Lean thinking in long term care staffing and scheduling

To survive the ever-changing healthcare realm, long term care entities are beginning to follow the hospital industry’s lead towards lean thinking, a business methodology that strives to maximize value by decreasing waste. A long-term care network in Western PA began its lean journey a few years ago working to continuously improve processes and performance to offer residents the highest quality of care. With a growing US aging population and an increasingly insufficient nursing and direct care workforce, this network looked towards lean thinking to combat the challenge. The public health relevance is clear with a need to build a long-term care system that is reliable and sustainable to serve some of the most vulnerable individuals in the US. This essay examines the staffing and scheduling process improvement journey of two skilled nursing communities, aiming to improve staffing processes and reduce agency staff utilization. Both campuses successfully implemented the improvements of building a standardized master schedule, incorporating a team huddle into weekly operations and creating a process to obtain accurate daily care hours. With these improvements, the primary goal of reducing agency use and cost was achieved; with Campus A completely eliminating agency use and Campus B reducing agency spending by over $20,000 in five months. This essay shows how influential lean thinking can be in improving process efficiency, accuracy and cost control in long term care