Business benefits:
• Retention of clinical staff.
• Continuity of patient care.
• Improved employee morale.

Statistics:
• Compressed workweeks began: 1975
• Staff participating: 25%.

"For some staff, work options are every bit as important as financial benefits."
– Dave Jones, Director of Facility Support Services

Providence understands the pros and cons of compressed workweeks as well as any organization. The two concerns uppermost in an employer's mind when considering compressed workweeks are cost and productivity, according to Dave Jones, Director of Facility Support Services at Providence Yakima Medical Center.

“We demonstrated there is no negative impact on cost in using compressed workweeks at a 24-hour facility,” he says. “And there is clearly a positive impact on employee morale which translates into better retention–and in some areas, such as with critical patients, there is increased continuity of care because of fewer transitions between nurses.”

Smart management of schedules yields success
Providence top management empowered supervisors to balance the medical center's needs with employees' personal needs in deciding whether to approve requests for alternative work schedules. This means asking employees and departments to demonstrate the best use of resources. It could include ensuring that nurses and other staff desiring to work a 12-hour shift have a “partner” on the following shift to avoid paying overtime to cover gaps between shifts.

“Smart management of alternative schedules has resulted in a win/win situation for our hospital, our staff, and our patients,” says CEO Barbara Hood.

Employment Coordinator Jerri Daily says sometimes it takes more total employees to run 12-hour shifts seven days a week, but it does not cost more if schedules are managed well. Solutions include staggered scheduling–with compressed workweeks falling on different days–and use of the partner concept or a pool of as needed part-time staff to cover any gaps, instead of paying overtime.

Recruiting and retaining employees
Providence finds the intangible benefits of compressed work weeks, including happy employees, are invaluable. Most importantly, offering innovative schedules helps the medical center recruit and retain clinical staff–a challenge due to the high demand for specialized training and the limited market of a small city. Offering work options became an established way of doing business during the years of extreme nursing shortages, Jones says.

Continuity of care
But beyond being a high-priority employee benefit, in some situations, continuity of care is improved with compressed schedules, due to care providers working with patients for longer periods of time. The hours after surgery are the most critical for patients when continuity of care, and actions based on thorough knowledge of a patient's state, could make a life-saving difference.

Creative shifts fill niche needs
Alternative schedules at Providence are more creative than 4/10s and 3/12s. Medical center staff refer to the wide variety of work schedules in use at the medical center as “innovative shifts.” Currently, out of 1,000 full-time staff, approximately 25% work compressed weeks.

While floor nurses choose as a group to stay with 8-hour shifts, critical care nurses in the advanced care unit, intensive care unit and emergency room work 3/12s. The operating room and recovery room employees work flexible 8s with differing start and stop times to accommodate peak demands. The pharmacy department works 10-hour shifts, seven days on and seven days off. The respiratory unit works 3/12s. About half of the maintenance staff work a variety of innovative shifts.

Employees appreciate needing less daycare and having more days off to travel, spend with family or simply recharge themselves for the demands of a high-stress job. Conversely, some of the health care workers hold secondary jobs in their “off” time. Providence Medical Center is one of two hospitals in Yakima, and many staff are shared between Providence Medical Center and Memorial Hospital. Eighty percent of pharmacists, for example, have more than one job, sometimes at community retail pharmacies. “Offering compressed schedules has a profound impact on their lives and our ability to staff certain positions,” Daily says.

Pay for holidays and leave
How does Providence deal with pay for holidays and sick leave on compressed workweeks? “It's not complicated,” Jones says. “If an employee is taking sick leave or would normally be scheduled to work on a day that falls on a holiday, he or she is paid for those hours–eight, ten, twelve or whatever their schedule is. If required to work on the holiday, the employee is paid time and a half.”

Because Providence operates 24 hours a day, seven days a week, staff working longer days than the typical 8-hour shift, are paid according to the time period in which they worked the most hours.

Value proved by experience
Providence's experience is that there is “no financial downside to compressed workweeks–no increase in the cost of operation,” Hood says. “A combination of innovative and regular work schedules seems to be optimal for both the organization's operation and staff preference,” she adds.

“For some staff, work options are every bit as important as financial benefits,” Jones says. The hospital administration retains careful control of scheduling to avoid needing to fill gaps in coverage with overtime. Providence has learned to use compressed schedules effectively and efficiently, resulting in high quality patient care and retention of clinical staff.

© 1998 Washington State University Cooperative Extension Energy Program.The Telework, Compressed Workweeks, Flextime case study is a publication of the Washington State University Cooperative Extension Energy Program in collaboration with Commuter Challenge with additional support provided by the Washington State Department of Transportation. This publication contains material written and produced for public distribution. You may reprint this material, provided you do not use it to endorse a commercial product. Please reference by title and credit Washington State University Cooperative Extension Energy Program and Commuter Challenge. Trade names have been used to simplify information; no endorsement is intended. Published Sept. 1998.

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