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Location, location, location – 5 Things to Consider When Evaluating At-home vs. On-site Staff

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Elizabeth Delahoussaye, RHIA, CHPS
May 6, 2020

As we start to see states across the U.S. begin to lift COVID-19 shelter-in-place or self-quarantine directives, our focus will naturally shift to so many unknowns. What is our new normal? What will our organizations look like? How will our teams and staff be impacted? Honestly, we cannot even begin to fully appreciate how many unknowns we will be facing in the foreseeable future. What we do know is that recently, you have more than likely sent some, if not all, of your staff to work from home. Now you are faced with a decision – bring staff back into the office settings or permit them to continue to work remotely. Not to state the obvious, but this decision is not simple and requires your organization to take many factors into consideration. As you have probably learned, there are some definite advantages to a home-based staff, but there are potential pitfalls that you should also consider.

Advantages of Home-based Staff

Real estate in healthcare settings is invaluable. Having home-based staff automatically creates available space for revenue-generating opportunities.

The space that was formerly occupied by your team can now be utilized for direct patient care services. We do not often get the opportunity to find space for additional patient care services without the costly and time-consuming process of adding physical real estate space. Repurposing existing real estate can benefit the entire organization. An unexpected bonus may be a positive impact to your operating budget.

Locating and hiring qualified local candidates for open positions is not an easy task.

Often you are limited to candidates within a specific geographical region near your facility. If your workforce is remote, the “Zip Code” limitation disappears. Your candidate pool immediately becomes much broader and with that, you have access to candidates with more experience, qualifications, and knowledge. You may also retain or attract highly qualified candidates that prefer a work from home position.

Challenges Associated with Home-Based Staff

Future training will require some thought and head-scratching.

Without an effective training platform, new staff that are onboarding will not be successful. A major decision point for you will be whether to bring the staff into the office for in-person training or can training be done virtually?

Leadership can make or break operational success. Do you have the right management in place?

The way in which staff are managed requires a completely different approach based on where the staff will be working (remote vs. onsite). The key question you need to answer is: Does your current management team have the right skills to be able to manage home-based staff? Are they able, and willing, to embrace the technology available (e.g., Zoom, Teams, etc.) within your organization to lead staff for successful performance?

Evaluating Operational Effectiveness

Now that you have thought through the positives and negatives of home-based staff, how do you make the decision on the best staffing model going forward? Following is a recommended process for evaluating the decision that focuses on factors that affect operational effectiveness.

  1. Identify the key performance indicators (KPIs) that are critical to your operational success, which should include, but not be limited to:
  2. Productivity
  3. Quality of work
  4. Absenteeism
  5. Establish a “pre-COVID-19” performance baseline by identifying a timeframe that was unaffected by COVID-19 (e.g., January through March) and capturing data for your selected KPIs. This baseline establishes performance in a normal operating environment.
  6. Capture data for the same KPIs for the next three months of the year or the appropriate timeframe when COVID-19 began to impact operations (e.g., April through June). This will establish the “active COVID-19” baseline. Using the same indicators, compare your “active” KPIs to the data collected for the “pre-COVID-19” period. What differences were identified? Do the differences impact the overall effectiveness of your operations? Do you need to make adjustments to minimize the impact?NOTE: When doing the pre-COVID vs active COVID evaluation, be sure to consider the fact that life as we knew it changed dramatically during this time. Due to shelter-in-place rules, schools were closed, spouses were home, and home environments were not as they had been prior to COVID-19. It’s important to measure performance over the full “active” timeframe; while initially performance may have dropped as people got accustomed to the new home-school-work environment, the true measure of effectiveness is evident once the “new” normal becomes just plain normal.
  7. Set a final “post-shelter-in-place” or “post-quarantine” timeframe (e.g., July through September), which will allow you to trend any impact to operations over time. Ask yourself a few questions:
  8. Was there a decrease or increase in productivity, quality of work, and absenteeism?
  9. Do you see any improvement in employee engagement?
  10. Consider the second wave of COVID-19, potentially in the fall or winter of 2020. Given what you have learned through your observations and analysis of performance before, during, and after COVID-19, would it make sense to bring staff back on-site if the possibility exists that you may need to send them home again?

Shifting your workforce from on-site to work-from-home was a necessity, part of your business continuity plan. Once the immediate crisis has passed, many organizations will be faced with a choice – should business continuity measures be transformed into “business as usual” models? Evaluating KPIs and overall performance will help you make that decision and identify the location and staffing model that provides the greatest operational benefits not just during the COVID-19 crisis, but for the new normal that inevitably will follow.

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