The cellular structure Saskatoon Health Region introduced to better support managers is not only improving the work environment and ultimately benefitting patients, clients and residents, it's also gaining interest from across the province.
The cellular structure, first rolled out in 2015, is meant to transfer certain tasks from managers to other specialists who are trained in particular areas and located either right on or very close to their units or departments. With tasks related to areas like human resources, quality improvement, and scheduling taken off a manager's plate, he or she has more time to focus on their staff and making team-based quality improvements and enhanced care practices.
As it continues to roll out across the region, this structure is resulting in an overall better work environment and is starting to measurably improve performance.
Due to this success, the teams involved have delivered presentations to several members of the provincial health authority transition team about their experience and how this new structure is working and reportedly making a huge difference for managers.
Zoe Teed McKay, Manager of the Irene and Les Dubé Centre for Mental Health, along with Mike Northcott, Transition Team Lead for Human Resources, Labour Relations and Change Leadership, and Colleen Stewart, Manager, Business Partnering, Human Resources, Saskatoon Health Region before one of the recent presentations on Saskatoon Health Region’s cellular model.
Assistance from her cellular team has already helped Zoe Teed McKay, Manager of the Irene and Les Dubé Centre for Mental Health, reduce overtime by 37 per cent, which has also reduced sick time.
"Staff are coming to work feeling supported because they are not working short-handed, or being called in on short notice," she says.
"Today's managers are being given enhanced responsibility for finances, scheduling and position management on top of large amounts of labour relations and employee wellness work, all balancing with the Region's strategic directions, daily operations and crisis management," explains Teed McKay. Before the cell structure, managers could access human resources and scheduling support, but it took time and a lot of consultation, and it was up to the manager to lead the process.
"With this shift to the cell structure, we most certainly are redefining the management role," Teed McKay says. "Overall, managers are less consumed with daily operations and crisis management, and are able to create positive outcomes for staff and the services provided."
For herself, Teed McKay says she knows her team and what matters to them better now. She knows their personal career goals and can coach them towards those goals accordingly. She's been able to devote more time to assisting them, and they are coming to her more and more with their concerns and questions.
"I have more time to focus strategically on a vision to lead my team towards, and to address my team's improvement ideas, aligning them with the Region's strategic direction," she says.
Ultimately, what has resulted has been a more positive work environment.
Things have also changed dramatically for the new cellular team members who have been pulled in to support managers. They feel far more linked to the units they support, frontline staff, and patients and families just by simple physical proximity.
"Before, we weren't directly involved with the units or the managers we worked with," says Jolene Froese, a coordinator with staff scheduling. "We had no understanding of the impact scheduling had on patient care, and it was hard to connect with the manager group. Often, we had to wait a couple of days for an answer from them or to get help solving a problem with getting shifts filled, which led to shifts being filled at the last minute and often involved overtime. There was just a feeling of distance between ourselves and the units we scheduled for."
Now, more direct access to managers and units has allowed for scheduling to have a complete picture of what they need to do for every unit they work with.
"It's really allowed us to become part of that team. We know what we need to do, because we know the impact our scheduling has on the unit. With a complete picture, we are more able to bring solutions and advice to managers about staffing that helps take pressure off them," says Froese.
The better stream of communication is allowing for more pro-active work when it comes to filling positions, which means less last-minute filling of shifts and decreased overtime.
Being closer to where the work is done has also helped the quality improvement specialists who have been pulled into the cell structure. Instead of doing mostly short improvement events with a large number of managers, they focus their work on helping specific units and managers.
"Being on the units makes us more accessible to managers and staff, which means we can build relationships and problem-solve in the moment," said Amanda Ror, Quality Improvement Specialist. "And there are more opportunities to informally learn about the day-to-day operations of areas, and what staff and patients are experiencing."
For Ror, the increased continuity in her work because of the cell structure means she can see the entire patient flow process through her units, allowing her to identify more readily areas where improvements can be made, and help staff understand how processes upstream and downstream from their unit may impact other areas and ultimately, the patient's journey.
The improved connection among the team has led to an increased sense of responsibility for some members.
"Now that I'm working in the hospital, I hear the overhead pages for Code Blues and other situations where someone's life is being impacted, and I feel connected," says Jolene Koenders, one of the human resources business partners now providing on-site support. "I realize that if I don't fill a position on a unit, that patient may not have anyone to care for them. It adds real weight to what I do every day."
Having the business partners filling postings is far more efficient than heaping that onto a manager's plate.
"It's about the right person doing the right job," she says.
As a human resources professional, she knows the ins and outs of job postings as that is her business; she has the necessary expertise. Taking those skills to the unit itself has helped professionals like herself become part of a strong team.
"Before, when we were part of a centralized human resources department, as human resources consultants, we had little to no relationship with scheduling," she explains. "They were just an email address. And we didn't know the staff on the units unless we were dealing with them as part of a return-to-work situation. We also had little to no understanding of the needs of different departments."
Now, they are that much more informed.
"We connect the dots and purposefully build partnerships and networks that are creating results. I know who the staff are – I've seen them through hiring onto the unit, answered their questions about benefits while on leave or returning to work after leave."
Instead of sending email or calling and waiting for a response from managers or staff scheduling, human resources business partners now have instant and timely communication with everyone on their unit, as they're in the same place.
As a result, they are even more invested in their work.
"Seeing the patients and families every day by working on site connects us to the work," Koenders said. "It shows how important everyone's role on the team is to the patient's care experience."
The unit staff are also seeing the difference these new team members are making. Shifts and new positions are being filled more consistently, and staff feel more supported.
But not all of the Region's human resources consultants have been placed on units as part of cell teams. A strong core needs to remain centralized in order to handle some of the more complex situations that arise, and to ensure a consistent approach to different situations is being applied across the Region.
"Our specialty team helps support our colleagues on the units, who are able to draw upon our expertise," explains Louise Sarauer, an accommodation consultant with human resources.
For instance, human resources business partners handle the straightforward return-to-work files, and their position on the unit means they know the work that happens and can respond more quickly to possibly tweak job duties to ensure safer, more meaningful work. Meanwhile, the specialist teams have more time to dedicate to the complex files.
"We have more capacity now to meet more employees face-to-face, which saves time in the end," says Koenders. "It helps us build a connection with employees during very challenging times."
Allison Laughren, a member of the Workforce Planning & Employment Specialty Team, says the cell structure has allowed her team to become more proactive and strategic.
"Prior to the cellular model, we were often reacting to situations. Since the cell model has been implemented, we have developed close working relationships with our HR business partners, and are able to better predict our recruitment needs," she says.
The business partners, with their connection to the units, know which open positions will be difficult to recruit for, and are great at connecting with the specialty team so that sourcing of applicants can take place prior to the closing of the posting. Meanwhile, the work on the units means the centralized team can focus on Regional projects such as recruitment, organizational change, layoffs and mergers of units.
Sharing their experiences within the Region and with provincial leaders has been gratifying for team members.
"I certainly was honoured to represent our business partner team and present in front of a very influential group of leaders in terms of what our provincial amalgamation will look like. I feel very privileged to have had the opportunity to speak of this work and share my experiences," says Koenders.
Creation of the cell structure has been the Region's first step to increasing capacity for point of care teams to continuously improve processes and the care experience. Step two, a leadership and quality improvement training and development program, is providing needed knowledge and skills. Application of this training, within the cellular structure, forms the basis of the Region's Patient First Management System which results in better teams, better care and better value.