“Nursing costs are way too high. Something must be done. Staffing is out of control.”
“My staffing is fine. I’m not over spending. I’m tired of being constantly asked to cut staffing.”
These polar opposite conversations occurred in separate meetings with the Executive Director and with the Director of Nursing within a twenty four hour time frame.
The Executive Director of the Hospital gave clear orders to me as the (brand new) budget manager to follow up with the Director of Nursing and get this issue resolved.
Looking at budget to actual line items, nursing salary expenses were over budget.
“Before you talk to me about staffing costs over budget, would you be willing to listen to how we staff the floors?”
For the next few minutes, I learned from an incredible Director of Nursing how nursing staffing was tied to census and how actual scheduling was determined on a daily and weekly basis.
“What if we monitor on a timely basis nursing staffing hours per patient day?”
After doing this calculation, I realized the Director of Nursing was actually ahead of her budget.
It wasn’t long before it was decided that actual to budget results would be monitored on a timely basis using an agreed upon hours per patient day key performance indicator. When the Executive Director would call with a concern about nursing being over budget, the hours per patient day key performance indicator was readily available. Usually staffing costs were no longer viewed as an issue. If staffing was above the agreed upon KPI, it was quickly dealt with and corrected.
- The interpretation and utilization of the same set of facts can either contribute to a peaceful working environment or to an environment loaded down with unnecessary conflict.
- Significant conflict is inevitable in the absence of agreed upon measures of operational performance.
- Financial statements should confirm what is already known rather than provoking tensions and conflicts due to totally unexpected and unplanned for surprises.
- It is essential to take the time to learn the story behind the number.
Do you have agreed upon key performance indicators that are built into your organizational DNA?
Are there conflicts and tensions that could be reduced and/or eliminated through the timely tracking of a handful of key performance indicators?