Is there a job in skilled nursing that can be likened to a Grandmaster chess player? According to Scott Erwin, workforce planning specialist at Reverence, it’s the role of the scheduler.
At Reverence, Erwin oversees the development of artificial intelligence and advanced technology that takes some of the burden off of schedulers, and so he has seen the service schedulers provide up close.
“Another apt comparison is London taxi cab drivers who have to memorize the entirety of a giant map of London in order to be able to actually receive their medallion,” he said.
But despite the complexities of the role — and its growing importance as staff flexibility becomes a more pressing issue — too many nursing home operators undervalue these workers, said Bernie McGuinness, CEO of Indiana-based Majestic Care.
Schedulers can be frontline practitioners, nurses, nurse managers, or, in some cases, CNAs. While the scheduler is not considered a supervisory position at most facilities, the role requires a keen understanding of the culture and people at any given community and the ability to have strong working relationships with each employee. Moreover, even with technological advances and availability of scheduling software, the need for human input in this role remains great even as some leaders suggest that schedulers aren’t valued enough for the service they provide.
Since the pandemic and the workforce shortage, the role of the scheduler has become more complicated. With many operators relying on both outside staffing agencies and their network of employees, configuring a working schedule takes more planning. And with the spread of infectious diseases, filling shifts given a moment’s notice has become a more significant part of the role.
Erwin said that equipping schedulers to succeed can help reduce burnout in the role.
“We want schedulers to have those deep and meaningful relationships with the people with which they’re engaging,” he said. “And what we want technology for is some of the more prescriptive and rote tasks such as issuing invitations and understanding with [artificial] intelligence [which workers] certainly are not going to be available for shifts.”
The bottom line for providers
McGuinness said that although the scheduler is in control of 35% to 40% of all expenses, the role’s importance has gone unrecognized.
“The role that I think is so undervalued is really the [scheduler] that we don’t count as a supervisor,” he said. “Typically nursing homes don’t classify this person as a salary employee. Our frontline care staff drastically believe that this person is their supervisor, because they control how many hours they get, whether or not they get the day off, and that controls their check and their personal life.”
Crystal Barnes is a scheduler and the director of workforce development at Majestic Care, where she works with all of the schedulers. She maintains the float pool schedule, and implements online scheduling platforms. Although she has worked with many different software platforms, she most recently oversaw the implementation of Axiom Scheduling, which allows clinical staff to see their schedules, request time off, and pick up shifts.
Despite technology helping to streamline the process of scheduling, the role is still very complicated and time consuming, and requires heavy employee input.
“We have about 44 buildings, and so I oversee their schedules when they need help adjusting or balancing schedules,” she said. “There’s nothing simple about long-term care scheduling.”
Barnes said that to be a successful scheduler, one has to be proactive, accommodating, and efficient.
“You’ve got to have your schedules out four to six weeks in advance, and a lot of schedulers, that’s their biggest downfall,” she said. “They wait two days before and post the schedule for the next two weeks.””
On this timetable, workers don’t have enough time to plan their lives.
Barnes said that one of the biggest challenges is that schedulers, who are often registered nurses or CNAs, get pulled to the floor to work, making it harder to set aside time to create a complete schedule.
At her organization, however, things work a bit differently, and Majestic has seen efficiencies from the change.
What CEO McGuinnesss did at Majestic, Barnes said, was try to hire individuals to fill the role of the scheduler who have the necessary skills but aren’t certified in health care. She said that a full-time scheduler who is not certified for clinical skills but has experience coming from another health care organization can be just successful in the role. Besides, they don’t have to get distracted with other clinical duties and devote their time to scheduling.
“I didn’t start out as a CNA,” she said. “When I started with (Majestic) many years ago, I was simply a scheduler, and I wasn’t pulled to the floor and it gave me time to focus on our building and our needs in our building.”
Training a scheduler
Barnes said it takes four to six months to train a scheduler. It is an ongoing process that starts at the high level of a company and goes down to the building level to allow schedulers to understand the intricacies of how to balance the schedule and create flexibility.
Despite attention paid to training, the position has a high turnover rate, which Barnes said is because schedulers are often falling behind due to being needed on the floor. Salaries are sometimes higher for schedulers, but it varies from company to company.
“Even as a new scheduler, you’re still at the high end of the CNA wage. If it’s a nurse, obviously, they’re probably going to be in the middle to the high end, probably closer to a management rate,” Barnes said.
McGuinness said he wants to change that.
“I think the role and how we invest in the role of the scheduler as we move forward will be crucial for our industry to look at the value of that workforce manager,” he said.
Erwin said that trying to leverage informal, flexible pools of labor to pick up last minute shifts can be more effective and reduce costs of third-party labor. But that involves the codification of those pools, which takes time.
“(If) schedulers spend their day as 80% fighting fires and 20% being able to plan forward about the workforce needs and build relationships with the kind of frontline labor they’re engaging, then it’s a very difficult job,” he said. “You actually can position schedulers in a much more sustainable environment, and the overall organization will really benefit as a result.”
Companies featured in this article:
