The Science Journal of the American Association for Respiratory Care

2004 OPEN FORUM Abstracts

SPECIFIC STRATEGIES FOR REDUCTION OF OVERTIME IN THE RESPIRATORY CARE DEPARTMENT –

Denise M. Rebel BS, RRT, AE-C, Mike Trevino MS, RRT, David Mussetter BA, RRT, Tim Frymyer BS, RRT, Gary L. Weinstein MD, FCCP, Presbyterian Hospital of Dallas, Dallas, Texas

Background: We are a 900-bed metropolitan hospital operating with a 77% occupancy rate. Our department includes a NICU and an adult care staff totaling 77 FTE’s. We define FTE as someone working 72 to 84 hours in a 2-week pay period. Our challenge was to reduce overtime by implementing changes to our staffing practice.

Methods
: Using objective monitoring we tracked total overtime which included both scheduled (84-hour work rotor) and unscheduled overtime and the practice of clocking-in early. We used numerous methods to address the unscheduled overtime: 1) increased lead tech and staff awareness through meetings and memorandums 2) installed alarm clocks that sound at the appropriate clock-in time 3) provided positive feedback to the staff when overtime was shown to be reduced 4) proactively insured staffing was adequate before a need for extra staff arose 5) built a staffing model for the lead therapists to use for making accurate work assignments 6) offered incentives to cut tardiness and unscheduled overtime 7) employee recognition for attendance and 9) continued to function within a protocol driven clinical practice model.

Results:
As a department, our overall overtime has been reduced by 8.3% from 2003 to 2004. Our more dramatic results were seen in the larger adult care side of our department. Reductions of >32% have been achieved in the adult care arena. In addition, the adult area also decreased unscheduled overtime by 26% from the 4th quarter of 2003 to the 2nd quarter of 2004. Early clock-in occurrences have dropped 98% on the whole, which realized a cost savings of up to $1200 in a single month.

Conclusion:
Reducing overtime does not have to be a difficult or distressing process. Implementation of specific strategies can address challenges faced in respiratory therapy departments. In this case, the challenge was to reduce overtime and maintain employee morale without compromising patient care. By raising awareness, educating and rewarding those who are involved in the staffing process and becoming proactive in our staffing model, overtime will be substantially reduced. This process does require continued monitoring and an on-going interaction with the staff to keep them informed as to how overtime affects the operation of the organization.

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