A 200-bed acute care hospital in California had become overwhelmed by staffing and scheduling issues. 50-70 percent of a manager’s day was consumed by this one challenge alone. The hospital needed to reduce staffing costs, meet California’s mandated nurse staffing ratios, improve relations with labor unions, and streamline all staff deployment functions. It was an especially challenging environment as the nursing union had recently had a work stoppage and there was a significant increase in staff dissatisfaction and high turnover in nursing management.

Managers were spending up to 70% of their time scheduling nurses.


The Optimé technology platform was used by Sr. Management to create highly accurate and executable demand based workforce strategies to begin to tackle the problems of; scheduling to demand; meeting mandated nurse:patient ratios; union rules; and inefficient processes. Traditionally the ‘flaw of averages’ were used to create simple schedules. These did not provide robust and easily executable strategies but rather caused significant misalignment of clinicians – when either too much or too few staff have been scheduled to meet patient demand. The Optime platform, using multi-dimensional mathematical modeling, allowed for strategy scenarios to be created and reviewed by both Sr. Management and unit managers across the entire hospital. Our operations and analytical team supported the execution of the agreed strategies as well as providing Big Data analytics to the client during union contract negotiations, staffing vendor selection and management, and other strategic staffing initiatives. Our team and technology platform became an integral part of the hospital operations on both a strategic level and daily tactical level.

An integrated, systems approach was needed to decrease cost, increase staff contentment and improve coverage.


  • Reduced variable staffing cost by 9%
  • Met state mandated staffing ratios 99% of the time
  • Reduced management time spent on staffing and scheduling by 50%
  • Increased staffing office productivity 70%
  • Improved the efficiency of the staffing process up to 60%

Beyond the numbers, we worked with the client to develop atypical shifts to accommodate hourly variations in the workload and to serve as recruitment and retention incentives. In addition, we developed a recruitment and retention policy with a particular focus on experienced nurses. We also utilized the internal float pool to help the organization meet two critical workforce planning goals:

  • To be the employer of choice by meeting nurses’ employment needs across the span of their careers.
  • To keep pre-retirement nurses in the workforce by offering atypical shifts and schedules.

We’ve reduced variable staffing costs by $1,200,000.