The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts


AUTHORDaniel J. Grady, Terrence F. Smith; Respiratory Care, Mission Health System, Asheville, NC

Background: Multiple strategies have been attempted to achieve healthcare cost reductions. It is well known that salary expense is a large portion of the Respiratory Care operating budget. According to the Advisory Board, significant salary cost reductions have been documented using daily staffing adjustments based upon service volume. The purpose of this study was to evaluate the efficacy of a novel, customized, RVU-based, daily, flex-staffing system which was used for a Respiratory Care Department in a 400 bed hospital. Methods: A management engineer was consulted to assist in constructing a novel software program to determine staffing requirements for each shift based upon AARC Relative Value Units and completed Respiratory Care procedures. Prior year annual financial reports were analyzed to determine the top 10 procedures by volume. The shift supervisor entered the number of staff present and the procedures completed during the shift, and the program would automatically calculate the number of staff required. When overstaffing occurred, staff were rotated off. When understaffing occurred during high volume months, float pool staff were called in and overtime was authorized. The overall target of staffing each shift was to achieve a staffing variance less than 0.5 FTE. Results: The flex -staffing system was utilized for 10 months, and achieved salary cost reductions of $ 247,900, which equated to a reduction of 5 FTE, without significant patient care issues related to staffing. The system was particularly effective for flex-staffing during a low- volume fiscal year in which the procedure volume for the department decreased by 26, 000 procedures, or 9.0%. Conclusions: Proper staffing levels are essential to maximize patient safety by minimizing missed treatments. The use of a daily, RVU-based, flex-staffing system provides internally validated information which makes staffing decisions data-driven, and the system may allow for significant reductions in health care salary costs based upon data for services delivered. Since this system was very effective for objectively determining staffing requirements for Respiratory Care services, it was modified for use in other procedure-based hospital services including, neurodiagnostic testing, pulmonary rehab, inpatient dialysis services, and sleep disorder center services.
Sponsored Research - None
Healthcare Salary Cost Reductions for A Respiratory Care Department in a 400 Bed Hospital Using a Daily, RVU-Based, Flex Staffing System to Adjust Staffing with Procedure Volume