Staffing to Workload in Phlebotomy Areas: Off-Site Operational Needs

By Mike Baisch • May 17, 2018

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In the previous three posts, we wrapped up the staffing needs that are related to direct patient-care effort, indirect-support effort, and on-site operational needs in a phlebotomy area. To complete our staffing-to-workload analysis, we need to include the final piece: off-site operational support needs.

Off-Site Operational Needs

Off-site operational needs are comprised of paid time off and unpaid time off. These needs should be accounted for to ensure we can allow staff to be away from work without compromising patient care. Examples of these types of needs are:

• Vacation.
• Sick days.
• Family and Medical Leave Act (FMLA).
• Other unplanned away-from-work time.

The timekeeping system is a great source of information regarding how much off-site operational needs the organization is experiencing. Typically, it is a calculated value displayed as a percentage. For example, if the timekeeping system for our organization indicates 1,500 hours in a month were assigned to off-site operational needs and the total hours in the month was 10,000, we have an organizational standard of 15% of the staff is away from work (paid or unpaid). Once we have that organizational standard, we need to apply it to our specific work unit.

In our example of the outpatient phlebotomy unit, we had a staffing-plan estimate of 2 phlebotomists at a 94% utilization. If we apply the organizational standard of 15% for off-site operational needs (2 × 15%), we would need an additional 0.3 of a phlebotomist. However, off-site operational needs such as vacation, FMLA, or sick days tend to happen as whole numbers (i.e., the phlebotomist is either here or not here). Combining a small work unit with the "all or nothing" nature of off-site operational needs means we will need to round the 0.3 to a full 1.0 phlebotomist. You may be able to avoid or mitigate this by combining a number of small work units and then create a float position, but that would only apply when there are multiple small work units that perform the same or similar tasks and cross-training is an option.

In a larger work-unit example, the logic will be slightly different. For example, an inpatient phlebotomy unit with a staffing-plan estimate of 14 phlebotomists is at a 90% utilization. If we apply the organizational standard of 15% for off-site operational needs (14 × 15%), we would need an additional 2.1 phlebotomists. Because the work unit is larger, the utilization is a bit lower, and we are just slightly higher than a whole number, we could adjust our off-site operational need to 2.0 phlebotomists instead of rounding up to a full 3.0.

Summary

Off-site operational needs are an important part of any staffing-to-workload analysis as these items are either overlooked or underestimated. Some of the impacts of not properly planning for these needs include:

• Decreased morale when staff aren’t allowed to take vacation or must cancel vacations.
• Placing our patients and other employees at risk when staff feel obliged to come in when they are ill.
• Increase in staff turnover, not because employees don’t like their jobs, but because they are getting burned out.

The next blog post will wrap up this series of staffing to workload in phlebotomy areas with an overall summary and additional tips and tricks to take into account with performing an analysis in a phlebotomy area.

Mike Baisch

Mike Baisch is a Systems Engineer within the Department of Laboratory Medicine and Pathology at Mayo Clinic. He partners with the various testing laboratories on their quality and process improvement projects including staffing to workload, root cause analysis, and standard work & training. Mike has worked at Mayo Clinic since 2005 and holds a degree in Industrial Engineering. Outside of work, Mike enjoys cooking and sampling cuisine from around the world, home brewing, and gardening.