Episode 23:
Short Staffing

Short-staffing occurs when an urgent care center has insufficient providers or support staff for the volume of patients presenting. The result is often long wait times, administrative and/or clinical errors, and lost revenue. Employees forced to do double- or triple-work while also bearing the brunt of angry patients will eventually quit, perpetuating the problem as the center can never seem to “get ahead.” While management often blames competitive labor markets and “bad” employees for the problem…fact of the matter is it’s management who hires and fires, it’s management who makes the schedule, and it’s management who drives the culture. Short-staffing is thus a problem of management, not employees. Solutions include employing a bench of PRN or flexible staff, cross-training of front- and back-office functions, providing market-competitive pay and benefits, and creating the type of engaging culture that makes employees want to stay and give their best. Industry expert, Alan Ayers has more.

Good Afternoon! This is Alan Ayers and I am Just Checking In from Rockford, IL to talk to you about the very serious management challenge of short-staffing. Now, quite simply, short-staffing is having an insufficient number of providers and staff tho handle the anticipated volume of patients or customers through a center on any given day. Short staffing results in long wait times. It results in errors due to overload and at the end of the day, short staffing is a significant customer satisfaction detractor. But it’s not just customers who take the brunt of short staffing.

So I’ve recently had an experience with a large home improvement retailer here in the Midwest. This is a store that in the past I’d always had good experiences, but on this one specific Saturday, the store was a mess. There were long lines at every single register, employees were not available to answer questions, everyone was just flustered, and it was not a pleasant customer experience. But when I spoke with the manager, the manager blamed the issue on short staffing and specifically about a third of the workforce, a third of the employees had called in sick that specific day. Well, first of all, to me that is hugely indicative of the culture. You should have a culture where employees are sufficiently engaged that on your busiest shopping day, “Hey! That’s a day that I’m going to get up early. I’m going to get breakfast. I’m going to hit the ground running because this is the busiest day of the year.” Instead, these employees looked and said “This is the busiest day of the year. It’s going to be a lot of hassle, a lot of work. I’ll just call in sick leaving my coworkers to bear the brunt of dissatisfied customers; leaving my coworkers to run around frazzled, trying to get these customers through in a timely manner.” Not a very considerate thing that these employees did to their coworkers and, of course, what would you expect after a weekend of employees working in a short-staffed situation? Those who can find jobs elsewhere will, which results in turnover, which then accelerates the problem of short staffing.

So, it’s interesting to me that management loves to blame short-staffing on customer service issues. But ultimately, in my opinion, it’s management who’s responsible for short-staffing. Management sets the culture. Management determines the schedule. There are some providers, particularly those in occupational medicine, who have figured out “Hey, labor is our #1 cost of operations. If we short-staff labor, we can make more money.” Well sure you can! But you’re going to leave patients with long wait times, people are going to leave dissatisfied, and they’re certainly not going to tell friends and family that they should use the center. So that is a short-term strategy and it’s not sustainable. So you should always look to schedule a sufficient number of employees to meet the anticipated volume that you would see on a given day. Now, that doesn’t mean you’re not going to have occasional spikes in volume, or you’re not going to have people that they call off occasionally.

Another solution is cross-training. So, when a short-staffing situation arises, say, because someone calls in sick, your manager or supervisor should be able to step in and fill any role in the center, except maybe that of a provider. In addition with cross-training, a front office person could fill in in the back, or a back office person could fill in in the front. The more that people know each other’s jobs, the greater they can support one another in making sure flow keeps moving and that patients are moving through the center when the short-staffing situations arise.

Also, management is responsible for hiring and firing. So if you find that you don’t have enough people, maybe because of turnover, you need to have a bench. Now, ideally, if you have multiple locations and a local urgent care chain, you can PRN, float, or temporary labor. In a single-site operation, that may not be feasible, but certainly you can develop a bench. If you’re waiting until you’re in a short-staff situation before you even post a job and then you’re hiring two out of every three people you interview, then you’re not being selective enough. So we’ve encouraged urgent care centers to hold job fairs, have a pool of resumes, and a pool of people you’ve spoken with that you may not be ready to hire today, but when a position opens, they’re individuals that you can call and potentially offer a job to. Having that bench is a critical defense against future short-staffing situations.

And then, clearly, having a culture where employees feel engaged. 80% of the U.S. workforce claims that they’re currently disengaged. So are you paying competitive wages and benefits? If you’re not, then you probably have people sitting on the sidelines looking for other opportunities. You need people who are vested long-term in your operation because they are paid well, they’re appreciated in the work they do, they’re vested in the long-term success of the operation, and they’ve really bought into your organizational culture. So at the end of the day they care. They care enough not to leave your customers with bad service. They care enough not to leave their colleagues struggling with a short-staffing situation.

So at the end of the day, short-staffing is a management problem. Short-staffing is not an excuse for poor service. Management must take ownership of the short-staffing problem. And management must act proactively before finding itself in a short-staffing situation.

If you have any questions as to, say, how to appropriately staff an urgent care center or anything else pertaining to urgent care operations, please feel free to contact us at Practice Velocity at the website that you see on your screen. Once again, this is Alan Ayers, Just Checking In.