Workforce Efficiency Sustainable Change for Bottom Line Impact

The Challenge

As the shift from volume to value-based care and reimbursement continues to gain momentum, providers must rethink traditional staffing models and develop a targeted strategy to maximize resource utilization and reduce labor expenses amidst fluctuating volumes and increasingly tighter margins. In addition, the Association of American Medical Colleges anticipates a widespread shortage of physicians and nurses by 2025, intensified by an aging U.S. population and increased access to health insurance stemming from the Affordable Care Act.

QHR Health Workforce Efficiency consultants understand these challenges and provide specialized support to help hospitals develop a comprehensive workforce planning strategy to increase alignment of labor deployment and revenue; identify barriers and opportunities for improvement; set realistic staffing targets, and proactively address anticipated workforce shortages.

Our Approach

1. Set Deployable Tactics & Goals

Staffing models in clinical and overhead departments are determined by revenue and volume:

  • Top-Down Forecast:
    • Set facility-level productivity metrics (i.e. Salary, Wages, and Benefits as a percentage of Net Patient Revenue) ceiling designed in light of margin goals and revenue projections
  • Bottom-Up Forecast:
    • Evaluate and establish custom performance metrics and benchmarks at the department level
500,000 Anticipated Shortage of Nurses by 2025
124,000 Anticipated Shortage of Physicians by 2025

2. Identify Barriers & Opportunities

Identify gaps and required structural improvements to optimize staff deployment.

Core Principles:

  • Set the appropriate course
  • Manage and measure performance
  • Develop a strategy to close gaps and implement improvements
  • Instill accountability
  • Provide coaching support

3. Align Labor Deployment with Revenue

Set deployable tactics and goals to achieve an efficient, productive, and affordable workforce.


  • Workflow and process redesign
  • Staffing model refinement
  • Skills mix planning
  • Accountability-control adoption
  • Pay practice audit and redesign

The Benefits

  • Overall Savings in Labor Spending
  • Enhanced Quality of Patient Care
  • Increased Alignment of Staffing with Patient Need

The Right Questions

  • Do current staffing models allow you to adjust to volume fluctuations?
  • Is the mix of full-time, part-time, and perdiem staff appropriate?
  • Are there departments where you can reduce labor cost without reducing headcount?
  • Do managers possess the appropriate tools and training to manage staffing on a daily basis?
  • Is your compensation plan tied to performance, and have traditional pay practices that inflate labor costs been eliminated?
  • Are you prepared with the right nursing and care management models to support ambulatory, post-acute, and population health efforts?

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