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.