With hospitals facing workforce and capacity challenges, aligning staffing levels with demand is essential for staffing resiliency and expense management. To accomplish this, more organizations are using regression analysis—a data-driven approach to assess staffing flexibility and determine how well departments adapt to fluctuating workload.
Leaders can use analysis findings to identify which departments could benefit from increased agility and then implement targeted initiatives to address limited staffing flexibility, drive meaningful change, and ensure their business remains adaptable.
Gathering the Data: Regression Analysis
Regression analysis examines the relationship between staffing levels and department workload. By comparing a baseline period (pre-intervention) with a measurement period (post-intervention), organizations can evaluate the effectiveness of process changes. As part of the analysis, departments are categorized based on their ability to flex staffing in response to workload variations. Furthermore, the analysis can approximate how the departments are operating relative to functionally fixed and variable positions.
Listed below are representative flexing categories commonly used, where a score of 1.00 indicates the highest correlation between staffing and workload.
- Flexing Well (0.75 to 1.00): Departments that scale workforce levels very closely to match demand
- Moderately Flexing (0.50 to 0.75): Departments that demonstrate effective responsiveness in adjusting staffing levels
- Limited Flexing (0.30 to 0.50): Departments that have some correlation between staffing and workload but exhibit limited ability to flex staffing
- Negligible Flexing (<0.30): Departments that operate with rigid staffing models and exhibit negligible flexibility
It should be noted that while regression analysis can be completed for all departments with a workload statistic, those that have variable workloads (e.g., procedural areas, imaging departments, nursing units) will typically exhibit higher correlations and therefore benefit from this analysis more than departments with highly stable or indirect workload statistics.
Using the Data: Targeted Interventions
Regression analysis is a valuable tool to assess staffing flexibility, but it is only part of the solution—what leaders do with those results is what ultimately leads to effective change. Achieving and maintaining agility requires executive support, empowerment, education, tools, and accountability.
Below are five actions leaders can take to bolster organizational agility where necessary.
- Encourage leadership engagement and sponsorship.
One of the critical success factors in any transformative project is enthusiastic support from the senior team. This is especially true when workforce-related changes are involved. Commitment is evidenced by meeting attendance (e.g., the CFO and/or CEO kicking off educational sessions) and full engagement during productivity reviews and position requisition meetings. - Supplement budget conversations with productivity targets informed by external benchmarks and operational insights.
Some workforce advisers assert that benchmarks are merely directional yet fail to adjust targets based on operational insights, which can leave managers feeling disenfranchised. Leaders should aim for more collaborative conversations that are supported by tools such as staffing sheets that allow managers to visualize requirements at varying workload levels. Doing so shifts the dynamic from a top-down, disconnected demand to a more engaged, data-informed dialogue. - Provide tiered education delivered during teachable moments.
A potential downfall of management training is timing. Providing training on processes or a new information system months ahead of active use can cause the knowledge gained to become "stale," yielding frustration once actually deployed.
As such, scheduling phased educational sessions that are aligned with the rollout of the productivity management and improvement programs ensures managers will be ready to apply the newly acquired skills right after the classes. For example, instruction on how to complete a variance explanation or action plan should be delivered within a few weeks of rolling out that process.
In addition, offering defined office hours with a productivity and staffing expert helps managers with action planning for improvement and reinforces knowledge acquisition at the most appropriate time. - Promote a culture of transparency and collaboration.
A primary objective of the educational sessions is to build rapport and respectful working relationships among department leaders and workforce management advisers. Establishing that solid foundation in a classroom setting makes department leaders more likely to seek support when challenges arise and proves valuable when leaders are later asked to provide variance explanations or develop action plans. - Establish or revamp the workforce management committee.
We often find that existing labor management or position requisition meetings lose effectiveness over time due to relaxed standards or workarounds. A key success factor in improving organizational agility is establishing a workforce management committee with a clear charter detailing member expectations, thresholds for approving position requests, and clear triggers for intervention when productivity targets are not being achieved. Documenting performance expectations within the charter and charging committee members with overseeing adherence to those expectations is critical to maintaining the effectiveness of the committee over time.
Tying It All Together: A Case Study
ECG recently partnered with a midsize health system in the South to improve its ability to staff to demand. Leadership had recognized that the system's workforce management processes were eroding and its workforce management committee was ineffective in controlling labor expenses.
ECG completed a two-month assessment, which included a regression analysis to illustrate the improvements possible related to organizational agility. Once the results were presented, system leadership engaged us to help implement the recommendations. Our approach focused on setting the groundwork to support the key improvement initiatives discussed earlier, including:
- Facilitating a phased productivity education series, which began with an overview of budgeting and staff planning tools and moved to performance improvement concepts for evaluating and streamlining processes as managers became accountable for productivity and other workforce KPIs.
- Redesigning tools and procedures to support the workforce management committee, such as more formalized approval criteria for position requests, updated variance and action planning forms, and a revised charter.
- Partnering with finance and HR leaders to cofacilitate weekly productivity and position requisition meetings, during which our team provided subject matter expertise and assisted executive leaders and department managers with staffing analyses and action plan development.
- Conducting a final education session that explored advanced productivity strategies and introduced job aids (e.g., time clock management, payroll corrections) to support leaders’ standard workforce management tasks.
The regression analysis was repeated at the end of the engagement, and the results were impressive:
- The percentage of departments flexing well nearly doubled, from 4.88% to 9.09%.
- Departments moderately flexing saw a significant increase, from 9.76% to 24.68%.
- The number of departments with negligible flexibility dropped from 67.07% to 49.35%, indicating a shift toward a more adaptable workforce.
This work effort yielded measurable results for margin improvement, with a financial impact exceeding the goal of $3.15 million, demonstrating just how lucrative investments in organizational agility can be.
Edited by Emily Johnson
