api healthcare overtime webinar

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How Overtime May Be Harming Your Business and Your Patients

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How Overtime May Be Harming Your Business and Your Patients

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About Our Presenter

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Patrick Ball General Manager, Consulting Sage Growth Partners

Overtime is Pervasive

Overtime

50% of full time nurses work OVERTIME

Source: Bae, Sung-Heui. "Nursing Overtime: Why, How Much, and Under What Working Conditions?" Nursing Economics, 30, no 2 (March/April 2012): 60-71.

Full time nurses work an average

of 7 OVERTIME hours each week

Overtime Hours

Source: Health Resources and Services Administration, "The Registered Nurse Population. September 2010," Accessed July 28, 2014, http://bhpr.hrsa.gov/healthworkforce/rnsurveys/rnsurveyfinal.pdf

Overtime is Expensive

Total Cost of OVERTIME = $12M

Based on a 300 bed hospital

Cost Implications

Source: Sage Growth Partners Analysis

Obvious Costs

Full Time Nurses 7 Hours Average

overtime(3)

75% Full Time Nurses(1)

25% Part Time Nurses(1)

Part Time Nurses 5.4 hours

Average

overtime(3)

Roughly 7.5% of Total Hours Worked are Overtime

50% Working

overtime(2)

15.1% Working

overtime(2)

(1) Health Resources and Services Administration, "The Registered Nurse Population. September 2010," Accessed July 28, 2014,

http://bhpr.hrsa.gov/healthworkforce/rnsurveys/rnsurveyfinal.pdf

(2) Sung-Heui Bae, "Nursing Overtime: Why, How Much, and Under What Working Conditions?" Nursing Economics, 30, no 2 (March/April 2012): 60-71.

(3) Health Resources and Services Administration, "The Registered Nurse Population. September 2010," Accessed July 28, 2014,

http://bhpr.hrsa.gov/healthworkforce/rnsurveys/rnsurveyfinal.pdf

Overtime

Overtime SAVINGS = $1,154,828

Potential Savings

Overtime Puts Patients at Risk

Nurses who work OVERTIME are

to make medical errors

3X more likely

Medical Errors

Source: Bae, Sung-Heui. Presence of Nurse Mandatory Overtime Regulations and Nurse And Patient Outcomes. Nursing Economics. March/April 2013; 31, no. 2: 59-89.

Medical Errors: Key Facts

• 3rd leading cause of death in the US(1)

• According to multiple studies, overtime among nurses increases the likelihood of errors by 1.46 to 3.71 times more than a nurse who did not work overtime. (2,3)

– Risk almost doubles when nurses worked 12.5 or more consecutive hours(3)

– Medication errors 3.71 times more likely when nurses work 40+ hours(2)

(1) Allen, Marshall. “How Many Die from Medical Mistakes in U.S. Hospitals?” ProPublica September 19, 2013. http://www.propublica.org/article/how-many-die-from-medical-mistakes-in-us-hospitals (2) Presence of Nurse Mandatory Overtime Regulations and Nurse And Patient Outcomes, Nursing Economics, 2013.

(3) Effects of Critical Care Nurses’ Work Hours on Vigilance and Patients’ Safety, American Journal of Critical Care, 2006.

Medical Error SAVINGS = $663,376

Potential Savings Medical Errors Overtime

Overtime SAVINGS = $1,154,828

Overtime Accelerates Staff Turnover

Nurses working 12 hour shifts are

to intend to 2X more

likely

leave their job within 1 year

Turnover

Source: Stimpfl, Amy, et al. The Longer The Shifts for Hospital Nurses, The Higher The Levels Of Burnout And Patient Dissatisfaction. Health Affairs, 31, no.11 (2012): 2501:2509.

Staff Nurse Turnover: Key Facts

• Overworked nurses are 1.772 times more likely to quit than your average nurse due to physical and emotional fatigue.(1)

• Average cost to replace a nurse is $82,000(2)

• Average turnover rate for nurses is 14%(3)

(1) Health Affairs, “The Longer The Shifts For Hospital Nurses, The Higher The Levels Of Burnout And Patient Dissatisfaction” (2) Revisiting Nurse Turnover Costs: Adjusting for Inflation, Journal of Nursing Administration (3) KPMG Survey, "Nursing Labor costs."

Turnover SAVINGS = $761,405

Potential Savings Turnover

Medical Errors Overtime

Overtime SAVINGS = $1,154,828

Medical Error SAVINGS = $663,376

Overtime Decreases Patient Satisfaction

patients are more likely to rate hospital 6 or lower out of 10 on HCAHPS survey

Patient Satisfaction

Source: Stimpfl, Amy, et al. The Longer The Shifts for Hospital Nurses, The Higher The Levels Of Burnout And Patient Dissatisfaction. Health Affairs, 31, no.11 (2012): 2501:2509.

Lifetime Value of

Patient = $150,000

Lifetime Value of

Household = $404,000

Value of Patient

Source: Wolf, Jason and Widmer, Thomas. "Return on Service The Financial Impact of the Patient Experience." 2011

(1) Health Affairs "Nurses' Widespread Job Dissatisfaction, Burnout, & Frustration with Health Benefits Signal Problems for Patient Care." (2) J.D. Power and Associates National Hospital Service Performance Study: (2005) (3) Kavaler and Speigel. Quoted by FACS http://www.facs.org/cancer/schedules/ogrady-dashboard.pdf

Patient Satisfaction: Key Facts

• Recommendations to hospitals decreased by 2% for every 10% of nurses reporting dissatisfaction(1)

• HCAHPS Scores - 7 or lower = 37% retention rate(2)

- 8 or higher = 80% retention rate(2)

• LTV of Patient = 40 years, $400k (potential to lose $8MM)(3)

Patient Satisfaction

Patient Satisfaction SAVINGS = $793,892

Potential Savings Turnover

Medical Errors Overtime

Overtime SAVINGS = $1,154,828

Medical Error SAVINGS = $663,376

Turnover SAVINGS = $761,405

Overtime Puts Nurses’ Safety at Risk

Overtime Schedules are associated with a

61% Increased Injury rate

Nurse Injuries

Source: Occup Environ Med. "The Impact of overtime and long work hours on occupational injuries and illnesses: new evidence from the United States. 2005;62:588-597" Accessed July 10, 2014.

(1) OSHA " Worker Safety in the Hospital - Know the facts" Sept 2013 (2) Occup Environ Med. "The Impact of overtime and long work hours on occupational injuries and illnesses:

new evidence from the United States

Employee Injuries: Key Facts

• The average injury rate for healthcare workers is 6.8% (twice the rate of other industries).(1)

• The average cost of a work related injury is $15,860.(1)

• 61% higher injury rate because of overtime schedules

(fatigue and stress)(2)

Employee Injury SAVINGS = $100,841

Potential Savings Turnover

Medical Errors Overtime

Patient Satisfaction

Employee Injuries

Overtime SAVINGS = $1,154,828

Medical Error SAVINGS = $663,376

Turnover SAVINGS = $761,405

Patient Satisfaction SAVINGS = $793,892

Broader View

Industry Challenges +

Overtime

Overtime

Medical Errors

Turnover

Agency Dependency

Nurse Manager Productivity

Employee Injuries

Patient Satisfaction

Potential Savings Turnover

Medical Errors Overtime

Patient Satisfaction

Employee Injuries

Overtime SAVINGS = $1,154,828

Medical Error SAVINGS = $663,376

Turnover SAVINGS = $761,405

Patient Satisfaction SAVINGS = $793,892

Employee Injuries SAVINGS = $100,841

Total Potential SAVINGS = $3,474,342

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Questions? Email Joe Strick: [email protected]