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Mountain States Health Alliance: A '3-D' Solution to a Common People Problem

How MSHA transformed itself into an organization that not only provides quality patient care, but is also considered a great place to work

By Jennifer Aden Murnane, Ph.D., and Kathryn Wilhoit, Ph.Dc., RN, NEA-BC, FACHE

When it comes to caring for the sick and injured, dedicated physicians, nurses and clinical support staff rank patient care as their top priority – and rightly so. However, the often hectic schedules and long hours these professionals work contribute to the perception (and reality) that the healthcare environment isn’t all that conducive to engaging and retaining staff in the long term. In fact, a 2008 survey of registered nurses found that 41% of RNs under 50 years of age were no longer working in the field of nursing due to stressful work environments and burnout.

Given this, how can healthcare organizations positively impact team member engagement, help staff avoid burnout and decrease overall dissatisfaction in healthcare providers’ roles? Using the right tools and techniques, it is possible to serve healthcare consumers and impact team member engagement at the same time. Efficient staffing patterns and nurse satisfaction are high priorities for hospitals, as one large Tennessee health system has proven.¹

Mountain States Health Alliance (MSHA), an innovative and transformational organization, provides quality patient care and is also considered a great place to work. Many years ago, MSHA joined with Avantas, a Nebraska-based organization, to develop a unique approach to its strategic workforce management program.

Three-Dimensional Engagement

Hospital leaders have a responsibility to place their talent pool in a position to thrive. When healthcare team members succeed, we all benefit with better health outcomes for ourselves and our community. Consulting firm Towers Watson defines employee engagement as having three dimensions: 1) Rational, 2) Emotional and 3) Motivational.² The Rational portion relates to team members’ understanding of how they contribute to their organization through their responsibilities. The Emotional dimension depicts the passion and dedication team members bring to their job, and the Motivational aspect describes the level of effort team members contribute to their job above and beyond their primary role to perform better.

Mountain States Health Alliance’s nursing colleagues worked side by side with Avantas to customize the business rules and processes that fed into an automated Labor Management System. This web-based solution, called Smart Square, is designed to tackle the end-to-end workforce management process. The Avantas Predictive Model, embedded within Smart Square, uses mathematical algorithms to forecast the required supply of staff in advance of actual patient need.

According to Jackie Larson, Vice President of Avantas Client Services, “It’s tough to describe the feeling we get when Clinical Leaders share the real-life impact felt by their staff. It’s really what Avantas is all about. The Predictive Model embedded within Smart Square creates an effortless way to balance patient care needs against employees’ scheduling preferences.”

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Work/Life Balance

Together, Avantas and MSHA developed an integrated resource management function called Central Staffing Services to deploy staff in parallel with emerging patient demand, created a clear differentiation between core and contingency staff committed to using each form of staff for its intended purpose, and adopted a revised incentive management philosophy.

MSHA execvutives Marvin Eichorn, Senior Vice President of Finance; Shane Hilton, Chief Financial Officer; and Jamie Parsons, Vice President of Human Resources, are ardent supporters of this project. They agree team member engagement is a critical component in achieving positive patient outcomes and financial success at MSHA and see technology, sound processes and strategic relationships as key to those outcomes.

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Tallying the Benefits

In the end, team members were better able to manage their time-off requests and were able to sign up for additional shifts to meet their personal schedules. This enhancement to work/life balance led to improved satisfaction scores, as measured in MSHA’s Team Member Opinion Survey, and executive recognition for improved self-scheduling processes at the annual Quality banquet.

In addition to contributing to team member engagement, hard dollar benefits were realized from these activities as well. In the year of implementation, overtime costs decreased by $824,000, and premium pay decreased by $444,000 over the previous year’s figures, having a positive financial impact on the overall organization.³ In February 2011, Central Staffing Services received the highest level award given at the 8th Annual MSHA Quality Banquet. The initiative was recognized by the national quality experts chosen to judge the competition as the top MSHA Operational Effectiveness achievement out of 104 eligible nominees.

Dr. Jennifer Murnane is the Client Relationship Executive at Avantas, a consulting and software development firm focused on solving complex human capital and labor management issues specific to the healthcare industry. Prior to joining Avantas, she served as the Associate VP of Strategic Initiatives for Bellevue University. She has authored several dozen academic and practitioner articles and is a sought-after public speaker in the area of strategic workforce management. Murnane is on the faculty of Bellevue University’s PhD in Human Capital Management program. Kathryn W. Wilhoit, VP & Chief Nursing Executive at MSHA, has over 30- years of experience as a CNO for a dynamic and growing tertiary medical center and CNE for a multi-hospital health care system. She is a Licensed Nursing Home Administrator with 10 years experience and has certification in the area of Nursing Administration at the Advanced level. She has also served on the Tennessee Board for Licensing Health Care Facilities and the Board for Licensing Nursing Home Administrators.

1. Danello S. (2008) Open Shift Management. Nursing Management, 39(12), 30-32.
Health Resources and Services Administration [HRSA]. (2010). Findings from the 2008 National Sample Survey of Registered Nurses. Online at http://bhpr.hrsa.gov/healthworkforce/rnsurvey/2008/nssrn2008.pdf

2. Towers Watson (2009, April). Turbocharging Employee Engagement: The Power of Recognition from Managers. Online at http://www.towerswatson.com/assets/pdf/629/Manager-Recognition_Part1_WP_12-24-09.pdf.

3. Wilhoit, K., Grindstaff, S., Eichorn, M. (2010, August 18) Collaborative Resource Management: How Nursing and Finance Can Drive Savings and Quality Improvements Through Analytics [webinar offered through American College of Healthcare Executives].

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June/July 2011

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