Healthcare News & Insights

FTEs in health care: It’s not one-size-fits-all

It’s no secret that healthcare facilities have struggled with finding the right balance of full-time employees (FTEs) on staff, especially now that the current global pandemic has made things even more complicated. Figuring out how to balance, and re-balance, the number of active employees is a tricky situation, especially when emergencies occur. 

How many FTEs can we have without over-crowding the department? Should I add more FTEs in the midst of an emergency? How many contractors are too many to respond on-site? These questions may seem all too common to facility managers evaluating their employee roster day-to-day. While there isn’t a one-size-fits-all formula when it comes to FTEs, there’s a method to the madness.

Calculating FTEs

Put simply, different facilities have different FTE needs, and must be determined on an environment-by-environment basis. For example, a 40-bed boutique hospital built in 2018 will have different FTE needs than an older medical office building (MOB) open five days a week or a multi-building cancer treatment center open 24/7.

The ideal number of FTEs can be calculated by first reviewing a variety of factors about the facility itself, including:

  • age of the facility,
  • number of buildings within the healthcare campus,
  • current and future infrastructure,
  • size of the facility, and
  • type of care provided.

To deliver and maintain the highest quality service, these factors must then be analyzed with the overall square footage of each facility to calculate the ideal number of FTEs. For example, a large hospital system with facilities across the U.S. could see an average of one FTE for every 36,000 square feet of space. Depending on the services provided at a facility, smaller or larger facilities could see more or less FTEs. Regardless, the “sweet spot” can only be determined after conducting these individual assessments from all facilities in a healthcare system.

Impact of COVID-19

As COVID-19 spread during the spring, it became clear rather quickly the global pandemic would impact emergency preparedness plans – and therefore the number of FTEs needed – both across the nation and around the globe.

It’s not just the brave doctors and nurses who are fighting on the frontlines of the virus, it’s also facility managers, emergency management and construction teams, maintenance staff and more. The initial phase of response had to accurately plan for how facilities management teams would work in tandem with clinical departments to execute a hospital’s mission safely for patients and staff, as well as review and conduct preventive maintenance for areas that may be inaccessible later. Performing preventive maintenance in potential-risk areas allowed team members to work ahead of the curve. More full-time facilities personnel on staff could lead to more hospital leaders feeling comfortable opening up to patients.

An emergency such as COVID-19 requires everyone to step up. Just as doctors, nurses and healthcare professions are essential to providing patient care, healthcare facility team members are fundamental to ensuring facilities are safe and functional. In addition to performing typical preventive maintenance solutions, FTEs could also be trained and redeployed on a moment’s notice to help convert rooms into isolated areas, put mechanisms in place to limit potential cross-contamination between rooms, design and place signage across all areas of a hospital, and much more to help fight the virus.

Preparing in advance is not just important for infectious diseases, but for all potential emergencies or natural disasters. Working ahead of the storm, whatever it may be, means employees are able to focus on on-site issues that may arise during a crisis, rather than balancing the existing problems with the new.

Final thoughts

Outsourcing work can cut back on costs initially, but it’s more likely that eliminating FTEs can come at a higher, long-term cost when facilities become overwhelmed with fewer staff and are locked into expensive external service contracts. It’s important to create an optimized workforce that can manage functions internally, efficiently and cost-effectively.

There’s a lot less scrambling and panic when facilities have the appropriate number of people to help execute emergency plans. This provides the flexibility to perform preventive maintenance, meet new challenges and handle new developments as a crisis frequently changes from day to day. As the pandemic continues to develop, facilities must continue to adjust emergency plans and ensure there are an appropriate number of FTEs to keep healthcare environments running smoothly, efficiently and safely.

Author: Michael Burgett, area VP for Medxcel, leans on his 20 years of experience in healthcare construction and design, site selection, facilities management, capital equipment sales, and both operational and customer development to determine the right fit of FTEs in his region. Medxcel provides healthcare service support products and drives in-house capabilities, savings and efficiencies for healthcare organizations that, in turn, improve the overall healing environment for patients and staff.


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