Sanford Health will soon start to schedule its more than 10,000 nurses leveraging an augmented intelligence tool it developed that uses the future instead of the past to predict staffing needs.
The rural health care system partnered withFlexwise将算法和临床专业知识纳入科技公司的劳动力优化软件。该平台使用预测分析和基于人工智能的技术，通过预测18个月的人员需求，在正确的时间安排正确的人数。
2022世界杯巴西阵容has been piloting its internally developed AI tool since April 2021 in Fargo, North Dakota, and will roll it out to 68 departments on April 15 and then other units. Sanford Health’s development is currently being incorporated into Flexwise’s commercial software product and the co-developed solution will roll out across the entire health system in 2022.
“The tool allows our teams to spend less time on spreadsheets and more time with our patients and their family members as well as help grow and mentor our nursing teams,” said Erica DeBoer, R.N., chief nursing officer.
“We have to be able to anticipate what our staffing needs are so that we can make sure we’re taking care of our patients and our communities. And this benefits our people by making sure our managers, our directors and other leaders can spend time and support our frontline teams.”
LAMP: A nod to Nightingale
Emily Buckingham-Carlson, R.N., head of enterprise clinical staffing and scheduling for Sanford Health, started the effort in 2019. Her job is to optimize Sanford Health’s nursing workforce. She thought real-time information could help identify efficiencies.
“As we’re looking towards the future, how can we use data in a different way, to help understand what our needs are going to be? We all are managing the workforce challenges that the pandemic has prompted,” she said.
“This work has brought to light some of the processes that we’ve had in the past that just really don’t cut it. We have grown exponentially over the last several years. One of the things that this tool is trying to do is stay ahead of our patient care needs and be able to have the nurses where they’re needed when they’re needed.”
她将这种人工智能工具称为“利用分析来动员(我们的劳动力)和准备(为未来)”，简称LAMP。它是为了纪念弗洛伦斯·南丁格尔，南丁格尔被认为是现代护理的奠基人，因为她在19世纪的工作包括在晚上用一盏灯查看受伤的士兵。
“It’s really a nod to Florence Nightingale. She was a disrupter. She was an innovator. She really challenged the norms of her time to move them into a new space,” Buckingham-Carlson said.
‘Forward facing’
传统上，护士经理也会根据过去的情况，将一年前的病人数量考虑进来，填写时间表。白金汉-卡尔森说，LAMP改变了这种做法。
“We’ve got to look at every single hour. What are our nurses doing? What is the workload? Understanding it at a very different level we ever have in the past will help us inform the future,” she said.
“这就是预测和预测的原因，因为我们一直在向前。我们用这些信息来告诉我们接下来会发生什么，而不是告诉我们明天会发生什么。这是一个巨大的转变。”
That shift to stabilize the workforce helps counteract the numerous destabilizing factors brought about by the COVID-19 pandemic and other unforeseen challenges.
“我们面临着许多不同的问题，这是三年前我们开始这项工作时所没有的。它的美妙之处在于，它意味着敏捷。这个工具会随着时间的推移而改变，而不是一成不变的。”
Front-line feedback
Though data drive the AI tool, frontline staff provide valuable input to guide the algorithm, Buckingham-Carlson said. They can assist in informing how many nurses are needed to treat each type of patient.
“We’re trying to engage with the nursing leaders to really understand their operations in a real way to help build this. One of the benefits, even though it’s new and disruptive, is that we have a lot of engagement,” she said.
LAMP helps nurse leaders plan for the right staffing level well ahead of time instead of reacting, which frees them up to lead and mentor, DeBoer said.
“If we don’t have a way to understand and see at the core what our needs are so we can take care of our patients, we have to spend more time on the phone calling and managing and reacting to situations instead of anticipating what those needs might be,” she said.
“LAMP helps us work smarter.”
DeBoer说，该工具已经在测试中证明了自己。“We’ve been able to show tried-and-true accuracy.”
Happier nurses (and patients)
Besides making sure there are enough nurses during each shift, the AI tool also will help Sanford Health make better decisions about how many nurses should be hired to each unit. That will help ensure they get the days off they request and can maintain healthy life balance.
“If we plan better and reduce turnover, our nurses are happier. If they can come to a shift and they know what to expect and have people to take care of the folks that we have, we reduce that variance and they’re happier. Then we hope to impact nursing turnover and retention and keep them happy with their schedule and important work they do every day to serve our patients,” Buckingham-Carlson said.
“We’re looking to really support our employees. That supports our patients.”
‘Can only consume so much information’
At the beginning of that effort to improve staff satisfaction and patient care is innovation, which is where Robert Menzie comes in. He’s the lead data scientist on Sanford Health’s advanced analytics group who developed the algorithm.
“I’m the math guy,” he quipped.
任何曾在医院地板上呆过的病人、家属或访客都亲身体会过医护人员的密集程度。门齐说，在这个行业工作过任何时间的护士经理通常都能在人员配备和病人需求之间找到一个合适的平衡。
“Their gut’s right 80 percent of the time. But we can solidify that and help make it more accurate,” he said.
除了准确性的提高，人工智能工具还减轻了很多安排日程的繁琐工作，这让领导者有更多时间与员工在一起。管理者仍然必须调整员工的日程安排，并最终掌握控制权。但是计算机模型可以考虑更多的信息，Menzie说。
“A lot of people making decisions now have lived through the data, so they are the database, essentially, for their own decisions,” he said.
“But they can only see so much of the data that they’ve collected over the years of experience. Whereas the computer, it doesn’t have short-term memory or long-term memory. It has memory in general. So it can look at everything that’s ever happened and apply the right pieces at the right time. Whereas a person, they can only consume so much information before it gets lost in the background.”
Multiple factors
That information includes patient numbers on the same date from the previous year as well as much more detail, some of it going back up to six years.
“It’s not just the hour of the day. It’s not just what day of the week it is. It’s not just the month. It’s not just the year. It’s a culmination of all of those and also what’s currently happening,” Menzie said.
“所以如果你拿去年的平均值，你将会在一些部门出现人手短缺，而在其他部门出现人手过剩，因为去年发生了COVID。如果你回到两年前，你仍然会错，因为现在我们有covid后的涌入，因为每个错过所有预约的人现在必须去看医生。因此，我们可以考虑过去几天实时发生的事情，但同时也可以考虑去年、两年前、三年前发生的事情，以及所有这些事情对明天或六周后发生的事情有何影响?”
Some departments, such as labor and delivery, also could use leading indicators. For example, if that manager knows how many Sanford Health patients will be 40-weeks pregnant in six weeks, they can schedule accordingly.
Menzie说:“它们不是万能的，但它们至少让计算机有机会找到这些模式，并以比人工更快的方式实现它们。”
Prescribe, don’t just predict
Beyond predicting staffing needs, the AI algorithm goes one step further: prescribing what could be done to solve a scheduling challenge.
“We predict months out. But then we also prescribe, which is the scheduling piece. And that prescribe piece is a true optimization,” Menzie said. “Now you don’t have to take the time to find the solution. The solution is provided.”
Another benefit is even longer-term planning. For example, game-planning for how many nurses a new 20-bed unit will need when it opens or what happens to staff levels if turnover decreases or the organization reduces the amount of time to hire a nurse.
“我们可以控制所有这些开关的打开和关闭，这让负责管理操作的人员有时间进行计划。所以我们可以告诉你，如果你想在五年内开放20个床位，它们就会被使用，而不是在围栏上挥挥手，希望你没有浪费资源投资。”
Flexwise partnership
Menzie said that while he delivered the algorithm, Flexwise “provides a modern software user interface rather than a spreadsheet” for nurse leaders to use when scheduling.
“Flexwise健康被认为是一流的精准招聘公司，”领导该项目的桑福德健康创新和商业化团队成员Braden Bills说。2022世界杯巴西阵容Flexwise非常重视与桑福德健康的合作2022世界杯巴西阵容关系，因为我们是在内部进行的，所以我们可以提供广泛的临床、操作和数据科学反馈。这是我们合作的主要内容。”
Flexwise, based in Nashville, Tennessee, helps organizations optimize scheduling for permanent clinical staffers and also manage a pool of float nurses who can quickly help where they’re needed most.
F2022世界杯巴西阵容lexwise首席执行官Kevin Godsey表示:“Sanford Health在开发预测分析概念以改善人员配备和日程安排方面是市场领导者，并开发了内部应用程序。”“他们进行了概念验证，看到了价值，但决定要在整个系统范围内实现这一点，还需要更多的努力。”
That’s when the organization engaged Flexwise to integrate the algorithm into its software platform as an “intelligence layer” onto Sanford Health’s existing electronic medical record system and applications that handle nurse scheduling, time and attendance, Godsey said.
Nursing changes
The pandemic obviously prompted severe staffing strains and shortages. But several factors already were in play that required a new, predictive approach to nurse scheduling, Godsey said.
Among them, he said:
- 护士的平均年龄超过50岁，而且没有足够的人进入劳动力市场来取代他们。
- Younger nurses want to be more in control of their work life. They are digital natives and want more of a digital connection to their work experience, including scheduling.
- More health care workers want to join the gig, or freelance, economy and choose when and where they work.
“And then the pandemic created massive disruption” that prompted many clinicians to leave the workforce, which further strains the system, Godsey said.
“Part of our mission is how do we engage them and build bridges that let us re-engage the workforce on their terms. They might be willing to work a few shifts a week. Our model opens that up in a way that’s very scalable and easy to manage. Our belief is we can help rebuild a certain part of the labor market by presenting a new way for these disenfranchised workers to come back and contribute again,” he said.
What’s next
DeBoer说，整个桑福德健康中心的主要医疗中心的住院部将在4月份开始使用LAMP，随后是支持服务。2022世界杯巴西阵容领导者还计划使用预测分析工具与人力资源合作，并计划未来的人员配备和招聘需求。她说，这也将有助于告知高等教育需求。
“When you stop to think about how we’re using data and innovation to help us anticipate staffing and patient care needs, it helps us manage not only the short-term but also look ahead so that we can shift resources, both HR with hiring but also how we guide our colleges of nursing and other expertise to manage what those needs might be for staffing,” DeBoer said.
与Flexwise的合作也可以帮助其他医疗机构使用人工智能工具，白金汉-卡尔森说。
If it works at a sprawling, integrated, rural system like Sanford Health – with 48,000 employees, two major medical centers, 44 other hospitals, 224 clinics and 233 senior living communities – it can work elsewhere.
她说:“现在感觉很小，但在我们如何支持全国的卫生系统方面，它可能是巨大的。”
Sanford Health is focused on innovation to bring new ideas to market that improve the health and well-being of its patients, people and communities. It values the ideas and problem-solving ability of nurses, physicians, researchers, clinical workers and support staff. Any employee with an idea for a device, therapy, software, tool or other method that helps patients is encouraged tocontact the innovation and commercialization team和桑福德健康公司的人一起创造2022世界杯巴西阵容
“The work that Braden (Bills) has been doing on this project is a great example of our innovation department helping accelerate innovative ideas and scale them across the enterprise to benefit our caregivers and patients,” said Katie Pohlson, senior director of innovation and commercialization.
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