HLTH 8750 Week 7 Workforce Timing Analysis Paper Example

Workforce Analysis: How Perioperative Staff Follow Cases Out of the Hospital, and When the Hospital Notices

Student Name

Walden University

HLTH 8750: Trends and Issues in Executive Level Management for Healthcare Administrators

Instructor Name

Month Day, Year

Workforce Analysis: How Perioperative Staff Follow Cases Out of the Hospital, and When the Hospital Notices

Introduction

Perioperative staff can follow cases out of the hospital long before the vacancy report notices. This analysis traces, for Northgate Health, a composite three-hospital system, how nurses, surgical technologists and anesthesia staff drawn to the weekday schedules of new ambulatory surgery centers would leave the hospital, and when the hospital's remaining operating rooms would feel their absence. It is organized as a timeline from a joint venture announcement to the point when the hospital's staffing pattern has visibly changed. Each stage is paired with the measure that would reveal it and the delay before that measure moves. The timeline carries no dated figures; it describes a sequence and its lags.

Why Staff Move

Surgery centers typically operate on weekdays during daytime hours, with no overnight or weekend call and a predictable caseload of shorter procedures. Center cases run shorter on average than the same cases in hospital operating rooms (Munnich & Parente, 2014), which makes the working day more predictable. For perioperative staff who have worked hospital schedules with call, weekends and long complex cases, that is an attractive offer, often more attractive than any pay difference.

The Timeline

Table 1 sets out the stages, the measure that would reveal each and how long that measure lags the stage itself.

Table 1

Stages of Perioperative Staff Movement, With Indicators and Delays

Reading the Delays

The vacancy rate, the measure most hospitals watch, is the last to move. Early departures are often filled quickly with newer staff or agency coverage, so the vacancy rate can stay flat while the experience level of the perioperative workforce falls. By the time vacancies rise, the second wave of departures may already be under way. The earliest reliable measures are exit interview reasons and resignations by tenure, which most hospitals collect but few review against a specific question such as whether a new center is drawing staff.

The middle measures, agency hours and call shifts per person, move within a quarter or two and are already in the hospital's payroll and scheduling systems. They are the most practical early warning, because they are routinely recorded and can be compared month to month.

Why the Movement Accelerates

The sequence is not linear; it accelerates. Systems thinking describes this as a reinforcing loop, in which an effect feeds back to strengthen its own cause (Sterman, 2000). Here, each experienced departure shifts call and complex cases onto those who remain, raising their workload. Research on hospital nurses found that heavier patient loads were associated with higher burnout and job dissatisfaction (Aiken et al., 2002), both of which predict leaving. Each further departure raises the burden again. The loop explains why the second wave can be larger than the first, and why the hospital may notice the problem only when it has already gathered speed.

The loop also points to where it can be broken: at the burden itself. Measures that limit how much call and complex work shifts onto remaining staff, such as temporarily reducing elective case volume or distributing call across the system's three hospitals, slow the loop even if they do not stop departures.

Where Action Is Still Possible

At stage 1, the hospital can still act cheaply: by asking departing staff about the center, by offering predictable schedules to experienced staff who value them and by planning which roles the joint venture should staff from the hospital. At stages 2 and 3, it can limit the loss by protecting experienced staff from absorbing all call and by using agency staff for routine rather than complex cases. By stage 5, options are mostly expensive, such as retention bonuses or premium pay for call.

The Joint Venture's Effect

If Northgate forms joint ventures in orthopedics and gastroenterology, the centers will recruit perioperative staff, and many will come from Northgate's own hospitals. That accelerates stage 1 within the system. But it also creates an option an outside center does not: a shared staffing arrangement in which staff are employed by the system and assigned to either the center or the hospital, with rotation that gives them some predictable center days while keeping their skills and some of their time in the hospital. Such an arrangement could keep experienced people within the system's reach rather than losing them to competitors. It would need careful design, since staff who joined for predictable hours may resist rotation back to hospital call. It would also need to be offered before recruitment begins, so that experienced staff see a system option alongside the outside center's offer. A rotation model that limits hospital call for joint venture staff, while asking them to cover a set number of complex hospital cases each month, is one design worth testing with the perioperative leadership. The analysis recommends that the joint venture staffing plan be written with this choice in mind before recruitment begins, because by the time the hospital's vacancy report notices, the choice will have been made by the staff themselves.

References

Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J., & Silber, J. H. (2002). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA, 288(16), 1987-1993. https://doi.org/10.1001/jama.288.16.1987

Munnich, E. L., & Parente, S. T. (2014). Procedures take less time at ambulatory surgery centers, keeping costs down and ability to meet demand up. Health Affairs, 33(5), 764-769. https://doi.org/10.1377/hlthaff.2013.1281

Sterman, J. D. (2000). Business dynamics: Systems thinking and modeling for a complex world. Irwin/McGraw-Hill.