Filling an open nursing shift can be a nightmare. It usually requires making phone calls until your index finger goes numb and swimming through a sea of credential paperwork, time slips, and invoices. You can hear the sound of the fax machine in your sleep. And, after all that, there is no guarantee the person who fills the shift will be up to snuff—if it gets filled at all.

The only tools many hospitals have to help them is a telephone and frustrated staff members whose time could be better spent actually caring for patients. “The bottom line is that hospitals can’t staff to capacity. Many of them staff on a census basis, and if the staff-to-patient ratio gets thrown off, a hospital may find itself with a week’s worth of shifts to fill,” said Jason Lander, founder and VP of business development at ShiftWise, a Portland, Ore.-based company that provides automated staffing management technology.

“If you don’t have the right tools, you are not in a good negotiating position. You’re calling people last minute. You don’t know who to call, what kind of rates you should be looking for, or how to screen candidates.” He added that out of the roughly 6,000 hospitals out there, only about 1,000 are using some type of vendor management system.

To make the frenzied search for temporary labor even more difficult, hospitals have been reducing the number of staffing agencies they work with. Although they may be saving on agency fees and reducing the administrative burden, they are also shrinking their pool of qualified candidates. It’s a lose-lose situation.

Put down the phone
But there’s a light at the end of the tunnel. ShiftWise has developed a software product that consolidates staff searches, booking, time keeping, billing, data collection, and record keeping into an easy-to-use online service. Hospitals can either search for candidates within their existing pool of employees or conduct an external search.

Filling more available shifts with their own employees allows hospitals to provide better continuity of care and reduce temporary labor costs. Hospitals can log onto ShiftWise’s Internal Resource Pool product to indicate which shifts are open; employees then enter the system and sign up for the shifts they want. Lander said that hospitals who have taken advantage of the product have experienced an increase in staff morale because employees feel like they are given priority over outside labor, have more control over their time, and have a greater opportunity to earn extra money.

Some organizations opt for the software’s bidding functionality, which allows existing employees to bid for an open shift above, below, or at their normal pay rates. To keep labor disputes at bay, the software never lets bidders see who else is vying for a shift.

Shift bidding is controversial: some hospitals love it because it encourages healthy competition, while some unions won’t support it because they feel it is forcing people to bid down their own wages. “That is why we built the system to accommodate all sorts of needs. Most people simply enjoy the flexibility of being able to confirm themselves for a shift at their regular pay,” Lander explained.

Get a handle on your costs
When it comes to conducting external searches, ShiftWise does not recruit, screen, hire, or place healthcare professionals. Instead, it provides a channel through which hospitals and staffing agencies can conduct business more efficiently. Hospitals log into the system and enter their open shifts. The hundreds of staffing agencies that have partnered with ShiftWise peruse the database and suggest candidates who meet the criteria set forth by the hospital. “The hospital knows that when a candidate is submitted, they are qualified for that order. That person’s profile would not be displayed otherwise,” Lander said.

And the rules that applied to “old-fashioned” shift filling still hold: if an employee doesn’t show up or doesn’t mix well with the culture of an organization, the agency is held responsible. The good thing is that hospitals have an opportunity to protect themselves from repeat offenders. They can put a “no client return” label on an individual’s profile. That person’s name is put on a restricted list, and he or she will not be able to work in that hospital again.

Using either product can save hospitals big bucks. Lander estimates that hospitals can expect a 10% to 20% reduction in soft costs like manpower and productivity and a 5% to 30% reduction in hard costs. Steve Krautscheid, employment coordinator at Hillsboro, Oregon-based Tuality Healthcare (a beta site for ShiftWise’s products) said when agencies signed up with ShiftWise, they dropped their prices to stay competitive. “We realized a minimum of a $10 decrease in hourly rates.”

The tracking and reporting capabilities are also saving hospitals money by pinpointing trouble spots. Tuality saved about $1 million last year alone. “About five years ago, we were trying to get a handle on our agency costs. We had to sort through piles of paper to figure out which departments used what type of staff and for what shifts. It was a nightmare just trying to identify what areas were using the most agency staffing so we could focus on improving that situation,” said Krautscheid.

“Now, I can pull up our usage for last week, last month, or last year in a matter of seconds. We know who worked where, what shift they were assigned to, and who signed off on the invoice.”

The next step for Tuality is to enter all of its on-call and per diem staff onto the ShiftWise system so they can be automatically contacted when a shift becomes available. “We have about 50 people on that list, so you can imagine how frustrating it is to play phone tag with them,” said Krautscheid.

Know who you’re hiring
For those who are looking for a more permanent solution to staffing, ShiftWise can help in that area. First, several agencies that focus solely on permanent staffing are on ShiftWise’s list of partners. Second, hospitals can test run a temporary employee for several months to see if he or she is a good fit, and then hire that person permanently. Thirdly, with the tracking and reporting tools, hospitals often discover that they have enough available shifts to hire someone permanently.

“Let’s say you pull up a report that reveals you’ve used an average of three FTEs of temporary labor in your med/surg unit in the last six months. You hire three more nurses, dramatically reducing—if not eliminating—your temporary labor costs,” Lander explained.