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Flexible Work Options in Health Care Can Result in a Win-Win

2016 Annual Conference & Exposition
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Flexible work arrangements in health care settings help not only workers but also patients, according to a panel of HR professionals.

On June 18 at the Society for Human Resource Management (SHRM) 2016 Annual Conference & Exposition, held in Washington, D.C., five representatives from the health care sector described their experiences and challenges in implementing and managing flexible work options for their workforces.

SHRM hosted the panel with the Families and Work Institute. The two groups are partners in the When Work Works initiative to help companies adopt flexible workplace policies and practices.

Flexible work can also be part of an organization’s recruiting strategy. Attracting and retaining quality health care staff will become even more important in the years to come, as staffing shortages are predicted to get worse amid an aging population.

In some respects, the 24/7 operations model of patient care has already prepared health care organizations to think creatively about staffing and schedules. Data from the National Study of Employers and the National Study of the Changing Workforce, both from 2008, revealed that employers in health services were far more likely than employers in other industries to see flexible work as a business tool rather than a favor or a perk. In addition, they were more likely than employers in other industries to use flexible work to attract and retain candidates.

“Flexibility results in a win-win situation,” said Sara Collison, director of HR for Cardinal of Minnesota, a company that manages residential homes for people with developmental disabilities, mental health concerns, brain injuries and elder-care-related conditions, based in Rochester, Minn. “It’s hard to be flexible sometimes, but you can’t put a price on flexibility. When it’s there, it’s very valuable. And fostering a culture of trust with employees—by letting them set their own schedules, for example—creates loyalty.”


Flexible work programs are not one-size-fits-all. Managers working within their staffing limits can experiment with flexible policies on a team or departmental level. Some of those flexible work options include:

Float pools. Many hospitals have created full-time float teams to cover deficiencies in staffing, allowing other nurses to take time off when needed. “Cardinal strongly encourages cross-training in different departments,” Collison said. “Then we can use them to cover shifts for other employees who need extra time off.”

Job sharing. Queenie Plater, vice president of HR at Johns Hopkins Medicine’s community division in the Washington, D.C., area, is piloting a job-sharing program for nurses at the three community hospitals she oversees. “We may have a nurse that wants to work part time. That nurse can make an arrangement with another nurse,” she said. “They can partner together and still complete the one FTE [full-time equivalent] requirement.”

Per-diem registered nurses. These professionals work on an on-call, temporary basis, filling in for nurses on leave or providing additional help when patient intake rises. Some work for staffing agencies while others work for a hospital or health care system, such as the nurses Plater employs to “help fill in the gaps.”

Alternative scheduling. Using nontraditional work scheduling is a common technique, the panelists said, from staggered start times and overlapping shifts to compressed workweeks, alternating days off and even unlimited paid time off for exempt workers at Cardinal. Exempt staff at Cardinal also set and manage their own schedules.

“If they want to come in early or leave later or work on the weekend, it’s fine with us, as long as the job gets done,” Collison said. “It’s more difficult for nonexempt workers, who are the direct-care providers. But we try to be as flexible as possible.”

At Cardinal, nonexempt employees can trade scheduled shifts and are always granted time off if it is requested two weeks in advance. If they ask for time off a day or two before a shift, Cardinal tries to modify the schedule to make it work, Collison said.

Employees at Casey Health Institute, an integrative primary care facility based in Gaithersburg, Md., are able to “dial up between full time and part time,” based on an individual’s need and the business’s need, said Kendra Janevski, director of HR for Casey.

Telecommuting. All the panelists said their employers offer telecommuting as an option, but mostly for exempt office staff. At Casey, some direct-care workers are allowed to work from home to complete administrative tasks like charting.

“Telecommuting is somewhat new to health care,” Plater said. “There are a lot of noncritical departments that can use a telecommuting option; for instance, the medical records coders can do that from home. Or in HR. At least once a month, recruiters stay home and source, place calls and set up interviews. We find that they are productive without all the interruptions. This took a little convincing for the president, but you have to show the return on investment.”


Flexible work in a high-stress, scheduling-intense environment like health care does have its challenges: fatigue when workers choose to work fewer but longer shifts back to back, overtime management, and the need to align other workers’ schedules.

It’s very important to consider the support staff schedule, Janevski said. “If you’re lowering a care provider’s activity, that will impact the support worker. Make sure that they have other tasks to do or are allowed a flexible schedule as well.”

It’s also critical to be fair, she said. “Be clear and upfront about what kinds of jobs are eligible for workflex and what kinds of workplace flexibility are eligible for those categories,” Janevski said. “For example, the medical assistants can have flexible schedules but can’t telecommute as often as administrative folks.”

Kimberly Ouwehand, head of outreach development and community relations for Boise, Idaho-based Treasure Valley Hospice, said the hardest things about managing workplace flexibility are “making sure there is clear communication, flexible workers are connected to a team leader and there are clear expectations about guidelines.”

Janevski agreed, adding that flexible work in the health care setting requires intensive management engagement to hold people accountable. “The trust factor is really important,” she said.

Roy Maurer is an online editor/manager for SHRM. Follow him @SHRMRoy


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