When it comes to senior/elderly care facilities, everything can look perfect at first glance AND on paper – stable staffing levels, low turnover, new hires coming in quickly. Just by looking at the numbers, the HR team would feel really good about themselves.
But this doesn’t tell the entire story.
In fact, it doesn’t tell the most important part, which is whether the residents are receiving proper care or not. Good numbers don’t mean that people aren’t waiting 30 minutes for a glass of water, or that everyone’s safe.
| A high number of U.S. nursing homes meet staffing thresholds on paper but still tend to get low care quality ratings because of unmet resident needs and delayed assistance. – Centers for Medicare & Medicaid Services |
Traditional workforce metrics simply aren’t enough here.
Why the Usual HR Metrics Aren’t Enough
For most care facilities, it’s usually headcount, turnover, and how quickly someone new can be hired that’s the focus.
And it’s true that those are good measures for efficiency, but for risk? Not so much.
And there’s plenty of risk in these facilities, which is why there are so many scandalous headlines and tragic stories all over.
A bedsore lawyer in Chicago couldn’t care less that the staff numbers look good on paper when there’s no one to take care of the residents. A judge in Los Angeles won’t drop the charges if they see that new hires are getting hired quickly. Lots of facilities have issues, but they’re especially visible in big cities, where there are more residents.
The problem with these metrics is that they don’t tell a lot. Headcount tells how many people there are; that’s it.
| Because of heavy workloads, long-term care workers tend to experience high burnout rates; burnout is linked to higher error rates and reduced quality of care. – Harvard T.H. Chan School of Public Health |
Turnover shows how many people left, but it doesn’t warn about the staff that’s left, who are exhausted and on the verge of burnout. And as impressive as fast hiring is, it doesn’t mean an employee is ready for work after 2 weeks of orientation. Stable metrics and being safe aren’t the same, and the latter is more important.
What HR Should Be Tracking Instead
Luckily, better metrics do exist. Here’s what they are.
How Heavy Each Shift Is
Facilities should start to measure the actual workload per employee.
Six aides might look fine on paper, but it can also mean that each of them is handling way more work than they should be. That’s not safe for anyone, neither the residents nor the employees. And with burnout being so common among medical staff, this is definitely a metric that deserves more attention.
What’s Getting Skipped or Delayed
Some things never seem to get done, and those tell more than the ones that do.
| Missed or delayed tasks, delayed assistance, medication administration, and similar issues in nursing homes are linked to insufficient staffing. – U.S. Government Accountability Office |
Facilities should be tracking every bathroom trip that doesn’t happen on time, every medication that gets missed, every routine task that’s not ‘urgent enough’ so it gets passed to the next shift, etc. One person skipping one step isn’t an emergency, but if this happens all the time, then it’s a pattern, and it’s only a matter of time before it causes an incident.
Small Warning Signs
Speaking of incidents, most of them don’t come out of nowhere.
They’re the direct result of many seemingly small tasks being skipped over to save time.
| Preventable incidents (e.g., falls, slips, infections, pressure ulcers, etc.) in nursing homes often happen because of cumulative minor lapses in routine care. – Centers for Disease Control and Prevention |
Small issues should be treated as important pieces of information because they could be the difference between catching an accident on time or getting sued.
Levels of Experience on Each Shift
A headcount is a necessary metric, no question about it.
But it doesn’t show whether each shift is covered in terms of skills. What good are 15 employees in the same shift if all of them are newbies who don’t quite know what they’re doing yet?
Facilities need to track the ratio of new to experienced staff on every single shift.
Conclusion
Many people mistake HR for being people who see open slots and then fill them.
But HR’s most important job is to make sure that, once those slots are filled, people who fill them suit them. And this is why, in some settings, like care facilities, teams should start tracking specific metrics.
Otherwise, all anyone has are a bunch of numbers on a dashboard that don’t actually show if the system works or not.
