“Promoting a High-Quality and Efficient Health System Through Improved Staffing Practices”
Los Angeles County Department of Health Services
Los Angeles, CA
The Los Angeles County Department of Health Services (DHS) is the second largest municipal healthcare system in the nation. It has an annual operating budget of over $4 billion and 670,000 unique patients a year, most of whom are low income. As a result, any changes to the County’s healthcare system can have a profound effect on the health and well-being of millions of people.
DHS is constantly seeking opportunities to improve the quality and efficiency of its patient services. For example, in 2015 it rolled out an electronic health records system, ORCHID, that covers its entire network of 4 hospitals and 21 health centers. Thanks to ORCHID, all DHS facilities operate on an integrated patient information system which improves access, enhances quality, facilitates care coordination and reduces variability across the facilities. In addition, patients can now access their health information online and are reporting improved follow up and communication across clinics, specialties and hospital networks.
At any given time, there are about 22,000 full-time staff and 8,000 contractors employed by DHS to meet the demands of its health system. The high proportion of contract staff is due to a number of factors, including need for coverage during employee leaves, regular turnover, recruitment challenges in certain fields and workload fluctuations. The department recognizes that there are challenges in employing so many contractors, including cost and quality of care implications, and it is seeking its first thorough analysis of the use and cost of its contract staff, using data culled from the ORCHID system, in addition to other sources of data that remain spread across different parts of the department, including human resources and its two dozen health facilities.
To advance these efforts, Los Angeles County DHS is partnering with FUSE Corps to host an executive-level Fellow for one year to create a methodology and an accompanying data dashboard providing real-time analysis of the use and cost of contract staff compared to full-time County employees. These efforts will allow DHS to identify the actual costs and benefits of using contract staff, realize much needed cost savings, and put in place a system-wide, sustainable, and evidence-based approach to managing labor use. This, in turn, will ensure DHS has the staff and resources it needs to provide superior health services to its clients, and to weather the uncertain future of national healthcare financing.
The following provides a general overview of the proposed fellowship project. This project summary and the potential deliverables that follow will be collaboratively revisited by the host agency, the Fellow, and FUSE staff during the first month of the project, after which a revised scope of work will be developed and agreed upon by the Fellow and the host agency.
Starting in October 2017, it is proposed the fellow will begin by meeting with all relevant stakeholders throughout the department and its facilities to gain a thorough understanding of DHS, its operations and labor use, and available pools of data. In particular, the fellow will work closely with human resources and the department’s finance and risk management teams, which manages issues including workers’ compensation and return-to-work. The fellow will then research industry standards and best practices on managing contract labor at comparable health and public service-oriented agencies in other large cities with a special focus on areas where DHS has a significant number of employees on long-term leave or with work restrictions.
The fellow will then create a methodology—and potentially lay the groundwork for a data dashboard—that allows DHS to regularly monitor the cost and benefits of using contract staff compared to County employees as well as the need for contract staff due to peak workloads, recruitment challenges, routine backfill and long-term leaves. The fellow will also assess the various compensation and classification barriers to insourcing some of the contracted positions as an alternative to using contract staff. The fellow may present a report on current findings and the proposed methodology to the Los Angeles County Board of Supervisors and to relevant labor unions.
- Provide a Current State Analysis of DHS contractor labor data availability and usage, employee backfill needs, compensation & classification barriers and identify healthcare industry utilization best practices – Understand all aspects of LA County Department of Health Services’ use of contract labor. Work alongside human resources and risk management departments who oversee recruitment, leaves, reasonable accommodation and workers’ compensation, as well as the central finance department which can provide existing data on the contract registry. Understand and evaluate the various data systems that DHS and its facilities use to manage contract labor decisions. Research the industry standard for leave rates and workers’ compensation in different clinical modalities. Evaluate the best practices in other departments, cities and private-sector companies nationwide for ways to innovate within the department.
- Create a methodology for new approaches to data use and analysis – Provide recommendations on information technology systems implementation. Determine if DHS needs a new contract labor management system or if a relational dashboard visualizing data from many systems will meet the needs of management. Research new ways to use data more efficiently and effectively in management decision-making to improve resource and staff utilization across the department. Develop new policy recommendations about how to use data to inform decisions about use of contract labor going forward.
- Develop a contractor labor data system and processes - Help improve the capacity of staff members to utilize and analyze data. Create systems and processes within the department that highlight key information to help staff make decisions that are better for the system as a whole. Work to create a department that is built around the needs of clients as opposed to the operation of programs or operation of existing systems. Encourage more open data and data sharing across departments and healthcare facilities.
- Implement new data tools and highlight impact for culture shift – Begin implementation of new data driven decision making tools and demonstrate the financial and service delivery impact of new contract staff utilization. Demonstrate the degree of improved service to the community with managers able to make more cost-informed decisions about labor utilization. Create and implement a plan to disseminate the results of these early wins and show the benefits of data collection and analysis in order to achieve a major change in culture within the organization.
- Elizabeth Jacobi, Director of Human Resources, Department of Health Services
- Edgar Soto, Director of Risk Management, Department of Health Services
- Allan Wecker, Chief Financial Officer, Department of Health Services
- At least 15 years of professional experience in management consulting, systems synthesis and analysis, process improvement, organizational design and systems management.
- Superior critical thinking and analytical skills. Ability to get up to speed quickly about the integration and application of multiple technologies to improve the lives of citizens across diverse populations.
- Ability to synthesize complex information into clear and concise summaries and recommendations.
- Ability to identify best practices, understand data and evidence and use it to support a business case, and make a persuasive argument to support recommendations.
- Strong record of success engaging a variety of cross-sector stakeholders and managing cross- functional teams. Ability to relate to a variety of diverse audiences and varying interests with strong emotional intelligence and empathy. Able to connect and collaborate across a variety of disciplines.
- Exceptional written and verbal communication skills with ease in public presentations.
- Self-motivated, goal-oriented, entrepreneurial leader who is an independent worker, resourceful in creating novel solutions to complex problems, persistent in obtaining information, and able to create direction and movement within potentially ambiguous environments.
- Flexibility, adaptability, persistence, humility, inclusivity, and sensitivity to cultural differences.
- Support and understanding the strength of diversity, and the need for solutions to support all regardless of race, religion, gender, immigration status, or ethnicity.
Click the link below to upload a resume and complete the online application questions in lieu of a cover letter. The application process will allow you to indicate interest in more than one fellowship opportunity. You only need to submit one application. Interested candidates are encouraged to apply as soon as possible, as selections will be made on a rolling basis and specific opportunities may close quickly.
This role offers the opportunity to work full time for 12 months as an independent contractor of FUSE Corps with an annual stipend of $90,000 paid through monthly installments.
The FUSE Fellowship is an equal opportunity program with a core value of incorporating diverse perspectives. We strongly encourage candidates from all backgrounds to apply.