Applying the Staffing-to-Workload Methodology: Identifying Daily Indirect Effort Needs

In the previous post, we began to modify a staffing-to-workload analysis for our offsite testing laboratory located at a remote outpatient care clinic. The laboratory had received feedback from care providers and their patients that we needed to complete all of the testing the same day it was collected. This would allow care providers to contact the patients the same day they saw them or first thing the next morning with their results, and the physicians could discuss any next steps in their episode of care.

We completed our analysis of the direct-effort impacts of this request and discovered that the variable testing volume each day would cause some instances of overstaffing or understaffing.

However, before proceeding with any of the changes to the staff schedule or the number of staff, we also needed to consider the impacts of the indirect effort and the operational needs of the laboratory. This blog post will focus on the inclusion of the indirect-effort needs of the laboratory.

Indirect Effort

In the blog post "Staffing to Workload: Indirect Effort," we discussed what indirect effort is and why it’s importance to any staffing-to-workload analysis.

In our example laboratory, we have documented about 23.65 hours of indirect effort each week. That effort was added to the 128.8 hours of direct effort to perform the testing each week and then divided by the 6 days of work we have. This means each day of the week averages 25.4 hours of effort or about 3.2 FTE, with the indirect effort portion contributing an average of 3.9 hours each day or 0.5 FTE.

To convert our weekly averages, we now need to split out the 23.65 hours per week into hours for each day of the week. To do this, we perform additional observations in the laboratory, review our SOPs for maintenance schedules, and discuss the indirect tasks with the lab staff. The result is the table below.

Daily Indirect Effort Needs (Hours)

Monday Tuesday Wednesday Thursday Friday Saturday Total
Daily calibration of the instrument 0.50 0.50 0.50 0.50 0.50 0.50 3.00
Planned maintenance 0 1.00 0 0 1.00 0 2.00
Performing quality control 0.15 0.35 0.35 0.35 0.35 0.15 1.70
Unplanned miscellaneous tasks 0.25 0.25 0.25 0.25 0.25 0.25 1.50
Stocking supplies 0.50 0.25 0.25 0.50 0.25 0 1.75
Filling out paperwork 1.00 0.50 0 0.25 2.00 0.25 4.00
Answering the phone 0.75 0.50 0.80 0.50 0.80 0.20 3.55
Repeated testing 0.20 0.35 0.30 0.35 0.35 0.10 1.65
Unplanned maintenance 0.25 0.25 0.25 0.25 0.25 0.25 0.25
Reconstituting standards 0 0 1.50 1.50 0 0 3.00
Total 3.60 3.95 4.20 4.45 5.75 1.70 23.65

When we overlay the indirect effort with the direct effort, after converting to FTE, we get an updated daily staffing needs displayed in the chart below.

The indirect effort compounded our understaffing issues on Tuesday, Thursday, and Friday. It created an understaffing situation on Wednesday when there previously wasn’t one. It did, however, make the overstaffing situations on Monday and Saturday better.

As discussed in the Balancing Act section of the previous blog post, we should evaluate each of the indirect effort tasks to see if they have to be done on the currently documented days or if we can move them to days where we have more available time to do them. In this scenario, the laboratory categorized the tasks into three buckets:

  1. Have to happen as currently documented (in blue).
  2. Can be moved to different days (in red).
  3. Process improvement opportunity (in green).

Daily Indirect Effort Needs (Hours)

Monday Tuesday Wednesday Thursday Friday Saturday Total
Daily calibration of the instrument 0.50 0.50 0.50 0.50 0.50 0.50 3.00
Planned maintenance 1.00 0 0 0 0 1.00 2.00
Performing quality control 0.15 0 0.70 0.35 0.35 0.15 1.70
Unplanned miscellaneous tasks 0.25 0.25 0.25 0.25 0.25 0.25 1.50
Stocking supplies 0.50 0 0.50 0.50 0.25 0 1.75
Filling out paperwork 1.00 0 0.25 0.25 0.25 2.25 4.00
Answering the phone 0.75 0.50 0.80 0.50 0.80 0.20 3.55
Repeated testing 0.20 0.35 0.30 0.35 0.35 0.10 1.65
Unplanned maintenance 0.25 0.25 0.25 0.25 0.25 0.25 0.25
Reconstituting standards 0 0 1.50 0 0 1.50 3.00
Total 3.60 3.95 4.20 4.45 5.75 1.70 23.65

The changes in the indirect effort schedules are reflected in the purple text in the table above. The impacts to the daily staffing needs are then reflected in the chart below.

While the changes may not seem like much, they did accomplish a number of things. First, it made Saturday and Monday much more similar to each other than before. Secondly, it brought the mid-week staffing levels consistently below the 4 FTE mark. Finally, it brought the mid-week staffing levels much closer to each other, specifically on Wednesday. All of these things will help when including the operational needs and creating the final staff plan.

The inclusion of the indirect effort tasks shows the “hidden” work the laboratory does and demonstrates how much it contributes to staffing plans and needs.

Next Time

In the next blog post, we will cover how to include the operational needs of the laboratory, including items such as PTO, FMLA, breaks, continuous education, and an effective factor.

michaeljba

Mike Baisch

Mike Baisch is a Systems Engineer within the Department of Laboratory Medicine and Pathology at Mayo Clinic. He partners with the various testing laboratories on their quality and process improvement projects including staffing to workload, root cause analysis, and standard work & training. Mike has worked at Mayo Clinic since 2005 and holds a degree in Industrial Engineering. Outside of work, Mike enjoys cooking and sampling cuisine from around the world, home brewing, and gardening.