3 Strategies to Reduce Nurse Labor Costs by Building Better Schedules

Perioperative leaders, are you over-reactive when it comes to staffing decisions? Are you forced to pay staff heavy premium bonuses when contingency staffing is needed? These are key practices to avoid if you're aiming to reduce overspending on staffing. And after all, who isn’t?

 “Nurse leaders should be proactively looking at staffing needs 3-5 days in advance and actively evaluating contingency plans to avoid unnecessary overtime,” said Shelley Simkins, MSN, MBA. “This would include looking at surgical cases and evaluating if staffing needs to be revised to meet the fluctuations.”

With 25 years of nursing experience and expertise in clinical operations, Simkins works closely with perioperative leaders to help optimize staffing and scheduling processes.

Her first suggestion is for nurse leaders to “step back and look at your staffing situation from a 10,000-foot view to see how the skill mix aligns with volume, cases, and schedule changes, especially as the demand for self-scheduling is on the rise.”  

From this vantage point, Simkins shares three strategies any nurse leader can refine to drive more effective and staff-satisfying scheduling practices in their own unique care setting:

Optimize Staffing for Efficiency and Equity

Ensure that all staff, both full-time and part-time, are scheduled according to their full FTE—neither over nor under. Per Diem staff should be scheduled according to their shift commitment. Consider whether a tiered PRN program might help provide better backfill across the OR.

Cross-Train Staff for Flexibility and Reduced Shortages

Many organizations continue to struggle with higher turnover rates, which can leave units with open shifts due to a lack of staff with the appropriate skill sets. A good practice is to cross-train OR staff to handle multiple roles, especially for nurses and surgical technologists, which can improve flexibility and reduce staff shortages.

Utilize Key Metrics for Proactive Staffing Planning

Nurse managers need visibility into factors that influence open positions, leaves, and other staffing elements that will affect future schedules. Here are two key metrics that give nurse leaders a forward-looking view of their staffing needs:

• OR Operational Metrics— Tracking metrics such as first case on-time starts, room turnover time, and case length can impact staffing. If cases are trending to start late or are complex and run long, your staffing plans should be adjusted to avoid consistently pushing teams into overtime.
• Absenteeism and Turnover Percentages— These metrics can lead to increased labor costs and staff burnout from working too many consecutive shifts. Managers should monitor for chronic absenteeism and engage in proactive conversations with staff who may be at risk for turnover.

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