ED saves $150,000 by using fewer agency nurses

With an ever increasing nursing shortage coupled with increased patient volumes, you may believe it’s impossible to cut labor costs in your ED. "Not so," says Laura Guerrieri, RN, MBA, director of emergency services at Gottlieb Memorial Hospital in Melrose Park, IL.

"By focusing on reducing staff turnover and placing yourself in a continual state of recruitment, it is possible to win the battle against excessive use of overtime and contract labor," she says.

She reports that the ED cut its agency staffing costs from $196,000 in 2001 to $51,000 in 2003.

Here are the changes made to achieve this goal:

  • Nurses were asked what would keep them from leaving.

    "A reduction in turnover reduces contract labor, overtime, and orientation costs," Guerrieri emphasizes. ED nurses were given a 30-question survey to assess what would make them satisfied, with the data analyzed and shared with administration.

    Surprisingly, most nurses weren’t interested in financial rewards, and instead, really wanted more control over their personal lives and schedules, says Guerrieri. To address this, a 0.9 full-time equivalent (FTE) program with full-time benefits and a flexible work schedule program were implemented. "We also added a last-minute premium program that equates to time and a half, even if you don’t work 40 hours," she reports. "This is much less expensive than the cost of agency nurses."

  • An extra nurse was hired.

    "I would estimate that 95% of all EDs have had at least one staff member per year off for an extended period of time due to illness or have had at least one staff member per year resign," says Guerrieri.

    These situations are what force the use of overtime and agency nurses, as there is no way to hire and orient an ED nurse in two or three weeks, she explains. "If you overhire by 1 FTE and create a large supplemental pool, you will not need to utilize agency nurses or extensive overtime to replace staff," she says.

[Editor’s note: For more information on decreasing staffing costs in the ED, contact: Laura Guerrieri, RN, MBA, Director, Emergency Services, Gottlieb Memorial Hospital, 701 W. Melrose Park, IL 60160. Telephone: (708) 450-4988. Fax: (708) 681-1545. E-mail: laura_guerrieri@ghr.org.]