March 30, 2007

elevate: Answering the Tough Questions

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Medical Center leadership answers the tough questions about what the elevate program is and what it means for the people who work at VUMC.

Question: Why doesn't the Medical Center hire more staff?

Answer: In a medical center like Vanderbilt, demand for services often outstrips the ability to provide them, and at those times we ask people — especially those in direct patient care roles — to work extra hours and shifts.

The burden this places on staff is sometimes difficult. Staffing levels are set based on anticipated volumes, and when volumes exceed predictions, we need to bring in extra help — temps, traveling nurses or our own staff who work extra hours.

This is a workable system as long as these spikes are short-lived and there are staff available to be brought in.

To be successful we need to have enough staff to do the job safely, effectively and without demanding more of each individual than is reasonable to expect. But we cannot be successful if we hire more staff than we need. It is a delicate but achievable balance.

We regularly monitor staffing levels per occupied bed — a measure most hospitals use to track staffing levels. By looking at national data we find that we are about at the median across most of our service lines.

The keys to successfully managing staffing is to budget and plan well, to hire the right people and to retain them so we are working with a team that is well coordinated, seasoned, experienced and who are committed to our work, our patients and each other.

Elevate includes a number of initiatives — better hiring methods, mentoring of new staff, employee recognition and reward — that will help us achieve these keys to staffing success.

— Harry Jacobson, M.D., vice chancellor for Health Affairs