What does adequate staffing mean? The reality is that it means something different for everyone. There will never be a fixed metric for staff based upon square footage or bed size that applies to all. Today’s health care facilities require a balance between insourcing and outsourcing. Several factors can be used to help develop what best fits the needs of a specific facility.

The first step is to develop a list of all the tasks that are required for facility maintenance and operations. Next, identify which tasks are currently completed in-house or contracted. Data from work orders, such as the quantity and labor hours, can be used to help determine workload. Separating compliance tasks from general operations tasks will help to establish the fixed “bucket” costs of doing business. Additionally establishing costs for break/fix and asset failure will establish the non-discretionary bucket costs for facility maintenance. Then, the remaining service costs will help determine which extra services the facilities team provides. For more information regarding facility and infrastructure cost categorization, check out an American Society for Health Care Engineering On Demand webinar on infrastructure investment by accessing the “More Online” link in this box.

The second consideration is the culture of the organization. Determining the expectations of leadership will help guide decisions around quality and response. Managing health care facilities takes resources, especially labor. Having a clear understanding of organizational goals will provide a comparison of expectation versus reality and can help in discerning the correct balance between reactive and proactive maintenance. 

Not only is recruiting staff a challenge in a post-COVID-19 world, but maintaining staff has also become even more difficult. Gone are the days of a line of qualified health care workers waiting for an opening. The average time for open positions has increased from a few weeks to several months with no signs of reducing. It is more critical than ever for managers to be leaders and make teams feel valued as critical members of the organization. Maintaining a positive culture with growth opportunities will be a major contributor to retention. A facility manager must be able to support staffing levels by knowing all that is needed to complete the in-house tasks well and manage outsourced workers with the same commitment.