Managerial woes

November 16, 2008 11:13 AM

My department is seriously understaffed. How do I effectively present a case to add more employees? Resources, tips and advice? What are some key elements to this request/plan?

A bit more information: I work as a manager in the healthcare industry, at a very large urban hospital. Arguing the need is somewhat straightforward due to all of the new regulatory requirements placed on my industry (e.x. increase in reporting to state agencies) and the penalties associated if non-compliant.

Since the budget for the hospital for 2009 is set and included no $ for additional staff, is it even feasible to think this is a possibility? I have been in this position for 5 months, so I had no way of getting this on the budget for next year. However almost immediately, I noticed the need and verbally brought it up to my director/VP, and was shot down. The person who held the position prior to me also wrote a formal plan/request, which was denied. I learned recently that this lead to him leaving the position. With the demands of the job and the lack of support for resources, he had enough. I can understand why.

Thanks!

posted by engling to work & money (8 comments total)

Even at a hospital, I suspect that the need for more staff is driven by their potential to generate revenue, rather than ease the work load on current employees.

If you can argue adding new employees would increase productivity, generate revenue, and produce better service to the customer, they may listen.

However, if you're only argument for adding more people is that you're working to hard... well, that's the idea.
posted by wfrgms at 11:33 AM on November 16, 2008

It wasn't in a hospital, but my last workplace was miserably understaffed and when I said we needed another person on shift, they thought I was just being lazy.

That was the job with the crazy Faginesque swedish people, though.
posted by dunkadunc at 11:39 AM on November 16, 2008

Maybe you could frame the argument in terms of cost of penalties vs. cost of staff -- say $35-50K to recruit someone new vs. $100-500K in penalties from the state?

I don't know what your exact costs are; I just pulled those hypotheticals out of the air.
posted by jason's_planet at 12:13 PM on November 16, 2008

no unions?
posted by matteo at 12:26 PM on November 16, 2008

Matteo, correct no unions.
posted by engling at 12:29 PM on November 16, 2008

You could also argue that it's better to get a full time employee early than to get several expensive temporary employees as you rush to meet the filing deadline which you aren't currently on course to meet.

You could also argue that there's a risk of overworked staff quitting, with the associated cost of recruiting someone new, and waiting (and paying) for them to get up to speed with your system.
posted by Mike1024 at 12:31 PM on November 16, 2008

The only way you'll get new staff is proving that it will make or save the hospital money. Making money is easier to prove in most businesses ("If we had three more people at $50K we could take on another $500K project") At a hospital, dpending on your area, it's more difficult.

For saving money, there are a few options, but you'll need more supporting evedence than you have now. If people are working overtime, it's cheaper to bring in someone than it is to pay overtime. (Add in a promise about cutting overtime hours by xx% within 6 months of the new hire.) Does your department have a high turnover rate because of overwork? If you do you can point out the expense of finding and training replacements. Can you find out if the staff has grown or shrunk in the year or so before your hiring? Putting that together with hard numbers about your work (number of tests done, patients served) might give you ammunition to say "we're having to do more with less."

You can go in the direction of saying that compliance will cost you, but it's a slippery slope. It's hard to present that without you or your staff looking lazy or incompetent. But there are a few ways you can do it.

One is to have everyone on staff document how much more time they are spending complying with the new regulations and work that into a report.

Then try to talk about it hypothetically. Point out the most outrageous penalties that you could incur for the smallest infraction. (Something like filing a paper late, not something where the quality of your your would endanger anyone.) Then point out how bringing someone in would drastically reduce the chances of this happening.

Be very specific about this (these) new person's job description and responsibilities. You don't want someone to help out around the place, you need a person to do A, B, C & D. This will show that you've thought long and hard about how to spend their money, you're not asking for the fun of it.

I'm sure the hospital spent time fighting the new legislation. See if you can find any of their lobbying or counteradvertising materials. You might be able to find a good supporting quote. ("Remember when you were fighting this and you said it would increase costs to the hospital by $xx million? Well here's a very small portion of that bill.")

Make sure you point out all of the steps that you have taken to minimize the changes so you can say that a less diligent manager would ask for five people, I only need three.

However if the hospital is going through a true budget crunch right now (and not just the usual annual one they have) your request is going to make you look bad.

And if the '09 budget is already set you're probably wasting your time. They probably have an emergency overflow fund, but that would be for temporary hires for real emergencies. But start making noise now, they're already thinking about the FY'10 budget.
posted by Ookseer at 12:58 PM on November 16, 2008 [2 favorites]

Staffing is all cost/benefit. Keep it simple: show the revenue (in your case, patient or claim throughput or whatever your unit of "how much $ we made" is) now, with the current staffing level. Then show the identical formula with the higher staffing level you want, explaining why it adds (x) here and (y) here, while costing (z) here.

If the end result is higher costs but also higher profit (or "efficiency") then it's a no-brainer for management to accept.

The biggest mistakes people make in pleading for new staff, in my experience, is (a) not taking the additional costs seriously or (b) not bothering to measure the prospective gains carefully. To pre-solve (a), be sure to include training, health insurance, ALL COSTS of adding the new people, and then show how it will STILL mean more profitability. To deal with (b), don't just say "we'd get SO MUCH MORE work done." You need to quantify it based on real data and logical conclusions.

Overall, you need to make a falsifiable case. Make sure it's able to be measured in six (twelve?) months against your predictions, and if it does not help, be willing to admit you were wrong and cut back to the smaller staff. If you present it as an "experiment" you would like to try because "you made these models that show we could make more money this way", then it's an easier sell as a trial for a few months. Of course, if you're right, it will be made permanent later and you'll be a hero.
posted by rokusan at 1:43 PM on November 16, 2008