ASC Management
How to Build Your Staff Schedule
Follow these instructions for handling common issues and minimizing overtime.

BY MYRIAM ASSOULINE, B.SC.N., M.H.A.

Staff scheduling is an important function contributing to the successful management of your ambulatory surgical center (ASC). The staff schedule is a snapshot of your employees, the positions they occupy, and the frequency at which they work. Simply put, it's a depiction of your human resources, which can represent as much as 50 percent of your total expenses.

The first step in constructing a staff schedule is determining what job functions are required for the operation of the clinic. Typically, an ASC will have reception, administrative, medical records, clinical and operating room staff. Thus, the staff schedule is the end product of an analytical process that portrays the manner in which labor is organized in the ASC.

FIGURING OUT YOUR SCHEDULE BASICS

Once you identify the necessary job functions, you'll need to decide how many employees you need to fill each of them. To do this, you must establish the hours that are required for each position on a weekly basis.

This step is essential in the calculation of the optimal full-time to part-time (FT:PT) ratios of employees for each particular position. Many permutations of FT:PT are possible. However, as I'll demonstrate later, only a few are beneficial.

Here's an example of following the steps described above:

Job function. Reception

Hours required: ASC operational hours are from 8 a.m. to 6 p.m., Monday to Saturday. That means 10 hours for 6 days, a total of 60 hours a week. In our example, a full-time equivalent (FTE) is equal to 40 hours a week. Therefore, ideally, you need 60/40 FTEs, which is 1.5 FTEs, to meet the requirements of this position.

Define your FTE. Usually, 1 FTE represents 5 days per week for employees working an 8-hour day (40/8). Consequently, 0.5 FTE equals 2.5 days per week. However, in our example, the position of the receptionist requires 10 hours per day. Therefore, 1 FTE represents 4 days per week (40/10). Consequently, 0.5 FTE equals 2 days per week; 0.75 FTE equals 3 days per week; and 0.25 FTE equals 1 day per week.

Calculate your FT:PT ratio. You can achieve your needed 1.5 FTEs for the reception position in 11 different ways. (See "Possible Combinations for Reception Position," at left.)

Selecting choices 1 or 2 would result in overtime hours, so you'd want to disregard those. You would also disqualify choices 7, 9, 10 and 11 because you would have 4, 5 or 6 people working one job function. This would prevent any continuity in the position.

You'd want to eliminate choices 4 and 6 as well. Hiring people to work only 1 day a week isn't recommended because they have difficulty establishing a sense of belonging and keeping up with organizational changes.

That leaves choices 3, 5 and 8. Because of the nature of the position, I'd select choice 3 (one person working 4 days a week, and another person working the other 2 days a week). If this were a task-oriented position, I would have considered choice 5 (2 people at 3 days a week). In positions that only involve repeating the same tasks, the need for continuity from one day to the next isn't as important.

Note that in our example, if an employee works more than 40 hours per week, he or she should be paid overtime. As a manager, your objective is to reduce overtime hours. When staff members work overtime on a regular basis, it results in increased labor costs and staff burnout. In such cases, staff recruitment and/or cross-training are two of your options for improving the situation.

You can also use your ASC schedule as a verification tool for payroll purposes and for monitoring absenteeism. For example, if an employee calls in sick or is absent, your clinic manager can mark an S on that particular day on his or her copy of the schedule. In addition, as illustrated above, you can incorporate staff training into your schedule.

PUTTING IT ALL TOGETHER

Once you've calculated the optimal FT:PT ratios for each of your staff positions, you can construct your staff schedule. (See "Sample Staff Schedule," above.) Making a schedule that covers an extended period of time, such as a month, has its advantages. Posting schedules in advance acknowledges people's other obligations and is therefore a sign of respect. It's a good practice to ask your employees for written requests for days off. This reduces the occurrence of misunderstandings, and you can file the requests in personnel files for record-keeping. It's also beneficial to post the schedule at the same place, and in an area where the employees congregate (e.g., staff lounge or kitchen).

Staff scheduling is an important management function. It's particularly significant when you first open your ASC and have to decide how many employees you need to recruit. Once the initial schedule has been made, subsequent ones are less time-consuming.

Myriam Assouline, B.Sc.N., M.H.A., is a healthcare consultant and the director of LASIK MD in Montreal. You can e-mail her at massouline@aol.com, or call her at (514) 685-0188.