How to define the required number of
staff for the ART program?
Amparo Ruiz, MD.
[email protected]
www.ivi.es
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Task Force Management of Fertility Units
Symposium HHRR
Contents
• The need of staff definition
• Factors affecting the staff size
• Staff definition according to the company
strategy
• Practical examples
• Take home messages
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The need of staff definition
Right-size your staffing!
- Understaffing can cause patient
dissatisfaction, frustration, burnout and a staff
exodus.
- Overstaffing can cause lower productivity,
reduction in profit and never really getting to
the root of why some problems exist.
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The need of staff definition
• The staff issues are always the most timeconsuming for managers.
• Personnel costs are usually the largest of the
entire budget.
• The size of staff affects the quality of work,
perception of patients, working atmosphere,
economic benefits.
• When employees ask for more personal, it
is difficult to know when it is really necessary.
How to calculate how much staff is needed?
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The need of staff definition
Some formulas has been suggested…
X
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=
The need of staff definition
3 embryologists + 5 technicians / 1000 oocyte retrieval.
13 (10) embryologists / 1000 oocyte retrieval.
5 embryologists + 6 technicians / 1000 oocyte retrieval.
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The need of staff definition
ASEBIR (Spanish Society for Reproductive Biology) suggests, for IVF
Lab:
1 embryologist / 150 IVF/ICSI
cycles
/ year
But… What kind of cycles?
And… this not apply for other departments of a Fertility Unit
Other formulas are commonly used in health care staff calculation:
FTEs (full-time equivalents). FTE=1.0 is an employee working a 40hour week, or a provider working the number of hours considered fulltime for providers.
This may work well for employees, but it doesn’t always follow for
providers nor for IVF laboratory staff.
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The need of staff definition
There is no single magic formula…
Because the staff size depends on many factors.
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Factors affecting the staff definition
•
•
•
•
•
•
Complexity of the treatments offered
Complexity of each treatment: way to work
Patient attention timetable: possible shift work
Activities apart of pure healthcare
Full clinic vs Hospital unit
Strategy of the unit: “Philosophy”
–
–
–
–
–
Focused on costs
Focused on exclusive care
Focused on effectiveness
Focused on clinical outcome
…
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Taking into account all these factors…
Although there is no single magic formula…
There is a calculation way
… and it’s easy
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Staff definition according to the way to work
and strategy
…In 5 steps
→
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Staff definition according to the company strategy
& practical examples
❶
• List the main activities of a given practice
Eg. Standard IVF cycle in the IVF lab:
- Laboratory basics (oocyte retrieval, washing and score; decumulation;
fresh sperm preparation, fertilization checking; embryo score,
embryo selection…)
- IVF: insemination of oocytes
- ICSI: preparation and microinjection
- Extended culture
- Embryo transfer
- Set up lab
- Freezing embryos
- Use of frozen sperm
-…
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Staff definition according to the company strategy
& practical examples
❷
• Assign the average time for each, based on your own
measurement (n minutes)
Following the example…
- Laboratory basics
- IVF: insemination of oocytes
- ICSI: prep and microinjection
- Extended culture
- Embryo transfer
- Set up lab
- Freezing embryos
- Use of frozen sperm
-…
90 min
20 min
40 min
45 min
30 min
120 min
45 min
30 min
Note: Assigned times are fictitious and not real ones
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Staff definition according to the company strategy
& practical examples
❸
• Mark those activities to be performed in the majority of
cases in your practice
Following the example…
- Laboratory basics
- IVF: insemination of oocytes
- ICSI: prep and microinjection
- Extended culture
- Embryo transfer
- Set up lab
- Freezing embryos
- Use of frozen sperm
-…
90 min
20 min
40 min
45 min
30 min
120 min
45 min
30 min
Note: Assigned procedures are fictitious and not real ones
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Staff definition according to the company strategy
& practical examples
❹
• Calculate the sum of these times (n minutes)
Following the example…
- Laboratory basics
- IVF: insemination of oocytes
- ICSI: prep and microinjection
- Extended culture
- Embryo transfer
- Set up lab
- Freezing embryos
- Use of frozen sperm
-…
90 min
20 min
40 min
45 min
30 min
120 min
45 min
+
30 min
--------------------------------
=
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280 min
Staff definition according to the company strategy
& practical examples
❺
Give a point value to unity of time. Eg:
5 minutes = 1 point
Then
280 minutes = 56 points
One standard IVF procedure = 56 “IVF_lab” points
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Staff definition according to the company strategy
& practical examples
Now you know the real score of an standard
procedure in your unit (Eg:56)
Then define the points per year per employee. Eg: 3500
points per embryologist/year
Then, simple math:
- Look at the total amount of points in your IVF lab per year
(Eg: 17500), divide by the points defined (17500 : 3500)
and… voile! You need 5 embryologists!
- It can be applied for any department/activity in the Unit
(Physicians, nurses, front desk, non-clinical staff…)
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Staff definition according to the company strategy:
Other considerations
• Extra time is needed to do other activities.
• There are lots of downtime between the main activities,
which must be used for these other activities: “Slack time”
(Slack. By Tom DeMarco. Editorial Broadway Books-2001)
• Slack at all levels is necessary to make an organization work
effectively.
“If your company’s goal is to become fast, responsive, and
agile, more efficiency is not the answer_ you need more slack”
(DeMarco T, 2001)
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Staff definition according to the company strategy:
Other considerations
• Since there is not a magic formula, it is also very useful to
compare among different units/clinics with similar strategy
and way to work.
• This is essential and very helpful in fertility units with more
than one clinic (like IVI).
• Then, a staff size average for each activity can be taken as
the right one, and significant deviations must be justified.
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Cycles per employee/year: some examples at IVI
Nurses and Ancillary
Cycles
2007
2008
IVF Embryologists + Technicians
2009
Cycles
2010
160
2008
2009
2010
250
140
200
120
100
150
80
100
60
40
50
20
0
2007
01
02
03
04
05
06
07
08
09
10
11
0
01
02
08
03
11
10
05
04
07
06
09
Clinic
Clinics recently established, may be understaffed 1st year due to a minimum
staff needed for weekends and shift rotation as well as a rapid activity increase,
then overstaffed 2nd year, and must be right-staffed onwards.
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Take home messages
• Staffing your unit is essential for patient
and personnel satisfaction as well as for
productivity and profit.
• Maintaining the right size staff must be a
continuous balancing act.
• Number of staff formula must be defined
according to the corporate strategy.
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This presentation is thanks to excellent teamwork
Very specially:
Luis Saurat
General Manager Equipo IVI
Carlos Blanes
Strategy and IT Director
Llanos Micó
Human Resources Director
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www.ivi.es
Thank you !
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www.ivi.es