Cath Lab Staffing and Productivity

Each issue of Cath Lab Digest includes a spotlight interview, generally authored by a cath lab manager. The interview begins with a question about the size of the cath lab and number of staff members. As a former cath lab manager, I understand the frustration of finding benchmarking information on staffing ratios and work labor units. Justifying the amount of staff required to safely and efficiently operate a department is an ongoing challenge impacted not only by volume of cases, but also technological advances and procedure type. Labor, as the most expensive component of operating expenses, is a primary target for expense reduction. The cost of labor is the driving force behind the need for management to evaluate their cost per unit of service (UOS). The cost per UOS looks not only at direct patient care, but also at indirect patient care. Most, if not all, hospital finance departments have a method they utilize to determine the UOS for each department, and often this method is derived from the methodology used by a firm that specializes in data collection for benchmarking purposes. Once a benchmark goal is selected, a department manager is asked to meet or exceed the benchmark goal. Utilizing benchmark goals is an objective method to determine if labor costs can be reduced by reducing the number of staff or full-time equivalents (FTEs), changing the staffing mix, or improving productivity by cross-training or sharing labor across departments. Cardiology continues to be at the forefront of technological advances and the impact on cath lab work labor units (WLUs) is often overlooked. When changes occur and impact staff mix, procedure length and complexity, the established benchmarks must be monitored and reevaluated. Changes may be due to the introduction of new procedures, the volume and mix of procedure types, physician technique, technology, and evidence-based protocols. Additional signs that indicate the department WLUs need to be reviewed may include the increased use of overtime, decreased productivity, increase in cancelled cases, scheduling delays, poor staff morale, and turnover. In Figure 1, the defined action steps can be utilized in any departmental setting. The terminology of individual hospitals may not be the same, but this or a similar process will be used to validate or justify current or projected staffing models. Any time a manager is updating or adding charges for a new procedure or product is also a good time to consider the impact on procedure time and staffing skills. Anticipating and quantifying any impact will help the manager justify labor variances and/or the need to adjust their department's productivity standards. Sandy Wilds can be contacted at: Phone: (317) 815-0801, ext. 120 Email: swilds@healthevolutions.com

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