HR TEST 4
List 4 ways of measuring Nurse staffing.
Measurement of Nurse Staffing: 1. Full-time Equivalent (FTE) 2. Utilization Data, Payroll Data, HR Data 3.Patient Classification System 4. Historical Data 5. Unit & Organizational knowlege
Difference between intrinsic and extrinsic compensation ?
1. Intrinsic compensation (praise or intangible rewards) 2. Extrinsic compensation (wages, salary, stock options, vacation pay)
Why are nurse workloads a poor measure for determining nurse staffing?
5. In calculation of nurse workloads, patient days or patients are used. But this method fails to capture the complexity of nursing work a. The complexity of nursing work should be taken into account when determining nurse staffing
List the 5 advantages of using Mulisource Appraisal (360-degree)
5. Multisource appraisal (360-degree appraisal) a. Advantages: i. Emphasis on aspects of performance valued by the organization. ii. Explicit recognition of the importance of consumer focus iii. Consistency with team development intiatives iv. Contributor to employee involvement and development v. Minimal bias, as it includes multiple perspectives
List the 6 methods of evaluating a job value
6 methods of evaluating a job value: 1. Ranking 2. Job Classification 3. Point 4. Market Pricing 5. Broadbanding 6. Factor Comparison
Three types of information needed to assess employee performance?
6. Three types of information needed to assess employee performance: a. Individual traits b. Behaviors c. Results or outcomes.
7 Strategic Roles of Compensation
7 Strategic Roles of Compensation: a. Rewards employee performance b. Achieves internal equity with organization c. Maintains external competitiveness in relevant labor markets d. Aligns employee behavior and performance with organizational goals e. Attracts and maintains high-performing employees f. Complies with legal requirements g. Maintains compensation budget with organization's financial restraints
Capitation definition
Capitation pays physicians a certain amount for each patient assigned to his list within a define payment amount A method created to encourage physicians to give appropriate care without generating excess costs
Define the Equity Theory.
Equity Theory: Employees calculate the ratio or balance between outcomes and inputs. they then compare the ration that other employees in the organization and other organizations. Result of the comparison is belief of inequitable treatment.
4 Drawbacks of using Multisource Appraisal (360-degree)
4 Drawbacks of using Multisource Appraisal? i. May be used as a source of retribution ii. Difficult to integrate information iii.Requires a trained individual with insight and growth iv. Not good for small organization due to challenges with keeping anonymous
4 Drawbacks of Pay-for- Performance
4 Drawbacks of Pay-for- Performance: 1. Hampers change because innovation disrupts tried-and-true ways of delivering service, thus lowering efficiency and affecting goal accomplishment 2. People are less likely to take risks or explore alternatives 3. Employees reluctant to report problems due to fear of loss of compensation 4. Decreased focus on customer needs
3 key facts about Job Classification?
...3 key facts about Job Classification: 1. Based on pre-determined requirments 2. Most commonly used in the public sector (federal jobs) 3. Problematic when applied to multi-system organization because 2 jobs may have same title but different duties
List the 3 categories of Historical data used to measure nurse staffing.
3 categories of Historical Data used to measure Nurse Staffing a.Utilization data: i. Patient turnover rates & work requirement (rate of admission, discharges, and transfers) ii. Staffing standard on number and mix of nurses (use average number of patients cared for over a period known as average daily census) iii. Temporal variations (eg. Flu season) iv. Extent to which unit capacity reached (use the occupancy rate or the number of beds used per day) b. Payroll data (productive and nonproductive time paid data) c. Human resources data i. Nurse turnover rates (used to estimate the productive hours) ii. Collective agreements account for personnel contract changes iii. New Vs. Old nurses- productivity differences.
3 key issues with aging nurse workforce?
3 key issues with aging nurse workforce: a. Shortages in young nurses to replace aging nurse workforce b. Aging nurse workforce is the reason for nurse shortage c. Difference in expectation about work and workplace, comfort with technology, generational difference in needs and expectations
2 Basic components of nurse workload?
2 Basic components of nurse workload: a. Increase in average nurse workload may be the result of more patients, fewer nurses, or both b. Average nurse workload is not reduced by an increased in nurse staffing if the workload (number of patients) increases at a faster rate.
2 Drawbacks of Graphic Rating Scale ?
2 Drawbacks of Graphic Rating Scale : i. It is very general and does not give information on how the trait or behavior can be changed. ii. Does not weigh behaviors and traits in accordance to their importance to the job. (one-size fits all approach)
List 2 facts on the Ranking method of evaluating job value
2 facts on the Ranking method of evaluating job value: 1. Simplest job valuation technique 2. Since ranking is based on personal judgement, there is difficulty in explaining why one position is ranked higher than the other and not suitable for large organizations
2 key advantages of using Broadbanding system of job evaluation.
2 key advantages of using Broadbanding system of job evaluation: 1. Allows for compensation to be changed without changing job title or reclassifying jobs. 2. Employees are more easily rewarded for taking on new responsibilities or obtaining new skills.
3 Purposes of doing Annual Reviews
3 Purpose of Annual Review: a.Administrative purposes (promotions, terminations, and compensation) b.To defend against charges of discrimination. c.Developmental purposes (improvement strategies)
4 Formal nurse staffing procedures used address nurse workload issues?
4 Formal nurse staffing procedures used address nurse workload issues: a. Use of committees with nursing representatives b. Staffing policies and procedures c. Hours-of-care requirements for different types of patients d. Nurse staffing issues are part of collective bargaining agreement between employers and nurse unions.
4 Methods to deal with staff turnover?
4 Methods to deal with staff turnover: 1. Administrators should get ongoing reports on nurse turnovers 2. Monitor retention rates 3. Gather data on why nurse leave, stay, and perceptions of the work environment. 4. Looking for detailed nurse turnover information to assist in managing existing staff and growth opportunities.
4 Perspectives of Stakeholders on workload and staffing?
4 Perspectives of Stakeholders on workload and staffing: 1. Healthcare administrators are concerned about nurse workload because: a. They are responsible for allocation of nurse resources and ensuring patient needs are met. b. They must balance the cost of delivering nursing care with HOC's reimbursements: i. Too few nurses- errors, burnout, turnover, dissatisfaction in work ii. Too many nurseswasted money. 2. Insurer & Payer perspective: a. Increase in overall healthcare costs because of workload and staffing also increase the cost of coverage, which are passed to consumers. Consumers then must decide whether or not to keep their coverage. 3. Policy maker perspective a. Policymakers view nurse workload in terms of ensuring that nurse resources are sufficient in providing safe, effective care to communities and in meeting changing patient care demands b. Policymakers must ensure that government and industry workforce policies recognize the changing demographics and support HR adjustment (eg. Nurse incentives to enter geriatrics). c. Policymakers must make guidelines to ensure that nurse staffing levels are safe and do not place patient at risk for harm or injury. 4. Nurse perspective—( how they are affected by the work)
4 drawbacks of using Ranking?
4 drawbacks of using Ranking: i. Focuses only a single dimension of work effectiveness and does not account for job complexity ii. Cumbersome for large organizations iii.Simply lists the employees in order of performance but does not distinguish between effectiveness of employees iv. No guidance on how to improve performance
What 4 things are needed to create a point system of compensation?
4 things are needed to create a point system of compensation: 1. Must be measurable and must be independent of each other 2. Must be relevant to the job under analysis 3. Must validly distinguish among jobs 4. Must convey meaningful difference between jobs.
What are 4 ways that employees try to equalize inequity?
4 ways that employees try to equalize inequity: 1. Illegal activities (theft) 2. Form unions 3. Change the perception on inputs and outputs 4. Work harder for promotion and compensation.
2 key purposes of healthcare compensation policy?
4. Purpose of healthcare compensation policy: a. Design of compensation systems in healthcare encourages providers to do things that improve health, such as prevention and health promotion activities and compliance with clinical guidelines. b. Healthcare sector presents with complexities & nuances not present in service or manufacturing sectors: i. Most of the healthcare employees are professionals with advanced education and training who must obtain & maintain licensure. ii. Shortage of skilled professionals drive up salaries & wages, allowing healthcare professionals to enjoy mobility and lucrative compensation iii. Health care providers cannot always determine the price of services because of third party reimbursements.
List the 5 Approaches to address staff concerns about workloads.
5 Approaches to address staff concerns about workloads: i. Involve nurse in decision making esp workload decisions. ii. Engage nurses in contingency planning and managing staff fluctuations iii. Awareness that changes in clinical practice polices and providers affect nurse workload iv. Examine workload and quality data to allocate nurse resources v. Have adequate support staff to relieve nurses of non-nursing tasks. vi. Provide nurses with autonomy over workload to reduce perception of overload.
5 Key Components of Performance Management?
5 Key components of performance management: a.Setting performance goals, and making development plans with the employee b.Monitoring employee progress towards goals c.Providing continued coaching, training, and education as necessary d.Conducting annual performance appraisal against goals and development plan activities e.Establishing a development plan for the next year.
5 Methods to create positive work environment for aging nurse workforce.
5 Methods to create positive work environment: 1. Ergonomic evaluation of work environment 2. Support in terms of patient transportation, lifting, and moving 3. Training on technological devices and equipment 4. Adequate staffing with meal breaks 5. Process for monitoring generational perceptions with job rewards, satisfaction, and ect.
List the 5 types of payment under productivity-based pay-for-performance system
5 types of payment under productivity-based pay-for-performance system: 1. Piece-rate incentive (reward for each unit of output) 2. Commission 3. Bonus 4. Profit-sharing plans (employees share in organization's profile) 5. Gain-sharing plans (employees are allocated a portion of organization's gain as result of increased productivity or efficiency)
What are the 5 ways of collecting job performance data?
5 ways of collecting job performance data: 1. Information collected from supervisor. 2. Self-appraisal a. is effective when manager is seeking to involve the employee in the appraisal process. b. Self-appraisals are done for development purpose rather then administrative purpose. 3. Subordinate appraisal a. Best if done anonymously; benefit of detecting "blind spots' of managers and improving managerial performance. 4. Team-based appraisal a. Best for enforcing teamwork , improving communication, and cohesion. b. Risk of alienation and conflict if feedback is given in divisive way c. Team-based compensation may lead to anxiety due to "free rider" syndrome. 5. Multisource appraisal (360-degree appraisal)
What is equity? List some inputs and outcomes of equity.
Equity is the perceived fairness of the relationship between what a person contributes to the organization and what that person receives in return. 2. Inputs (education, skills, loyalty, seniority, and experience) 3. Outcomes (pay, benefits, growth opportunities, recognition, job satisfaction)
8 Advantages of using Broadbanding?
8 Advantages of using Broadbanding: 1. Enable companies to base compensation decision on characteristics of people who perform jobs rather than characteristics of job alone 2. Authority for compensation decision is largely decentralized to operating managers---allows for employee rewards without going through myriad of justifications and rewards different levels of individual contribution. 3. Simpler job evaluation because there are fewer job grouping. 4. Allow employees to evaluate their own skill acquisition and cross-training opportunities in terms of professional development and personal growth than pay grades. 5. Allows for compensation to be changed without changing job title or reclassifying jobs. 6. Employees are more easily rewarded for taking on new responsibilities or obtaining new skills. 7. Narrow range of traditional pay system serves as automatic cost control that keeps the compensation expenses in check. Broadbanding allows all employees to reach the maximum level of pay band 8. Boardbanding implies fewer upward promotions.
How do Acuity levels impact staffing needs?
Acuity Levels' Impact on Staffing Needs 1. To predict staffing levels accurately, the patients' severity variance on different hospital days must be recognized and the staffing levels must be adjusted appropriately. 2. Each unit must be analyzed for the type and severity of patients that they treat, and nursing workloads must be adjusted according to this assessment. 3. Patients with co-morbidities need more treatment and require staffing. 4. Patient classification system has proven to be a good predictor of need for the next day and allows nursing leaders to allocate their resources more appropriately. 5. IT or a computerized system that captures census data, care hours, patient acuity, ad patient activities is invaluable in formulating staff ratios. 6. Units of service is traditionally used in making staffing decisions.
How does market pricing provide job valuation?
Market pricing: Market wages are largely derived from salary survey carried out in the organization.
6 Advantage of using Behaviorally Anchored Rating Scale (BARS)?
Advantage of BARS: i. Reduced error rates because jobs are clearly defined ii. Clearly defines the response categories to the rater iii. More reliable, valid, complete, and meaningful iv.Gets higher degree of commitment and acceptance from employees and supervisors. v. Improves managers' ability to identify areas for training and development vi. Minimizes employee's defensiveness and conflict with manager.
Areas of inefficiencies in HR issues that add expense to the organization:
Areas of inefficiencies that add expense to the organization: a.Unclear work policies and procedures (late arrivals, long lunches, minutes of not working) b.Lack of productivity standards (HCO's uses hours per unit of services to set the budget figures) c.Time inefficiency (personal conversations, notes written at the end of the day) d.Poor work layout (employees have to walk down the hall to get supplies) e.Poor training (slow work due to lack of strong understanding of their duties) f.Poor system (failure to evaluate work processes to ensure the best flow)
List 3 methods of Balancing Quality and Cost of Care.
Balancing Quality and Cost of Care: a. Pay for performance programs b. DRG payment c. Increasing RN hours only without increasing total hours of licensed nursing staff was linked with net reduction in costs.
What is the Behavioral Observation Scale (BOS) ?
Behavioral Observation Scale (BOS) a. Asks the rater to indicate the frequency that employee exhibits desirable behaviors.
What is Behaviorally Anchored Rating Scale?
Behaviorally Anchored Rating Scale: a. Managers are able to explain the reason behind ratings, rather than vague "average" or ect.; Managers can state their explanation of expectations. b. Best used when large number of people are holding same position.
3 Benchmarking metrics used for measuring labor budget ?
Benchmarking metrics used for evaluating labor budget : a. Budget adjustments b. Evaluation of the revenue and expense side of HR. c. Clinical and operational performance
Define Broad-banding
Broad-banding: 1. Pay bands used to classify jobs into more flexible salary ranges ; A broad band is a single, large salary range that spans pay opportunities formerly covered by several separate small salary ranges. 2. Created due to the rigid job classification system that limited employee compensation.
Which type of job evaluation is best for a flatter hierarchal organizations?
Broadbanding More appropriate as trends go toward flatter, less hierarchial organization and the use of cross-function job positions. Cross-functional job aloo organization to respond more quickly to competitive pressures
What are budgeting staffing requirements dependent on?
Budgeted staffing requirements are dependent on the productivity of the workers.
What are two ways that budgeting process is used in determining nurse workload?
Budgeting process & Nurse Workload: a. Requires calculation of nurse workload to prepare the HCO's operating budget and to determine nursing personnel requirements and costs. b. Involves decision-making about the level and nurse staffing mix, the workload the nurses will assume, and resource allocation.
2 Compensation Decisions & Dilemmas?
Compensation Decisions & Dilemmas: 1. Discrepancy between an employee's worth and the amount the employee is paid is determined by the market. 2. Conflict between the goal of internal equity and external competitiveness is one of the major challenges in establishing an enlightened compensation policy
5 Compensation decisions that affect the goals and architecture of the compensation program:
Compensation decisions that affect the goals and architecture of the compensation program: a. Determination of whether to pay above/below/ at the prevailing rates. b. Type of employee performance, practice or contribution that is rewarded. c. Rewarding longevity contradicts the current pay-for-performance culture. d. Pay-for-performance encourages good performance and compensates for commitment e. Performance criteria are important when designing pay-for-performance compensation.
What is Critical Incident and give its one key advantage?
Critical Incident a. Record-keeping of favorable and unfavorable occurrences in employee's work. b. Advantage is that it provides factual record of the employee's performance and can be useful in subsequent discussions.
Define Cross-departmental model
Cross-departmental Model: Employee are trained to work in job in other parts of the organization.
Decision about the number and type of nurses employed in patient care unit are based on?
Decision about the number and type of nurses employed in patient care unit are based on: a. Patient population b. Nurse's education and skills c. HCO's philosophy about nursing and patient care delivery.
Define FTE (full-time equivalent)
Definition of Full Time Equivalent (FTE) FTE is a metric for determining the number and types of nurses. FTE includes both nonproductive time and productive time i. Nonproductive time (paid time off that is based on individual length of service plus organizational policy) ii. Productive time (time spent on patient care)
List 5 benefits of using Demand-based Staffing.
Demand-based Staffing: 1. Sources of controllable variability must be reduced (coordinated discharge planning, block scheduling of physician Operating Room time) 2. Support staffing that is based on patient outcomes, measured in real time, and used to project future short-term patient demand 3. Forecasts demand for controllable and uncontrollable admissions (based on staff & historical data) 4. Used for making short-term staffing projections 5. Identify demand by day, unit, or shift.
3 Drawbacks of extrinsic compensation?
Extrinsic compensation (wages, salary, stock options, vacation pay): a. Extrinsic rewards are insufficient elements in keeping employee motivation. b. Extrinsic rewards does not lead to employee satisfaction. c. Managers must attend to rewards that may not require financial resources (encouraging employees, establishing collegial practice environment, consistent setting of performance objectives, performance evaluations)
Define the Factor Comparision system of job valuation.
Factor Comparision system of job valuation: Differs from point system in that compensable factors are evaluated agains compensable factor in benchmark jobs in the organizaiton.
When should first quartile strategy be used? Advantages & Disadvantages?
First Quartile Strategy: When confronting a tight labor market, HCOs use a quartile strategy to position themselves. It allows HCO to balance employer cost pressure with need to attract/retain employees Risk of high employee turnover; pays below the market.
What is forced ranking?
Forced Ranking i. Employees evaluated not based on objectives but in comparison to other employees ii. "rank of yank" where the bottom listed employee are told to improve or be terminated.
What is Graphic rating Scale
Graphic rating Scale a. Rating scale that uses points along a continuum and measures traits and behaviors b. Most common way to assess performance c. Series of dimensions where anchor points indicate different levels of performance.
Give 2 ways of addressing the issues with the nature of nursing work.
Handling issues with Nature of Nursing work: a. To address the complexity of nurse work, mangers can engage nurse in dialogue to gain insight into the current processes and system that support/impede the nurses ability to do job. b. Strategies to ensure sufficient staffing to allow breaks
What type of payment mechanism used in Hospitals?
Hospitals Physician Payment Mechanisms: 1. Contractual basis of payment= the basis of payment represents the billings that the unit generates, with additional amount included for such items such as administration and participation on hospital committee 2. Residents and physicians in academic centers are paid via Medicare (salaries not linked to performance or productivity/quality measures) 3. Salaries are lower than those in private practice 4. Faculty practice plan (medical group consisting of faculty) a. Principle source of income for academic physicians is salary from the institution. b. Billings generated by faculty are levered into some sort of shared distribution or at least to negotiate a higher salary for those physicians who produce higher clinical volumes 5. Physicians who do research (no patients) get salaries from grants
What type of payment mechanism is used in IPA
IPA used fee-for-service and salary As the fee-for service are discounted, doctors have incentive to increase volume to make up the differ
Define the Job Accural Model
Job Accrual Model: 1. Used when there is a variety of jobs for which an employee may be trained. 2. Jobs are given point rating that is based on difficulty of mastering job skills, and compensation is increased in accordance to point earned.
Define Job Valuation and list the 5 ways it is used.
Job Valuations: Definition= Formal process for determining the value of jobs in monetary terms and requires accurate job specification and job descriptions. Job Valuation used for: 1. To design pay structures 2. To obtain objective assessment of a job's worth or contribution to the organization. 3. Limite use in setting compensation levels 4. Examines and prices a job relative to its importance to the organization. 5. To ensure employee get equity in compensation system
Key advantage of using Factor Comparision?
Key advantage of using Factor Comparision? Easily converts jobs into monetary wages and tells which jobs are worth more.
2 Key differences between nurse staffing and nurse workload:
Key difference between nurse staffing and nurse workload: a. Nurse workload refers to the quantity or nursing services b. Nurse staffing comprises the planning, budgeting, and costing aspects of proving nursing services
List the 6 factors to consider when linking HR budgeting to Employee Productivity.
Linking HR budgeting to Employee Productivity: 1. Salaried Employees a. Paid a fixed amount of income regardless of how many hours 2. Wage earners (hourly pay) 3. Downtime= hours spend at work that are important to the job role but don not generate revenue 4. Labor budget= expenses associated with salaries, wages, and benefits 5. Acuity level= level of caregiving difficulty that determines staffing needs 6. Cost of payroll taxes includes the employer contribution to Social Security and Medicare Taxes: a. Social Security has wage gap between which it no longer taxes the employer or employee during the calendar year. b. Medicare has no wage cap. c. Worker's compensation is pay at predetermined rate for specific employee classifications.
How should HCO managers prepare for staffing issues realted to unions (5 ways)?
Managers in unionized hospitals must understand the collective bargaining process and conditions of specific agreements: 1. Should keep strong ties with HR and address staff questions about agreement 2. Keep a contingency staff planning in case of union strikes 3. Keep the lines of communication open; to focus on patient care, protecting the safety, security, well-being of patients and nurses, take the high road by using factual data and acting in professional manner. 4. Manager can take advantage of what nurses actually seek by unionization----improving the work environment, nurse staffing levels, and quality care.
List the 6 Methods for workplace diversity?
Methods for workplace diversity: 1. Education on cultural diversity 2. Opportunities for minorities 3. Promote diversity via hiring practices 4. Engage staff in making a unit-based diversity plan. 5. Diversity-focused recruitment and retention strategies 6. Leadership pathways for nurses of diverse backgrounds
6 Methods of improving physician-nurse relations?
Methods of improving physician-nurse relations: 1. Workshops on interdisciplinary collaboration 2. Clear processes for conflict resolution 3. Constructive conflict management 4. Interdisciplinary staff meetings 5. Positive role-modeling 6. Offer Educational professional development to empower nurses
8 Metrics used in HR for evaluating the labor budget?
Metrics used in HR for evaluating the labor budget a. Accession rate b. Cost per employee hired c. Time to fill jobs d. Benefits claims response times e. Training hours produced f. Number of employees trained g. HR expense per employee h. HR FTE ratio
4 Non-financial benchmarks used in evaluating labor budget:
Nonfinancial benchmarks used in evaluating labor budget: a. Patient satisfaction b. Patient wait times c. Number of facility-acquired infections d. Number of readmissions
Give 3 disadvantages and 3 advantages of non-standard staffing.
Nonstandard staffing Involves hiring of employees on temporary or contingency basis. (temp agency, per diem) b. Advantages i. Meets current need for staffing and patients are taken care off ii. No need to provide benefits iii. Managers can better match working time to business activity at different times of the day c. Disadvantages i. Higher pay rate than a permanent employee ii. Less committed staff (motivation problems, turnover, communication problems) iii. Reduced quality service standards (less detailed work output from nonstandard employees)
Number and type of people needed in a given situation are dependent on many factors, including? (list 4 factors)
Number and type of people needed in a given situation are dependent on many factors, including: a. Skill level of workers b. Worker's familiarity with organization c. Standards the organization sets for productivity d. Regulatory and Accreditation requirements
How is nurse staffing determined?
Nurse staffing involves determining the number and types of nursing personnel employed on a patient care unit in hospital
Define Nurse Staffing
Nurse staffing means a. Number of nurse deployed (staffing level) b. The process by which the appropriate number and type of nursing personnel are deployed to satisfy the nurse workload requirements
Explain the human capital theory in terms of nurse workload approach (4 terms)
Nurse workload approach is grounded in human capital theory. (Moody): a. Knowledge worker concept values nurses based on thought processes and judgments b. Captures patient intensity, infection and error rates, and organizational resources c. Cost of turnover included in workload model because nurse turnover reflects loss in human capital that is considered in valuing nurses. d. Staffing based on the number of beds works well when patient demand is high and nurse supply is sufficient but it is wasted resources when low patient demand.
Define Nurse Workload.
Nurse workload means: a. The number of patients or patient days for which nursing care is required on the unit/department/ HCO b. Number of patient cared by an individual nurse (patient-to-nurse ratio)
How does Nurse-Physician Relationship affect Nurse staffing?
Nurse-Physician Relationship: a. Key ingredient in keeping health work environment b. Influences nurses' perceptions of staffing adequacy c. Poor nurse-physicians relations creates challenges in staff recruitment d. Walk-rounds by managers will provide opportunities to address concerns that affect work environment.
What is nursing FTE used for?
Nursing FTE used to determine the unit and departmental staffing needs and key to the budgeting process.
How to monitor Nursing productivity and resource utilization?
Nursing throughout, productivity, and resource utilization should be monitored: a. Variances among nursing units of the same facilities should identify internal best practices and internal benchmarks should be created. b. Skill mix should be identified for productivity and resource utilization. c. Assistive personnel should be used where labor shortages and cost restrictions surface.
5 Objectives that a compensation system must accomplish?
Objectives that a compensation system must accomplish: a. Fairly reward individuals for labor and expertise b. Align incentives for workers with organization c. Reduce/eliminate undesired behavior d. Should be prepared for evolution of the job e. Should be comparable/exceed compensation systems of other organizations
5 Outsourcing Advantages in terms of labor budget
Outsourcing Advantages: a. Accessing expertise in a given area b. Obtaining sufficient personnel in the needed area c. Accessing better technology for advanced applications d. Controlling costs e. Gaining competitive advantage through specialization and economies of scale
Define Patient Classification System. What are the Pros & Cons of using Patient Classification System?
Patient classification System a. Categorizes individual patient demands and nurse care requirements Pros & Cons of using Patient Classification System: i. Not reliable and not used for decision-making process (Scored by nurses or managers) ii. Fails to account for nurse's education and skills and not a good indicator for matching patient needs with nurse skill set. iii. While patient classification system is used to estimate staffing and workload, it does not replace a manager's judgment and staff input for day-to-day or shift-to-shift staffing.
Define Pay-for-Performance
Pay for Perfomance: a. Managers evaluate employees based on estabished goals, standards, and company values. b. Motivates employees to perform their highest level regardless of role or speciality
What type of payment mechanism present for locum tenum physicians?
Payment Mechanism Locum Teneum Physicians: 1. Temporarily employed physicians hired via staffing agencies are paid a fixed amount (a fee-per-day basis) and payment is sent to the staffing agencies. Linked to : a. Increase in female physicians b. Persistence of physician shortages c. Growth in the number of partially retired physicians d.Lifestyle considerations by new physicians
What type of payment mechanisms are used for physicians in roles as leaders, administrators, and experts?
Payment mechanisms for physicians as leaders & administrators. Medical director employed by state/federal agencies are given salaries.
Definition of Performance Management
Performance management a. Tools and practices that comprises setting performance goals with employees, designing strategies with employee to make and sustain improvement, monitoring employee progress toward goal, ongoing feedback and coaching by supervisors and measuring individual performance.
Define the Point System of Job Valuation
Point System of Job Valuation: Assumes that the organization do not pay for jobs for specific aspects of job, known as compensation factors (eg. job experience, working condition, supervisory responsiblities, accountability, skills) Time consuming and difficult to implement
List the 5 political factors for distortion of performance rating.
Political Factors for distortion of performance rating: i. Managers may inflate rating to prevent employee from have a bad record ii. Managers may inflate/deflate/avoid rating due to fear of retaliation. iii. Promote an undesirable employee "up and out" iv. Managers may deflate appraisal to speed up termination process. v. Manages may deflate to send message that employee should leave organization.
List 5 purposes of labor budget.
Purpose of labor budget to predict the following: a. Required staffing levels based on volume projections and productivity measures b. Projected expense related to regular, overtime, and overall productive hours c. Nonproductive hour expenses related to paid time off, including vacation, sick, holiday, personal, education, and other training hours. d. Total salary, wage, and benefits e. Expenses for benefits, including payroll taxes, insurance, and other employee benefits
What is the difference between 1st, 2nd, and 3rd quartile strategy?
Quartile Strategy: 1st Quartile strategy= pays below the market 2nd Quartile (preferred)= pays in the middle of market 3rd Quartile= pays avoce the market values; Ensures that employees are productive and deliver high quality services.
What is the key advantage of using Ranking?
Ranking: Advantage= forces supervisors to distinguish between employees
What are the 3 rationales for using forced ranking?
Rationale for use of Forced ranking: 1. Ensure that lenient managers do not inflate appraisals 2. Push managers to distribute their ranking 3. Limit bonuses and financial payouts
5. Relationship of Performance Management to other HR functions? (4 ways)
Relationship of Performance Management to other HR functions: a. Job Analysis i. Performance information may lead to redesigning of jobs. ii. Accurate information about jobs is key to develop criteria for performance appraisal. b. Recruitment & Selection i. Performance information lets managers know about the effectiveness of alternative sources of recruitment and the effectiveness of their selection criteria and procedures. ii. Ability to recruit and select employees may affect the types of criteria and standards developed for performance appraisal. c. Training & Development i. Performance management systems provide information on employees training and development needs; Assesses the effectiveness of training ii. Performance appraisal tools may be designed to assess the impact of training programs. d. Compensation i. Compensation systems may be designed such that performance appraisal information has an impact on employee compensation. ii. Fair and equitable compensation system may lead to higher levels of employee performance
How are physicians in academic centers compensated?
Revenue-based compensation pays academic physicians according to the clinical revenue they generate, thereby raising faculty member's income as well as that of the medical center
Define Skill-based pay
Skill-based pay: 1. Employees are based according to work-relatd skills; Compensation is increased by getting new skills, knowlege, or competencies
2 drawbacks of staff model
Staff Model drawbacks: 1. Physician under employer's control 2. Physician recruitment difficult
True or False: Deficit Reduction ACt mandates CMS to implement value-based pricing for Medicare patients
TRUE Deficit Reduction ACt mandates CMS to implement value-based pricing for Medicare patients
Define Team-based incentive.
Team-based incentive: a. Can be used to boost productivity and performance, improve quality and customer services, and increase retention. b. Variable pay is added according to team performance but base pay is determined by job valuation and market information.
Three approaches used to address the appropriateness of nurse staffing levels?
Three approaches used to address the appropriateness of nurse staffing levels: a. Regulatory approach i. HCO accountable for establishing and implementing staffing plans based on patient needs and other nursing-related criteria, and with input from frontline staff nurses. b. Legislative approach i. Nurse staffing ratios are mandated by law c. Combination approach i. Nurse staffing plans must with in accordance to specific, legislative nurse staffing ratio.
Three reasons that nurse workload is measured?
Three reasons that nurse workload is measured: a. To inform the nurse budgeting process b. To meet regulatory and accreditation standards i. Nurse workload systems may be used to gather staffing and outcomes data to document compliance with this requirement. ii. Staffing plans allow managers to develop policies for reasonable work schedules, which promote a positive work environment, and for accommodating operational uncertainties and contingencies c. To inform the development, implementation, and evaluation of staffing plans.
Two reasons employers use below market compensation?
Two reasons employers use below market compensation: 1. Shortage of funds or inability to pay more may converge with the need to continue to meet organizational objectives. 2. Lare numbers of applicants with lower skills are available in the labor market
Two things that HCO should do when developing labor budget?
Two things that HCO should do when developing labor budget: HCO should develop flexible budgets—budgets that include revenue dependent on volume and expenses that fluctuate with volume. Each HCO determine its financial break-even point and the profits it need to remain viable.
List the two types of Pay-for-performance
Types of Pay-for-Performance Models: 1. Productivity-based 2. Quality based
List the 5 types of Rating errors and define each type of rating errors. How to overcome all rating errors?
Types of Rating errors a.Distributional i. Errors come from raters using only a small part of the rating scale ii. Too lenient rating, too strict, rating, or rating everyone average. b.Halo effect i. Rating of all employees high on all criteria with out distinguishing different aspects of the job. c.Personal bias (rating based on personal opinion rather than performance) d.Similar-to-me bias (rating those similar to them with high rating) e.Contrast effect (raters compare employees to others rather than rating on the basis of established objectives) ****. To overcome rating errors, trainers uses in different rating methods to improve inter-rater reliability
Explain the importance of Unit & Organizational knowledge in Nurse staffing measurements
Unit & Organizational knowledge used in Nurse staffing measurements includes: a. Efficient nurse staffing hinges on unit and organizational knowledge (clinical policy, nursing personnel requirements, treatment risks) b. Knowledge of internal organizational changes in care delivery is needed to estimate the effect of changes in programs, procedures, or treatment protocol on staffing requirements c. Knowledge of collective agreements is needed to ensure that staffing in compliance with provision agreed upon.
List the 4 types of Utilization Data?
Utilization data i. Patient turnover rates & work requirement (rate of admission, discharges, and transfers) ii. Staffing standard on number and mix of nurses (use average number of patients cared for over a period known as average daily census) iii. Temporal variations (eg. Flu season) iv. Extent to which unit capacity reached (use the occupancy rate or the number of beds used per day)
List the 3 types of variable compensation
Variable Compensation Methods: 1. Team-based incentive 2. Skill-based or Compensation-based pay 3. Pay for performance
How can managers compare employee productivity?
When comparing productivity, the manager must compare employees who perform similar tasks or compare employees with themselves.
What is the best way to compensate employees when financially stressed?
When financially stressed, managers should use intrinsic rewards to supplement for extrinsic rewards.
How does workload stress & burnout affect nurse staffing?
Workload stress and burnout a. Workload is the significant predictor of negative health outcomes, decreased job satisfaction, and burnout b. High nurse workloads are associated with higher 30-day patient mortality and increased levels of nurse burnout. c. High nurse burnout linked to low patient satisfaction.
Why is Equity important in healthcare? What are two types of percieved equity?
b. Two type of perceived equity: i. Overpayment Equity—guilty feeling ii.Underpayment Equity—decline in employee morale iii. Equity issues are important in healthcare due to staffing shortages. iv. Job-hoping is a tried and true way of increasing compensation.
How can Graphic rating scales be improved?
e. Graphic rating scales can be improved by the use of behaviorally anchored rating scales, where specific observable behaviors are associated with each point on the scale.
