workers claim shifts over time, those model predictions get more and more accurate, which influence the rate. So for example, if fill rate continues to persist in a negative fashion, the rate will continue to climb towards the top of the range to ensure that folks are being directed to the areas of i s E. So Nida, I'm gonna pass it back to you for the visibility into performance.

Nida (14:57):

Thank you so much Lou. And the key thing to reinforce around this pricing model is to create a very objective lens in how we determine that economic model. But the bottom line is our number one goal here is exceptional patient care delivery and ensuring that there is an exceptional coworker experience and that we dignify and honor our coworkers in that way. And this economic economic model is very much reflective of that. Everything boils down to fill rate, fill rate your needs versus haves is the ultimate driver in dictating what that incentive rate is going to look like in driving people in into the areas of greatest needs. And so let's talk about visibility to be able to fill those gaps. 'cause That is a key area of opportunity from an operational lens that is very important to call out. We often are overly inundated with quite a bit of information and data, but it's how we make data meaningful and actionable in a centralized view that helps with driving operational decision making out into the front line and really getting away from the firefighting and chaos.

(16:02):

For us at Mercy, that is not an option. It's not acceptable to to, to continue on a path like that. And we have addressed it in this way with having the appropriate organizational structure, but equipping our teams with the right tools and resources to not only execute whatever they need to operationally, but also to sustain that operation in a very meaningful way with less friction. And so that's the outcomes that we've been able to achieve is one, we're getting exceptional patient care delivery happening because we're bringing the right people to the bedside in the right way, but also we are honoring and dignifying our coworkers and giving them the choice to work in the way that they want, how they want for the rate in which they want, and really bringing that not only choice back, but that joy into nursing to have more time at the bedside, but also balancing our labor costs so that we can sustain ourselves organizationally and ensuring that, again, we have something to work towards.

(17:01):

We always hear no margin, no mission, no mission, no margin. And that's what that's really getting at. But the key piece here is having shift insights into that per performance. And we'll talk a little bit more and I'll show you in the next upcoming slides of what that looks like. But meaningful and actionable data at the operational level is something that is a big area of opportunity that we've been empowered to do and also bring to the bedside. Lou, I I'd love for you to just dive in a little bit deeper around how we created and the key principles into visibility of, of workforce insights.

Lou (17:35):

Yeah. Have happy to talk more. So what Nida was highlighting is that this visibility allows us to build a more defensible pricing model. And I've actually seen some questions come in about the, the risk of gaming the system or how, how do we make sure we're making it easy to do the right thing and hard to do the wrong thing to steal one of the terms before. So if you have a too simplistic of a pricing model, perhaps it's an if then statement or it's very simple flat rate, we'll call it that. It's very easy to gain this by making demands of the nurse manager just to ask for additional incentive. It also anchors workforce expectations on a specific rate. If rates have always been $30, people are gonna anchor on $30. The more that that rate varies, the harder it is to anchor.

(18:26):

 Fixed pricing is incredibly manual. If you want to achieve consistent savings, if you wanna be a partner with nursing and finance, you're constantly updating rates and, and your coworkers might be a little put off by that. It takes a lot of time to distribute those. So additionally, not all shifts are equally needed if you have a unit with a one need that's quite different than the same unit with 10 needs. So we don't wanna be pricing things the exact same. And kind of kind of the ultimate point of dynamic pricing is nursing leadership isn't, they're not economists. They're excellent at delivering care and structuring the workforce in a way to deliver fantastic patient care. They shouldn't be sitting there building pricing models all day long because that's a very complicated thing to do and people try to gain the system. So we've built it in such a way that the system can learn over time and do the work for the nursing manager and nursing leadership. And the idea of introducing pricing models, not a across the workforce, analyzing the propensity, excuse me, across the workforce, it really does actually defend a little bit of the system gaming system. We can chat through that a little bit later as well. You know, I'm gonna Yeah, I do.

Nida (19:38):

Yeah, and I think that's a really good call out point. 'cause That is the number one question that we have is how do you get around that? And again, this is a very dynamic living breathing ecosystem that has been created fully embedded and integrated in your staffing scheduling system into a visualized tool on your mobile device. But the constant change of supply and demand relative to your fill rate and census, you can always count on that variability to be. And so that basically nudges our coworkers to say, I gotta pick up when I see something, because it is always going to be changing. The more that people pick up that market rate is going to change dramatically. And it also depends on the amount of people that match to a particular shift. And so we have not seen any examples since our inception of this, of people being able to gain the system in that way.

(20:34):

But we have seen and gained from all of this is people are empowered to work in the way in which they want to work. And I, I cannot stress that enough because when you have empowered people who work in the way at the time in which they wanna work, they're always going to show up fully themselves and exceptional in the way that they deliver care. And so that is a huge call out. You have satisfaction and empowerment at that level by giving them the information that they need to make the decisions that they want for themselves. <Affirmative>.

(21:06):

So back to our earlier point around visibility and making information actionable. And so this is a preview of our insights dashboard that we have that not only our frontline leaders have access to, but all leaders across our organization at various levels have access to. And what's noteworthy about this is we have information all the way down to the shift level to the coworker level, categorized by unit, service line, multiple facilities. You multi-select the possibilities are endless when you wanna look at comparisons or a particular view. But what this does is shows you your fill rate and you see visually if someone is balancing their schedules or not from their staffing and scheduling system, it comes directly from that source of truth. And it is showing you in real time things changing as people are picking up shifts. So your fill rate is always going to be dynamic, not only in real time, but also prospectively.

(22:04):

You get to see those changes a week out, 2, 3, 4, 5, and et cetera. That gives you quite a bit of information. So again, the way that we define fill rate is your total planned hours versus your total filled hours. So your needs versus haves based off of your staffing matrices, your workload planners, so be it. But that gives you that percentage. And we believe that anywhere from 80 to 85% is very a comfortable spot to be in depending on the unit that you're at. So that is a benchmark for us here at Mercy. But it also gives you your average hourly rate based off of the incentives that are being offered and also the number of confirmed shifts, the number of people filling shifts. And the key thing to call out is that this serves as a basis of information around skillset and staffing by hours and not by shifts.

(22:58):

And so again, it gives you more specificity into patterns around the total number of people picking up in a particular unit or service line or facility depending on whatever skill mix has been selected. So you can look at if you RNs only, or RNs, LPNs and your UAPs, whatever that mix may be, you'll be able to see that distribution here. One thing that's very noteworthy is it shows you your performance or your trends by time of day and day of week and the fluctuations in rates, which is very important. It's very insightful to see what is your localized market looking like and where are people going. And in this example, you see that we really struggle on nights and weekends by time of day and day of week. And it gives us more calculated visibility into saying, this is how we want the technology to behave or how we drive people in our, in the way that we staff our core towards those consistent gaps that we have.

(23:58):

So it gives you visibility in real time, but also trends and patterns that takes a historical view and projects things outwards based off of real time decision making. It also shows you your different types of workforce layers. And so again, that concept around how we categorize and organize the different types of labor pools that we have, and it shows you by workforce group who's active in the application and participating, who's picking up those shifts week over week and, and showing you where that utilization is coming from. And again, aligning right, your strategies with these operational metrics to make adjustments in real time. I also do wanna call out where when you see a lower fill rate, you have the ability to, to do targeted messaging. And so what a frontline leader can do is take action not only now that do they have visibility in real time around the performance of their operations and their staffing and scheduling performance metrics, but it also enables them to reach out and a targeted way rather than having to do Facebook group chat.

(25:00):

So be it. Which is very, very powerful when you think about how we equip our leaders at the front line with the correct resources and ability to take very specific and directive change. So this is something that I love. I drive everybody crazy when I keep talking about this, but this is the Jarvis. When we think about how we manage the totality of our workforce ecosystem, and I wanna call out nursing at mercy, not just nursing, we often support our ancillary services, our perioperative and procedural spaces branching out into the clinic space. We're everywhere. And and what makes that very exceptional and important is you have a centralized workforce moving in the right direction with the right amount of visibility at the right time. It's not latent information in which you can take informed data-driven decision making to a whole nother level. And for that, that brings back empowerment to our leaders and moving them away dynamically from that firefighting and getting people where we need them to be to deliver that exceptional patient care.

(26:10):

So let's talk about organizational alignment and results. I think this is very compelling and again goes back to the team members that I highlighted that have contributed to this. But we have seen a tremendous increase in total head count. So 12.5% for nurses, 3.5% in all FTEs. Our fill rate has substantially increased from 83% to 86% across 44 facilities. And we've seen a vacancy rate drop to 5.8%. So we know that this is bringing back the joy in nursing. People don't have to leave us depending on where they're at in their life, they can stay with us because there is an option for them. And again, it brings people to the bedside to do that consistent care delivery. But another key piece to call out is our first year turnover has decreased by 13%, and turnover overall has decreased by 7.5%. And this gives our clinicians, again, the opportunity to be at the bedside and keeping them there and enabling them and empowering them to work wherever they want to be.

(27:19):

And so our vision for this is two days you work in the inpatient setting, one day you work in the ambulatory setting. The other day you may wanna work at virtual nursing, but that's okay because we have an infra infrastructure and ecosystem designed to be able to facilitate that consistently to bring and do what's right for our patients and our coworkers. So this number is, is very large, but we have decreased our low our premium labor spend by $30.7 million. It's not number that I calculated that Benny Jo calculated, that Lou calculated. This really came from our year end clean yearend close with finance. And it's something that again, we work very hard to achieve in one fiscal year. And we've seen 62% reduction in agency spend. So I'll give you rough estimates. Our starting point was at $12 million and now we're consistently at $3.2 million.

(28:15):

And so showing you that that decrease is, is quite substantial. And our total cost to deliver care has decreased by 16%. So we've made quite a bit of progress. It's very tremendous outcomes that we've seen and we're pushing forth for even greater, greater savings here in the next upcoming fiscal year. But the bottom line in all of this is that we're bringing the right types of people to the bedside to deliver patient care. And we do it in a way that dignifies and honors our coworker by giving them the choice to work in the way that they wanna work and how they wanna wanna work. And the technology's working for us and not against us. It's empowering us to do the right things and making it very cha challenging to do the wrong things. So now I just wanna pass it on over to q and as. So the Becker's team please would love to answer some questions.

Becker's Healthcare Host (29:11):

Yes, thank you all for an excellent presentation. We're now gonna go ahead and hop into today's question and answer session. As a reminder, you can submit any questions you have by typing them into the Q&A chat box on your webinar console. So I'm gonna go ahead and get started here with our first audience question, while you've decreased your traveler utilization significantly, what are the savings you can directly attribute to the dynamic shift pricing algorithm?

Nida (29:41):

That's a fantastic question. Yeah, go ahead, Lou. Sorry,

Lou (29:44):

I was gonna say I can chime in here. We've achieved a ton of savings across the board and dynamic pricing has been live across the ministry for a number of months now, and I believe it's about three to $4 million of savings. I can rerun the numbers again if there's questions again, but it's about 3 million of savings directly attributable. And note that it is tied to reducing the total incentive rate. It's hard to get in a fully baked rate off of, across one feature of a tool. But in terms of where the rate was and where the rate is now, it's about 3 million.

Nida (30:17):

Yep. 30 million. Yep.

Lou (30:21):

For that was the dynamic pricing unit, just the, just the dynamic pricing.

Becker's Healthcare Host (30:27):

So our next audience question is what have nurses said about the dynamic pricing experience and is there negative sentiment if the shifts are being priced lower than their historical highs?

Nida (30:39):

Yep. So this is a really excellent question because this is a lot of change. This fundament fundamentally changes the way we think about staffing and scheduling, the way we get people to the bedside and really around the behaviors of how you incentivize somebody financially. And so in the beginning there was some reluctancy, but I will say that we've come substantially a very long way because it was definitely a, a journey in in getting there. But we've come a long way in in how they have accepted this. The rest, the, the, the overall feedback of how people respond to dynamic pricing is, is one, you've given me my choice back, right? And I can work in it in any type of workforce. I don't have to work in a traditional set. I don't have to work with all of these requirements. I can pick and choose where and I wanna work.

(31:31):

And for that, a lot of the responses is a sense of empowerment and being able to pick and choose when they wanna work, how they wanna work for the rate in which they are comfortable with, rather than it being a very top down approach around, you know, the traditional requirements of working as a core coworker. And so there has been some questions around, well, why is the incentive rate changing so much? And the key thing here is, is to call out. We can't sustain $90 an hour, a hundred dollars an hour as we were in, in the pandemic. Nobody in the country can do that. That is not a sustainable model in, in doing not only what's right for our patients, but for our coworkers for the work that they do. And so starting with that component has really helped do that transition. And again, this is a different trans, you know, a a way, a different model of how we do staffing and scheduling, but for the most part, it's a very fairly positive response because it brings back, gives the power back to our clinical staff and working in the way that they want at the rate that they want.

(32:36):

Lou, is there anything else that you wanna add to that?

Lou (32:41):

Nothing that I would add other than the rates improve over time and as something that's been amazing to watch, as users interact with the system, they begin to learn how the system is prioritizing shifts. And so back to Nida's point about you wanna incentivize the right behavior and disincentivize the wrong behavior, we've seen that as we tie things closer and closer to fill rate in areas of biggest need, including where there's shortages of candidates, those workers are like, oh, this is exactly where I need to go. And folks who are potentially more motivated by money are actually driven to the right area. So as it learns and gets more creative, the workers kind of will learn alongside the system. And we've seen some positive response as it's learned over time.

Nida (33:23):

Yeah, and again, the key piece here around dynamic pricing, it's attributed to fill rate. Fill rate is the driver. So it's really gaining people to the areas of greatest need. And at Mercy we know that our coworkers are motivated by giving exceptional patient care delivery. And so that is, that is something that is rewarding for them, that they're doing the right thing consistently and and supporting the areas of greatest need.

Becker's Healthcare Host (33:51):

Our next audience question is how do you prevent a nurse from picking up a shift on a unit they have not been oriented on or do not have the proper skillset for? Do their credential? Are their credentials matched to the need as well?

Nida (34:05):

They are, they are. I'm gonna give the operational lens and then Lou's gonna talk through the technicalities of it, but we have automated guardrails into the system. So depending on their credentials, their licensure things and training and competencies, they are matched to only those areas in which they are qualified to be in, in a very automated and streamlined way. And that's the benefit of this platform is we have our credentialing system embedded into this so that way there is that automation matching people to the area. So you could have an ICU nurse work in med surg because they are qualified and can get away with giving that care. They may not want to 'cause the workload is higher, but that's another scenario. So there is job profile mapping that occurs on the onset of put turning something like this on. So there's absolutely no way that someone can work in an area that is either a closed unit and not part of that unit or not qualified or competent to be in.

Lou (35:08):

Yeah, from a technology. One second, from a technology side, tying this thing in, we've actually been able to sync it with the schedule within U K G dimensions. So when need says, Hey, we, we've onboarded someone or credentialed someone for a particular unit or role, like the same data that the unit manager is seeing is syncing with the app in such a way that no one's matched outside of anything confusing, if that makes sense. So the hiring manager sets it once and it only matches based on what the manager has determined to be Correct. So, sorry to interrupt.

Becker's Healthcare Host (35:42):

And does this work in each facility individually or is there reliance on others nearby to fill in gap?

Nida (35:50):

Yes. So the way that you wanna manage your workforce can be as big as in a small as you want it to be. And that is something that is remarkable about this, this, this platform. So you can isolate it to a unit level, to a facility, multiple facilities within a region, health system wide. If they're within proximity of each other, the options are limitless.

Becker's Healthcare Host (36:22):

And going off of that, can a user pick up a partial shift? For example, if a nurse sees an open 12 hour shift but can only do seven hours, can that work within the technology?

Nida (36:34):

Absolutely. It certainly can. And at Mercy, we've, and again, that flexibility that we've introduced is combination of 4, 6, 8, 12 hour shifts. You can't have partial shifts. The technology's very sophisticated enough to be able to recognize that and translate that. And as it updates the, the schedule in staffing and scheduling

Becker's Healthcare Host (37:02):

And what app is being used in the demonstration in order to connect scheduling and workforce.

Nida (37:09):

So our staffing and scheduling platform is UKG dimensions, but this presentation is largely the technology that we talked about today for shift pickup and insights for workforce management is the platform we developed with Trusted Health, and it's called Works on Demand.

Becker's Healthcare Host (37:31):

Does this supplement or replace traditional staffing modes? As in, does the nurse manager fill a schedule and Mercy Works on demand is used to fill the gaps in the schedule?

Nida (37:43):

Yeah. So they're compliment to each other. Your central source of truth will continue to be your staffing and scheduling system. And then the works on demand platform, again, is a connector and visualizer and and a ability to give you that insights in that way. So there are a compliment to each other. Please do not get rid of your staffing and scheduling system. You will always need that. 'cause That's where your need parameters are being set. So fundamentally from an operational perspective, you're not going to change the principles that you have to do staffing and scheduling and deployment. All of that needs to remain intact. And, but what this does is it pulls key proxy points outta your staffing and scheduling system to make it easier to see things and make decisions, but also to take action around prospectively meeting your fill and your staffing and scheduling needs. So they connect, they work with each other and it's an automated feed in that way with bi-directional feedback loops as things change with your census,

Lou (38:48):

One extra note to include there is it is integrated across multiple different points within UKG. So it's, it's the worker bear with me as I get a little technology nerdy right here, and the worker is synced, the schedules are synced, the credentials are synced, everything's working in tandem to make sure that while yes, it is a supplement to UKG, you're not creating chaos for shift air traffic control. You're here supplementing the schedule, you're here making the schedule easier to fill, but you're not creating much extra work for unit managers or anyone else to tackle. The goal is to reduce manual work, not add to it.

Becker's Healthcare Host (39:25):

Do all shifts end up having an incentive or does the system price some at the regular rate?

Nida (39:31):

That is an organizational decision. It can do either or You could do flat rate pricing, you can do dynamic pricing. It really just depends on what are your financial targets that your organization is trying to achieve. But you can, you have the option of selecting the way that you reach. And one thing that I wanna call out too for Mercy, right, this is a singular way. We have one way to do staffing and scheduling from a technology perspective and one way to pick up incentive shifts, and it's not just for our external workforce or our flex workforce, it's also to manage our internal core workforce as well across different care settings. And so with that being said, you have the ability to choose directionally where, where you need to be from a financial perspective. All of that is possible.

Becker's Healthcare Host (40:23):

And it looks like we have time for one more audience question here. If you have a nurse who normally picks up a fourth shift a week, would they start to change their scheduling practices to only pick up three a week until after the schedule is posted with the incentive shift and then pick up the fourth shift a week?

Nida (40:43):

That is a very specific question, and it all boils down to, in the way in which you what your staffing and scheduling practices are, what your FTE definitions of eligibility requirements are. And that speaks to the pre-work that needs to be done from an organizational and operational perspective. And so when we saw on this journey, not only did we align our workforce layers, we had a a look at all of our FTE eligibility requirements in the way that which we practice people based off of the FTE levels that would describe the situation in which you're, you're, you're saying. But the short answer here is, is yes, there is a possibility to be able to do it. It just depends on the guardrails that you've set from an organizational perspective around how you want those FTE eligibility rules or guardrails to be operationalized. And so that's gonna vary from organization to organization. But from a technology perspective, is this something that can be accommodated? Absolutely. Now the question will always go back to is this aligned with your strategy and the way in which you wanna operationalize your workforce? And that will be a local decision.

Becker's Healthcare Host (41:54):

Well, unfortunately that's all the time that we have for today. But I would like to thank Nida and Lou for an excellent presentation and trusted health for sponsoring today's webinar. To learn more about the content presented today, please check out the resources section on your webinar console and fill out the post webinar survey. Thank you all for joining us, and we hope that you have a wonderful afternoon.

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