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  1. 1. STAFFING
  2. 2. staffing Staffing has been described as the managerial function of filling and keeping filled the positions in an organization structure. This is achieved by identifying requirement of work force, followed by recruitment, selection, placement,promotion, appraisal and development of Managerial functions of attracting, personnel. acquiring, retaining and developing the human resources required by an organization.
  3. 3. Definitions  According to McFarland,“ Staffing is the function by which managers build an organization through the recruitment, selection, and development of individuals as capable employees.”
  4. 4.  According to Koontz, O’Donnell and Heinz Weihrich,“ The management function of staffing is defined as filling position in the organization structure through identifying workforce requirements, inventorying the people available, recruitment, selection, placement, promotion, appraisal, compensation, and training of needed people
  5. 5.  Staffing pertains to recruitment, selection, development, compensation of subordinates Theo Haimann  Staffing is the whole personnel function of bringing in and training the staff and maintaining favorable conditions of work Luther Gullick
  6. 6.  Staffing is the personnel activity that brings people to an organization to fulfill its mission, as delineated through strategic and human resource planning Schmidt M J et al  The most important resources of an organization are its human resources. Thus, among the most critical tasks of a manager are the selection, training, and development of people who will best help the organization meet its goals. Stoner and Wankel, 1987
  7. 7. Nature of staffing  Staffing is staff centered.  It is universal and applicable in all organization.  It is concerned with all categories of personnel from top to operational level.  It is a continuous activity as the manager is to guide and train the subordinates and also evaluate their performance.  It helps in placing right men at right job.  Staffing is concerned with training and development of human resources.
  8. 8. Need for staffing  Advancement in knowledge and technology  Specialization  Increasing size of health organizations  Health awareness and awareness of Consumer’s Rights  Shortage of staff  Emphasis on human relation  Occurrence of major crises
  9. 9. Importance of staffing  Lower patient mortality and morbidity  Reduce incidents of adverse events  Shorten the length of hospital stay  Increase patient satisfaction  Increases nurse’s job satisfaction  Absenteeism and turn over rates are reduced  It has positive impact on continuity and quality of care by the nurses  Ensures the continuous survival and growth of the enterprise through the succession planning for managers
  10. 10.  Makes for higher performances, by putting right person on the right job.  competent personnel for various jobs.  Improves job satisfaction and morale of employees through objective assessment and fair reward for their contribution.  Helps to ensure optimum utilization of the human resources. By avoiding over manning. It prevents under- utilization of personnel and high labor costs. At the same time it avoids interruption of work by indicating in advance, the shortages of personnel.
  11. 11. Philosophy of staffing  There are three general philosophies of personnel management. The first is based on organizational theory, the second on industrial engineering, and the third on behavioural science. The organizational theorist believes that  Human needs are either so irrational or so varied and adjustable to specific situations that the major function of personnel management is to be pragmatic as the
  12. 12.  If the jobs are organized in a proper manner, he reasons, the result will be most efficient job structure, and the most favourable job attitudes will follow as a matter of course. The industrial engineer believes that  The man is mechanistically oriented and economically motivated and his needs are best met by attuning the individual to the most efficient work process.
  13. 13.  The goal of personnel management therefore should be to concoct the most appropriate incentive system and to design the specific working conditions in a way that facilitates the most efficient use of the human machine.  By structuring jobs in a manner that leads to the most efficient operation, the engineer believes that he can obtain the optimal organization of work and the proper work attitudes.
  14. 14. The behavioural scientist believes that  The behavioural scientist focuses on group sentiments, attitudes of individual employees, and the organizations’ social and psychological climate.  Personnel management generally emphasizes some form of human relations education, in the hope of instilling healthy employee attitudes and an organizational attitudes and an organizational climate which he considers to be felicitous to human values. He believes that proper attitudes will lead to efficient job and organizational structure
  15. 15. Philosophy of staffing in nursing  Nurse administrators believe that it is possible to match employees’ knowledge and skills to patient care needs in a manner that optimises job satisfaction and care quality.  Nurse administrators believe that the technical and humanistic care needs of critically ill patients are so complex that all aspects of that care should be provided by professional nurses.  Nurse administrators believe that the health teaching and rehabilitation needs of chronically ill patients are so complex that direct care for chronically ill patients should be provided by professional and technical nurse.
  16. 16.  Nurse administrators believe that patient assessment, work quantification and job analysis should be used to determine the number of personnel in each category to be assigned to care for patients of each type( such as coronary care, renal failure, chronic arthritis, paraplegia, cancer etc)  Nurse administrators believe that a master staffing plan and policies to implement the plan in all units should be developed centrally by the nursing heads and staff of the hospital.
  17. 17.  Nurse administrators believe the staffing plan details such as shift- start time, number of staffs assigned on holidays, and number of employees assigned to each shift can be modified to accommodate the units’ workload and workflow.
  18. 18. Functions in staffing  Identifying the type and amount of service needed by agency client.  Determining the personnel categories that have the knowledge and skill to perform needed service measures.  Predicting the number of personnel in each job category that will be needed to meet anticipated service demands.  Obtaining, budgeted positions for the number in each job category needed to service for the expected types and number of clients.
  19. 19.  Recruiting personnel to fill available positions.  Selecting and appointing personnel from suitable applicants.  Combining personnel into desired configurations by unit and shift.  Orienting personnel to fulfil assigned responsibilities.  Assigning responsibilities for client services to available personnel.
  20. 20. Objectives of staffing in nursing  To understand all function of in an organization.  To understand manpower planning so that people are available at right time and at right place  To understand issues related to job analysis and to overcome the problem.  Provide professional nurse staff in critical care units, operating rooms, labour and emergency room  Provide sufficient staff to permit a 1:1 nurse- patient ratio for each shift in every critical care unit  Staff the general medical, surgical, obstetrics and gynaecology, paediatric and psychiatric units to achieve a 2:1 professional- practical nurse ratio.
  21. 21.  Provide sufficient nursing staff in general, medical, surgical, obstetrics and gynaecology, paediatric and psychiatric units to permit a 1:5 nurse patient ratio on a day and afternoon shifts and 1:10 nurse- patient ratio on night shift.  Involve the heads of the nursing staffs and all nursing personnel in designing the department’s overall staffing program.
  22. 22.  Design a staffing plan that specifies how many nursing personnel in each classification will be assigned to each nursing unit for each shift and how vacation and holiday time will be requested and scheduled.  Hold each head nurse responsible for translating the department’s master staffing plan to sequential eight weeks time schedules for personnel assigned to her/ his unit.
  23. 23.  Post time schedules for all personnel at least eight weeks in advance.  Empower the head nurse to adjust work schedules for unit nursing personnel to remedy any staff excess or deficiency caused by census fluctuation or employee absence.  Inform each nursing employee that requests for specific vacation or holiday time will be honoured within the limits imposed by patient care and labour contract requirements.  Reward employees for long term service by granting individuals special time requests on the basis of seniority.
  24. 24. ANA Principles of Nursing Staffing  Patient Care Unit Related ◦ Appropriate staffing levels for a patient care unit reflect analysis of individual and aggregate patient needs. ◦ There is a critical need to either retire or seriously question the usefulness of the concept of nursing hours per patient day (HPPD). ◦ Unit functions necessary to support delivery of quality patient care must also be considered in determining staffing levels.
  25. 25.  Staff Related ◦ The specific needs of various patient populations should determine the appropriate clinical competencies required of the nurse practicing in that area. ◦ Registered nurses must have nursing management support and representation at both the operational level and the executive level. ◦ Clinical support from experienced RNs should be readily available to those RNs with less proficiency.
  26. 26. Institution/ organization related - Organizational policy should reflect on organizational climate that values registered nurses and other employees as strategic assets and exhibit a true commitment to filling budgeted positions in a timely manner. - All institutions should have documented competencies for nursing staff, including agency or supplemental and travelling RNs, for those activities that they have been authorized to perform. - Organizational policies should recognize the myriad needs of both patients and nursing staff
  27. 27. Steps of staffing  Determine the number and types of personnel needed to fulfil the philosophy, meet fiscal planning responsibilities, and carry out the chosen patient care management organization  Recruit, interview, select, and assign personnel based on established job description performance standards.  Use organizational resources for induction and orientation
  28. 28.  Ascertain that each employee is adequately socialized to organizational values and unit norms.  Use creative and flexible scheduling based on patient care needs to increase productivity and retention  Develop a program of staff education that will assist employees meeting the goals of the organization.
  29. 29. Eight elements of staffing  Human resource planning: Assessing current employees, forecasting future needs, and making plans to add or remove workers.  Recruiting: looking for qualified people inside or outside the company  Selection: testing and interviewing candidates and hiring the best available  orientation-: new employees learn about their surroundings
  30. 30.  Training and development  Performance appraisal: establish the criteria for evaluating work  Compensation: establishing pay and, in some cases, benefits.  Employment decisions: transfers, promotions, demotions, lay offs and firings.
  31. 31. Part I: Staffing Model  Defining “staffing” ◦ “the process of acquiring, deploying, and retaining, a workforce of sufficient quantity and quality to create positive impacts on the organization’s effectiveness”  Acquiring: external staffing, new blood  Deploying: internal staffing (promotion, transfer)  Retention: turnover, compensation, etc.
  32. 32. Part I: Staffing Model  Can “good” staffing lead to better organizational effectiveness? ◦ Yes, strongly supported by research findings  Youndt et al., (1996, Academy of Management Journal)  Selectivity +ve  organizational performance  Greer et al. (2001, Journal of Business Research)  Countercyclical hiring +ve  organizational performance 2 years later  Russell (2001, Journal of Applied Psychology)  Using the effective selection system used by a Fortune
  33. 33. Part I: Staffing Model  The Basic Model ◦ Staffing = counting  Considering quantity but not quality  The simplest model  Exhibit 1.1
  34. 34. Exhibit 1.1 Staffing Quantity Projected Staffing Requirements Projected Staffing Availabilities Compare Overstaffed Fully Staffed Understaffed
  35. 35. Part I: Staffing Model  The person/job match model ◦ Staffing = counting + the person-job match  Job characteristics x individual characteristics  Designers: create new items  Creative, imaginative  Social workers: help people with problems  Empathetic, not selfish  Researchers: discover new knowledge  Hardworking, curious to knowledge
  36. 36. Exhibit 1.2 Person/Job Match Job Requirements Rewards Person KSAOs Motivation Match HR Outcomes Attraction Performance Retention Attendance Satisfaction Other Impact
  37. 37. Part I: Staffing Model  The person/organization match model ◦ Staffing = counting + the person-job match  Job characteristics x individual characteristics x organizational contexts  Organization values, culture, career development  East Han Dynasty
  38. 38. Exhibit 1.3 Person/Organization Match Job Requirements Rewards Person KSAOs Motivation Match HR Outcomes Attraction Performance Retention Attendance Satisfaction Other Impact Organization Values New Job Duties Multiple Jobs Future Jobs
  39. 39. Part I: Staffing Model  Relationship between applicants and job ◦ Depending on the economy  At times, organization may be the dominant player  At other times, the applicant may be the aggressor ◦ Depending on demand / supply  For jobs that the supply is more than the demand  Organization becomes dominant  E.g., The demand of IT jobs dropped significantly in and after 2001  For jobs that the demand is less than the
  40. 40. Part I: Staffing Model  Staffing Organizations Model ◦ Strategic Human Resource Management  Organizational Strategy  HR (Staffing) strategy  Staffing becomes part of the overall organization strategy  Core staffing activities are carefully “calibrated” to match the organization strategy
  41. 41. Exhibit 1.5 Staffing Organizations Model Organization Missions Goals and Objectives Organization Strategy HR and Staffing Strategy Staffing Policies and Programs Support Activities Core Staffing Activities Legal compliance Planning Job analysis Recruitment: external, internal Selection: measurement, external, internal Employment: decision making, final match Staffing System and Retention Management
  42. 42. Components of Staffing 1 Staffing pattern: it is the number and mix of personnel that should be on duty per each unit per shift, per day. 2 Staffing plan: It determines the number of nursing personnel that must be hired to deliver nursing care on the nursing units.
  43. 43. scheduling  Cyclic scheduling: it is the best ways to meet the requirements of equitable distribution of hours of work and time.  Advantages:  Once developed, it is relatively permanent schedule requiring only temporary adjustments  Nurses no longer have to leave in anticipation of their time off duty, because it may be scheduled for as longer as 6 months in advance.
  44. 44.  Personal plans may be made in with a reasonable degree of reliability  Request plans may be made in advance  It can be used with rotating, permanent or mixed shifts and can be modified to allow fixed days off and uneven work periods, based on personal needs and work period references
  45. 45.  Self scheduling: it is a process in which staff on a unit collectively decide and implement the monthly work schedule. It provides opportunities for staff to increase communication among themselves and promotes empowerment and professional growth.
  46. 46. Patient classification system  Patient classification system(PCS), which quantifies the quality of the nursing care, is essential to staffing nursing units of hospitals and nursing homes. In selecting or implementing a PCS, a representative committee of nurse manager can include a representative of hospital administration, which would decrease skepticism about the PCS
  47. 47.  The primary aim of PCS is to be able to respond to constant variation in the care needs of the patient  Characteristics  Differentiate intensity of care among definite classes  Measure and quantify care to develop a management engineering standard  Match nursing resources to patient care requirement
  48. 48.  Relate to time and effort spent on the associated activity  Be economical and convenient to report and use  Be mutually exclusive, continuing new item under more than one unit  Be open to audit  Be understood by those who plan, schedule and control thre work
  49. 49.  Be individually standardized as to the procedure needed for accomplishment  Separate requirement for registered nurse from those of other staff  Purposes  The system will establish a unit of measure for nursing, ie. Time, which will be used to determine numbers and kinds of staff needed
  50. 50.  Programme costing and formulation of the nursing budget  Tracking changes in patients care needs. It helps the nurse managers the ability to moderate and control delivery of nursing service  Determine the values of the productivity issues
  51. 51.  Determine the quality: once a standard time element has been established, staffing is adjusted to meet the aggregate times. A nurse manager can elect to staff below the standard timet o reduce costs
  52. 52. Components  The first component of a PCS is a method for grouping patient categories. Johnson indicates 2 methods of categorizing patients. Using categorizing method each patient is rated on independent elements of care, each element is scored, scores are summarized and the patient is placed in a category based on the total numerical value obtained.
  53. 53.  Johnson describe prototype evaluation with 4 basic category for a typical patient requiring one-on- one care. Each category addresses activities of daily living, general health, teaching and emotional support, treatment and medications. Data are collected on average time spent on direct and indirect care
  54. 54.  The second component of a PCS is a set of guidelines describing the way in which patients will be classified, the frequency of the classification and the method of reporting data  The third component of a PCS is the average amount of the time required for the care of a patient in each category.A method for calculating required nursing care hours is the fourth and final component of a PCS
  55. 55. Area of care Category I Category II Category III Category IV Eating Feeds self Needs some Cannot feeds Cannot feed self help in self but is able any may have preparing to chew and difficulty in swallowing swallowing Grooming Almost entirely Needs some Unable to do Completely self sufficient help in bathing, much for self dependent oral hygiene Excretion Up and to Needs some In bed, needs Completely bathroom alone help in getting bed pan/ urinal dependent up to placed bathroom/urinal Comfort Self sufficient Needs some Cannot turn Completely help with without help, get dependent adjusting drink, adjust position/ bed position of extremities
  56. 56. Treatment Simple- supervised, simple- dressing any treatment more than once per shift, foleys catheter care, I&O Any treatment more than twice/ shift Any elaborate / delicate procedure requiring 2 nurses, vital signs more often than every 2 hours Health Routine follow Initial teaching More intensive Teaching of education and teaching up teaching of care of ostomies, new diabetic patients with mild adverse reactions to their illness items, teaching of apprehensive/ mildly resistive patients resistive patients
  57. 57. Methods of determining the staffing pattern 1- The traditional system 1 - The number of beds per unit ( one nurse per 4-6 beds), or 2 - The average census of patients per unit ( one nurse per 4 patients).
  58. 58.  The distribution of nurses is based on the nurse manager' opinion of the proportion of care that is needed on each shift and the adequate staff number to provide that care.  Example: Days: Evenings Nights 45% of the staff 35% of the staff 20% of the staff The traditional system ignored that the group of patients might need more care than another group of the same number
  59. 59.  2- The advanced system A- PATIENT CLASSIFICATION. B- TASK QUANTIFICATION.
  60. 60. Factors affecting staffing pattern determination * Nursing organization factors: 1 Patient care objectives. 2Determined level of patient care. 3-Assignment system. * Patient factors 1- Acuity and general health status 2-Length of stay 3 Patient number. 4Age group (pediatrics or adult) 5-Care expectations of patients
  61. 61. The staffing plan  Methods of determining the staffing plan Using calendar days Divide the number of days in a year by the number of days actually worker per nurse per year. Nurses are not working the 364 days of the year , but actually working 272 days only in a year, because the rest 92 days are considered as follows: - Number of days off (1 day off per week) - Number of vacation days - Number of ill days ( hosp.policy) - Number of holidays 52 days. 20 days. 10 days. 10 days. 92 days
  62. 62. Total actual work days = 364-92=272 days Number of nurses needed to fill one position of staff nurse= Number of days in year Number of actually worked days 364/ 272= 1.33 nurses that means you will need 1.33 nurse to fill one position. Then calculate the total number needed for staffing pattern for all units.
  63. 63.  A system of shift differential is established to compensate for hours worked in evening and night (30% more salary). The same compensation applies to work during holidays
  64. 64. Using the care hours for developing staffing pattern Hospitals used the patient care hours for developing staffing pattern, can calculate the staffing plan using the care hours methods. For example: X Estimating a core staff per shift Bed number in surgical unit= 25 bed The average daily census for 6 month = 19 patients The average daily care hour to be provided= 5 hour per pt/24 hour. Total hours of care will be needed= 19x5= 95 hours. If the work day is 8 hours , then 95 divided on 8 = 11.9 or 12 FTE staff needed to unit for 24 hour.
  65. 65. Total of 12 EFT x 7 days / week = 84 shift / work------------- x If the employee work 5 hours shift / week, then 84 5 = 16.8 the number of EFT needed. The needed on each shift and the adequate staff number to provide that care. Example: days: 45% of staff 45x16.8/100=7.56=8 Evenings 35% of the staff 35x16.8/100=5.88=6 Nights 20% of the staff 20x16.8/100=3.34=3
  66. 66. Category Day Evening Night Total RNs 4 3 1 8 LPNs 2 2 1 5 Other 2 1 - 3 Total 8 6 2 16
  67. 67. Various Research Studies
  68. 68.  Staffing Studies can be used to identify:  How to work more efficiently without adding staff  Technology that can be used to improve processes and ultimately service to the firm  Gaps in knowledge that need to be filled for the firm to get the services it expects.  Training needed to move support staff from responsibilities that are going away to those being added as the needs of the firm change  Where new staff is needed to better support
  69. 69. The Challenge  To demonstrate, let’s walk through the results of a staffing study we did for a large AmLaw 200 firm. That firm had seen rapid growth of attorneys with the library staff taking on new roles while maintaining those they already had. After defining the study with the library director, going through background information, and interviewing staff and key stakeholders, our findings included:
  70. 70.  The department was well thought of by firm members  The workload was unbalanced with some teams having workloads (knowledge management (KM)) that they could not keep up with and other teams (competitive intelligence) feeling comfortable with their workload  Some responsibilities were holdovers from the past  Some of the entry-level research projects could be handled by others in the firm with training
  71. 71.  Some research conducted was at an associate level  The research staff also did court documents retrieval  The library system had never been fully installed and was problematic  There were too many cross functional assignments  The knowledge management team was supporting all library software
  72. 72.  The lawyers and staff in the branch offices did not get the same support as those in headquarters  The director had too many direct reports keeping her from accomplishing more strategic goals and more…
  73. 73. The Solution  From these findings we created a three-year plan for library staff growth based on the services expected by the department and the firm’s goals for attorney growth. That plan for Year One included:  Hire a regional librarian to support the branch offices with that position located in one of the larger branch offices  Move the research manager and KM
  74. 74.  Add the CI librarians to the research team (they were direct reports to the director)  Move responsibility for cataloging and collection development out of a research librarian position that did those tasks half time and research the other half, making her a full- time researcher  Move responsiblity of collection development to the research manager  Train legal administrative assistants to do the
  75. 75.  Hire a technical services assistant to support the work that was not being done because of workload  Outsource cataloging and serials management to outsource with the Technical Services manager handling the relationship and results  Replace the library system and move the management of that system to Technical Services
  76. 76.  Years two and three included adding additional specialized staff to support the increased workflow while maintaining the attorney/staff ratio.
  77. 77. The Result  The library director made several of the Year One changes right away and reported back that they were successful in balancing workload while providing more focused support. Year’s two and three have been placed on hold because of the change in firm growth because of the economic issues the entire legal industry faces. Still, the library director reports that she is more confident in making
  78. 78. Research Studies  A study to calculate the nursing staff requirement for the Maternity Ward of Medical College Hospital, Kolkata Applying WISN method.  Objectives:  • To calculate the number of nursing staffs in the Maternity Ward of Medical College Hospital, Kolkata, required to serve the present workload, applying WISN method.  • To measure the difference between this ideal number and current staffing levels.
  79. 79. Methodology  It was an observational, cross-sectional study conducted in the Maternity ward of Medical College & Hospital, Kolkata (except O.T.). The duration of the study was from January to March 2013. The study population was the staff nurses (total 34) working in six maternity wards of Medical College  Results It was observed that in the maternity ward of Medical College Kolkata, total working days available in a year were 234. Total 131 days were unavailable for work due various reasons; weekly days off per year was 72, annual leave was 30, public holidays were 16, official leave per year (out of station on official duty) was 4, sick leave per year was 3 and maternity leave was 6. Total 1872 hours were available for work in a year..
  80. 80.  Maximum time was needed for assisting delivery of primigravidas (60 minutes per delivery) and assisting delivery of multiparas (50 minutes per delivery). Regarding category allowance standard it was observed that per week 180 minutes was spent for general cleaning and for supervising students 100 minutes per year was needed. About individual allowance standards for staff nurse, medicine distribution rounds were the most time consuming process. Total basic staff requirement for the maternity ward was 13.76. Intermediate staff requirement for the maternity ward was 22.15. Total staff required for all activities in the maternity ward was 24.03(table 5). When night duty is considered the total requirement for nursing officers, GNMs in the maternity ward became 24.68. Actual number of staffs posted was 34 with a difference of 9.32. So the WISN ratio became 1.38.