Engage Employees and Drive Productivity with Lean Utilization and Workforce Management

April 18, 2022 Lynne Jackson

The aging population and intensifying nursing shortage threaten to create a cataclysmic need for skilled nursing resources over the next few years. The United States Registered Nurse Workforce Report Card believes the shortage will continue until at least 2030. Meanwhile the demand for skilled nursing care will soar as the number of Americans over 65 doubles to 95 million by 2060, according to the US Census Bureau.   

Workforce management systems play a key role in caring for the elderly and infirmed people. They empower healthcare facilities with the ability to assign medical personnel, track attendance, and ensure regulatory compliance. But are these same workforce management systems prepared to help skilled nursing and senior care facilities navigate these growing staffing and operation demands? 

Well, maybe. The answer depends on the operator’s: 

  • Management Strategy 
  • Workforce Management Capabilities 

Management strategy dictates how the facility will address the growing demand, strict regulatory requirements, and staffing limitations. A legacy approach that deploys workforce management systems in the background to create schedules, document attendance and run reports won’t suffice. To succeed, senior living providers must take a proactive, innovative strategy to: 

  • Anticipate staffing needs 
  • Quickly resolve issues 
  • Adjust to changing resident populations and acuity in real time 
  • Derive real-time workforce analytics to make smarter decisions, faster 
  • Use technology to improve employee hiring and engagement 

Workforce management system capabilities. Not all workforce management systems are created equal. In assisted living, providers must ensure their system can promote the business outcomes that advance quality and counter staffing shortages. They should also make sure the system is: 

  • Easy to navigate so administrators can find needed information at a glance. 
  • Provides real-time notifications when quality thresholds are violated.  
  • Pushes out recommendations for staffing shortages and openings.  
  • Helps remediate quality issues.

Before they can create an effective strategy to counter the staffing crisis, providers must analyze its underlying causes and how specific measures can address these causes and affect their environment.  

Understanding the Staffing Shortage

Rising employee turnover 

High turnover means providers tasked with caring for the aging population face even greater workforce challenges than their peers at other healthcare facilities. In senior living facilities, turnover rates among nursing staff exceed 33%, according to Argentum.  Consequently, many providers are enhancing salary and benefit packages to attract candidates as well as devoting more resources to hiring.  

Some turnover is natural and should be expected as experienced nurses approach retirement. It’s the quantity of nurses retiring that will exacerbate the depleted resource pool.

“The U.S. is projected to experience a shortage of Registered Nurses (RNs) that is expected to intensify as Baby Boomers age and the need for health care grows. Compounding the problem is the fact that nursing schools across the country are struggling to expand capacity to meet the rising demand for care given the national move toward healthcare reform,” according to the American Association of Colleges and Nursing (AACN). 

High turnover compounds daily problems at many facilities that are striving to keep shifts filled. Argentum’s The 2019 Forecast Report: Workforce Trends states that 1.2 million jobs remain unfilled in healthcare and social assistance industry, which includes skilled nursing and senior care. 

Healthcare providers are looking to other industries that have successfully navigated similar scenarios. Lean approaches and workforce management systems help industries, like manufacturing and retail, consistently deliver high service levels with limited resources. However, skilled nursing and senior care providers face additional challenges since quality of care hinges on the availability of skilled medical personnel. As a result, providers must break down the shortage’s impact on quality of care. They must also analyze the staffing shortage and strategies that can alleviate their staff’s burdens and better position staff to deliver quality care. 

Workforce management systems help counter turnover by streamlining applicant recruiting, hiring, and onboarding processes.  

How the shortage impacts senior living  

Lack of educated nurses directly correlates with poor resident care and even leads to fatalities. According to research, a 10% increase in the number of bachelor’s degree nurses equates to 7% decrease in patient mortality in overall healthcare practices. A report in the New England Journal of Medicine  confirms this research and estimates the understaffed units have a 6% higher patient mortality rate than fully staffed counterparts.

Certified Nursing Assistants are also in short supply, which makes it even more difficult to provide quality care.

MIT Professor Paul Osterman, a professor at MIT, projects a national shortage of 151,000 paid direct-care workers by 2030 and an estimated gap of 355,000 by 2040.

When facilities are short-staffed, nurses spend less time with each resident and are more likely to make mistakes. In fact, research proves when RNs are on site, residents experience less falls and are less likely to need emergency medical treatment. CNAs lack the expertise needed to troubleshoot resident care needs, forcing them to take on this responsibility jeopardizes resident care.

Pursing Quality with Lean utilization and Workforce Management 

Since spreading nurses over a greater patient population hinders their ability to provide quality care, providers must find ways to alleviate the burden on nurses while maximizing the productivity of their available resources. The right workforce management system that leverages lean principles can help. 

When part of a comprehensive strategy, workforce management systems that follow lean principles can increase employee productivity, job satisfaction, and promote career advancement, which in turn reduces turnover and enhances quality care. 

Applying Lean principles with workforce management systems 

Lean principles have been helping organizations in multiple industries, especially manufacturing, reach productivity goals for decades. Lean seeks to fundamentally change organization thinking and value, which helps transform organizational culture. Lean comprises a set of operating philosophies and methods designed to maximize value for patients by reducing waste and waits, according to the National Institute of Health.  

Lean utilization helps fuel lean principles and compliment workforce management systems by helping the workforce expand their abilities. Lean utilization requires developing employees to their highest level of skill through role enhancement, which often includes delegation skills, flexibility, and technology, especially workforce management. Find out if Your Organization Wasting Its Most Valuable Resource.  

Enhancing roles   

According to the NIH, role enhancement involves expanding worker skills through innovative and non-traditional roles so they can assume a broader range of responsibilities. Ongoing professional development expands nursing skills and enables nurses to provide current, safe, and expert care. 

Many senior living providers use their workforce management systems to look for development-minded nursing candidates. The provider trains them in multiple skills from wound care and EMR to QA auditing, and quality management measures. 

Enabling staff to spread their wings enhances their engagement and advances their career path while increasing productivity and care quality. In the activities department, staff are also trained in feeding residents as well as managing the facility gift shop.

“We try to expand their horizons as much as possible,” said Mordecai Finkel, Greek American HR Director. “The result? Staff are more likely to be invested in their profession.” Find out:  How Company Culture & Happy Employees Go Hand in Hand.  

Delegating with ease

Delegation practices helps staff communicate more effectively and reduces stress. They increase productivity by helping teams finish tasks on time rather than cramming tasks to the end of the shift, which often spirals into unnecessary overtime. Everyone must understand expectations and responsibility.  

The six steps to teaching better delegation are: 

  1. Prepare 
  2. Assign 
  3. Confirm understanding 
  4. Confirm commitment 
  5. Avoid “reverse delegating” 
  6. Ensure accountability 

Basic workforce management systems can ensure properly qualified staff are working in the appropriate positions and clock in and out on time. More systems can also identify trends that diminish workforce attendance and productivity

Driving flexibility

Developing a flexible skillset and mindset promotes cost efficiencies and superior performance. Greek American’s Human Resources Director learned this firsthand after eliminating the word specialist from job titles as a result.   

“I can’t tell you how inefficient things are when a person specializes in one area and can’t move on to another skill or task. At our facility, every CNA is trained in rehab skills, in feeding, and creating a fine dining experience. This is above and beyond their regular job description. We’re never going to be stuck if one of our ‘specialists’ calls out one day, so all of our employees are trained to do all of the different aspects of the other responsibilities as well,” Mr. Finkel said. 

Integrated workforce management systems promote flexibility by enabling providers to create staffing policies that support their unique needs and incorporate expanded employee skills. Advanced systems can factor these skills and policies into scheduling and compliance functions and apply them when creating schedules and filling open shifts.  

However, these tailored capabilities only work when the workforce management system is designed specifically for senior care facilities. Many workforce management systems treat all healthcare environments the same, which limits their ability to apply lean principles and resolve staffing  issues.  

In addition, generic workforce management systems are often difficult to navigate.

How SmartLinx Supports Lean Principles 

Lean principles help organizations focus on value to boost productivity and resource utilization as well as better understand costs. When tailored for the organization’s environment, workforce management systems represent an ideal technology for organizations striving to apply lean principles.  

Promoting quality and effective resource utilization  

Assisted Living  facilities must abide by different regulations than other healthcare providers. SmartLinx can staff according to federal requirements and Lean principles. In addition to scheduling staff based on the number of residents and services provided, the workforce management system also quickly adjusts schedules to match changing resident needs.  See how SmartLinx streamlines scheduling at 110 facilities. 

SmartLinx notifies administrators when a sudden scheduling change (missed shift, tardiness) causes a facility to fall out of compliance. The system automatically presents a list of qualified employees able to close the scheduling gap.

Administrators can verify full staffing at every facility by glancing at the SmartLinx dashboard and quickly drilling down to discover the source behind any scheduling issue. With a quick click of the mouse, administrators can offer the shift to employees in each one’s preferred method, such as the SmartLinx Go mobile app, a text message, email, or phone call. SmartLinx automatically collects employee responses and notifies administrators, who can easily close the gap.  

 Increasing productivity and eliminating inefficiencies  

Designed specifically for senior care providers, SmartLinx streamlines the administrative processes by presenting all scheduling functions in an intuitive graphical dashboard. Administrators can quickly access what they need and modify schedules on the fly. Not only that, the SmartLinx centralized console lets administrators view schedule status for all their facilities at once and drill down to details. See how Excelerate cut overtime by 30% and overall labor costs by 15% with SmartLinx workforce management system. 

Using advanced business analytics, the workforce management system helps providers prevent overtime. With the unified dashboard, administrators can quickly ascertain who’s approaching overtime and adjust schedules accordingly. When a shift opens, SmartLinx automatically recommends qualified employees who can work without incurring overtime while also supporting internal policies, such as seniority. Administrators can send out shift requests knowing the software will notify them when employees respond.  

SmartLinx advances productivity by enabling employees to adjust their schedules on demand. Employees can also receive and respond to open shift requests in real-time on their mobile device. If they cannot work a scheduled shift, employees can use SmartLinx mobile workforce management system to swap shifts with qualified co-workers and view responses in real time. Discover How to use a Mobile App to Enhance Productivity.  

Reducing costs

Every day, many employees clock in a little early and clock out a little late. Over time, these extra minutes add up to substantial costs. Instead of having administrators sift through volumes of attendance data to identify these incidents and then manually address them, SmartLinx presents all incidental overtime on one unified console. Administrators can quickly spot trends and implement policies to block early punches, late punch outs, and buddy punching. In addition,  


Demonstrating quality care will remain a top key performance indicator. Integrated workforce management systems that support lean utilization principles will enable providers to maximize employee productivity and eliminate inefficiencies. They can use workforce management systems to reduce labor costs while ensuring the staffing meets quality standards and complies with evolving regulations.  


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