Bill Klaproth (Host): This podcast is brought to you by in for a global leader in business cloud software, specialized by industry, including healthcare to learn more, visit in four.com.

This is a special AONL podcast as we record from the show floor at AONL 2023. With me is Brianna Zink, she is the Senior Director of Product Strategy for Workforce Management at Infor, and Joanna White, Chief Nursing Executive for Infor, as we talk about how to improve safety through acuity-based scheduling and data-driven patient assignments.

Host: This is Today in Nursing Leadership, a podcast from the American Organization for Nursing Leadership. I'm Bill Klaproth. Brianna and Joanna, welcome.

Brianna Zink: Thank you. Great to be here.

Joanna White: Thank you. We are so excited to be here.

Host: I'm so excited you're here. So, let's jump into this. Brianna, let me ask you, as we talk about acuity-based scheduling and data-driven patient assignments, what are the challenges surrounding this?

Brianna Zink: So, we have definitely seen a trend before the COVID pandemic, but definitely coming to a head from the pandemic of a nursing shortage. We're looking down the pipe of a lot of nurses nearing retirement, not nearly as many nurses coming into the field of nursing, needed to replace those. And then, many different states looking at potentially mandating nurse-patient ratios, and health systems really struggling with their margins and specifically very high labor spend. So, we have developed a solution that looks at the care required for patients because we believe that there's ways to look at how you're deploying your staff for those patient needs outside of just simply a nurse-patient ratio, but that can help augment that. So, we're really working to help with the nursing shortage and ensure that patients are receiving high-quality patient care.

Host: So, a lot of things going on now. But on the horizon, it sounds like you're predicting in the future we're going to be facing these types of challenges as well. Is that right?

Brianna Zink: Yeah. Just the nursing shortage is something that is not necessarily going away. We're still navigating how we're going to work through that. Our population, especially in the United States with the baby boomers aging, our population's getting older, so they typically require more care. So just kind of all of those combined, we need to figure out how we're deploying staff in the most efficient way possible, assigning patients in the most efficient way possible, and really aligning the care needs with the staff that we have.

Host: Yeah. And Joanna, what's your thoughts on that?

Joanna White: Yeah, I was going to say I think a lot of it too comes down to keeping your nurses, your team altogether engaged. Looking at those assignments, are they fair? Are they equitable? Do you have one nurse who has an assignment maybe at one end of the hallway and then they have another patient at the other end of the hallway? Do you have one nurse that's assigned maybe three patients that are total care and you have someone else who may have three patients but they're being discharged that day? You know, the acuity levels are completely different. So, just trying to keep everything fair and equitable.

Host: So for a nurse leader listening to this who might say to themselves, "I've got so much going on now. I don't need to worry about all this. I got enough on my hands," why is it important for what you're telling us in this podcast, for them to really pay attention to this?

Brianna Zink: Yeah. So right now, there's just so much that goes into these decisions that a nurse leader or a scheduler or a nurse manager is making around deploying their staff and making those patient assignments. They're often jumping between multiple systems, which include potentially paper, EMR, ADT systems, you know, digital systems as well as having to make phone calls or send text messages. So, we're really working to consolidate all of that into one single system, so they have all that data from their employee data and their staffing data to the actual patient care requirements in one place to really streamline those decisions and ensure that they're supported by up-to-date data.

Host: Okay. And Joanna, your thoughts on that?

Joanna White: Yeah. I completely agree with everything that Brie said. Having that clinical data and marrying it to the operational data as far as like scheduling, it's definitely a win. And nurse leaders are going to pay attention to it. They have to, they really don't have an option at this time, because the nursing shortage is not going to get any better anytime soon.

Host: So, let me ask you this. What are the things that Infor brings to the table then? How are you addressing these challenges?

Brianna Zink: So, Infor has a workforce management solution. So, we have timekeeping and scheduling, really great features around advanced scheduling specifically for nurses and kind of those nuances of scheduling around the clock. And then, we also have a solution that we just made available in the cloud called clinical science. So, it's based on the GRASP methodology, which is a methodology that has been around for years that looks at patient workloads. And based on documentation happening in the medical record, so without putting any additional work on the nurses, we pull that information and we develop a workload value, that's essentially the time it takes to care for each patient. And then, that is fed through the different areas within staffing. So, you're making those decisions based on that real-time patient data all the way down to the individual unit level where a charge nurse can help get guidance on how those assignments should be made to be fair and equitable with still having kind of that final say, because we understand that those charge nurses have that clinical expertise. They know their staff and the patients. So, we can't ever take that away, but we help give a rough draft of what that should look like.

Host: Right. And how do you work with your patients? Do you do an audit first? How do you come in and you assess what's going on? How do you work with your clients?

Brianna Zink: We work with the individual units to understand the care that they're providing. So, clinical science looks at the direct patient care, so all of the things that are documented in the medical record. But then, we also look at indirect care. So, we look at the different units and understand what do you have to do on this unit to keep it running smoothly and effectively that may not be documented in the medical record, because that's a huge piece of the work that nurses and other support staff are doing. So, that's the main work through that implementation, is understanding how the different units run, the different policies and processes they have in place, and make sure we're incorporating that into the total unit workloads.

Host: So Joanna, as the Chief Nursing Executive, give us your thoughts on that.

Joanna White: Yeah. I mean, I think that one of the things that set our solution apart than others Is that we are measuring that indirect care. Because whenever it comes to the end of the day, whenever nurse leaders are looking at their productivity, it's really hard to measure that indirect care. Whereas with our solution, we're also adding a value to that.

Host: Okay. I think that's really interesting information. So, Brianna, can you share some successes or tell us a story about a client of yours that have implemented this and the positive changes that have taken place?

Brianna Zink: Yeah. So, I actually have a pretty unique use case that one of our previous clients use. They were actually using the GRASP methodology quite a few years ago, but they were looking at replacing some of the equipment that they were using and they were looking at two different equipment providers of who they would purchase that from. And their nursing staff was really inclined and really pushing for the more expensive piece of equipment, where the finance side was kind of like "This does the same thing. Let's do that." So, they actually pulled a lot of the data from GRASP or clinical science, and they were able to essentially run an analysis and show that the amount of money they would save from the time saved by this more expensive equipment, being able to run these processes quicker more than justified the cost of it. So, it kind of spoke to justifying a purchase and to that patient satisfaction, because things were done quicker and to the employee satisfaction, because it was a much less cumbersome piece of equipment to use.

Host: So, it kind of paid for itself.

Brianna Zink: Yeah.

Host: And you get the positive outcome with the staff as well. Better job satisfaction, which leads to better health outcomes, which is really important. Joanna, thoughts on that, on the results that you've seen or experienced?

Joanna White: Yeah. And just another like little piggyback that I want to add, so one of the things that happened with that experience was we were able to have the nurse have the same language as the CFO. And so just having that, it was very easy to go ahead and define what that was, rather than a lot of times we see nurses have a different language than what the CFOs do. And so, that was just one of the great things that was another outcome of that.

Host: Yeah, that is an important point too, when you get everybody on the same page understanding the same language. That's really important when you break down some of those barriers. So when it comes to Infor, anything else you want us to know about your company, how you work with your clients or solutions that you offer?

Brianna Zink: Yeah. We have a great focus on the healthcare industry. We offer solutions specific to healthcare, so we also have finance supply chain. Our supply chain has some really great features unique to healthcare around recall management and some other kind of uniquenesses here. So, we are proud of our offering that's really everything that you need to run a hospital outside of the medical record.

Host: Yeah, that's really cool. Joanna, your thoughts?

Joanna White: Yeah. We also have HR talent and payroll. That's another one of our cloud suite offerings. So whenever we were talking about engagement earlier, we offer some solutions for that such as check-ins and having all of that electronic, everything in one place. Even your whole HR personnel profile, we can even get therapy animals as a resource. You know, so then that way whenever joint commission comes in, you can go ahead and prove the immunization record. So, having everything all in one place. And then also, we have unique to Infor is Cloverleaf or Clinical Bridge, which allows our solution to go ahead and talk to the electronic health record or EHR/EMR to and marry that data, the clinical data with the finance data. So whenever executives are looking at all of the data, everything is right beside each other, so they can go ahead and make those business-driven decisions.

Host: customer support too as well, I imagine. Yeah.

Joanna White: Oh, yeah.

Host: So, you're in it every step of the way with your clients.

Brianna Zink: We are, yes.

Host: I love that.

Joanna White: We also like to call them partners.

Host: Partners? I like it.

Joanna White: Yes. Because they are totally a partner of ours.

Host: I love it.. That's great. Well, Brianna and Joanna, thank you so much for your time today. This has really been interesting. Thank you for talking to us and sharing information about Infor. We appreciate it.

Brianna Zink: Thank you.

Joanna White: Thanks for having us. This has great. Thank you.

Host: You bet. And for more information, you can visit aonl.org. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is Today in Nursing Leadership. Thanks for listening.