Manpreet Singh Dhalla

Sunday, 7 p.m. Lindsey, a home care scheduler, has been on-call all weekend. With only a few shifts remaining for the day, she decides it’s safe to take her 10-year-old, Ava, to the movies. Ava has been begging to see the new Pixar film. As the previews roll, Lindsey’s phone rings. She steps out to the hallway to discover that one of her caregivers can’t make her night shift. 

The shift starts in two hours. Now sitting on a bench beside the popcorn vendor, Lindsey racks her brain. Who will take this shift? How long will this take? Should she go pull Ava out of the theater? Her daughter will be crushed. Lindsey starts calling and texting multiple caregivers, hoping this process will be quick so she can rejoin Ava and watch the movie …

Unfortunately, as any home care operator knows, this situation is far too common. I ran and operated a home care agency for over five years. I would help serve as the scheduler on-call and experienced the stress that goes into after-hours and weekend scheduling. Home care operators, especially schedulers are often overworked, underpaid, and underappreciated — yet business continues as usual. Meanwhile, industrywide labor shortages are compounding this issue, limiting the pool of aides as well as the pool of schedulers. 

It’s time, once and for all, to put an end to Lindsey’s predicament.

Overdependence on any scheduler is unfair and frankly unsustainable. It’s also an inefficient way to manage an agency’s workforce. 

This way of working is taking a toll. High levels of burnout among schedulers and office staff, resulting in a significant turnover rate, have sadly become the norm — currently averaging 25% industry wide. Lower-performing home care agencies note that turnover rates among their office staff are as high as 95%.

Turnover magnifies scheduling issues. When an experienced scheduler departs, agencies lose their ”matching magic” — all the institutional knowledge inside the scheduler’s head. Recouping this level of situation-specific proficiency can take considerable time for newly hired schedulers to acquire. As a result, the agency experiences operational stress leading to mismatches between caregivers and patients, unfilled shifts, suboptimal quality of care, dissatisfied clientele and additional turnover.

While scheduling and operational turnover don’t grab providers’ attention the way caregiver turnover does, the two problems are strongly correlated — and likely causally linked. According to the Home Care Pulse Benchmarking Study, for every scheduler who leaves a home care agency, five caregivers also leave. Simply put, home care agencies that maintain office staff longer will retain caregivers longer as well. The role of a caregiver is physically and emotionally demanding, so when the same caregivers get frequent calls to fill a last-minute shift or they are scheduled for a shift they are not best suited for, it leads to frustration and, ultimately, turnover. 

High turnover rates amongst schedulers and a caregiver turnover rate of 65% are causing home care agencies to operate in survival mode. 

With home care agencies at a crossroads, it’s time for operators to focus on what they can control and, specifically, how they manage their workforce and scheduling.

Fortunately there are several steps home care agencies can take today to improve working dynamics. Some examples include:

  • Understanding your scheduling process:  Take time to map out the scheduling process for your most stressful scenarios (new clients starting within 48 hours, immediate new shift requests from existing clients, call-outs, and no-call no shows).  Assess who is doing what at each step and where there might be opportunities for streamlining, better coordination, or leveraging technology.
  • Innovating on staffing mix strategies:  Most caregivers are employed or contracted as hourly workers.  Consider creating a limited full-time, flexible pool of caregivers that are readily available to meet last minute scheduling needs.
  • Championing schedulers: Just as there is a push to acknowledge and appreciate caregivers, we also need to champion the schedulers who work everyday magic to ensure shifts are filled and patients get the care they need. Foster an environment where open communication is prevalent and the work-life balance needs of schedulers are taken into consideration.  This approach will help ease the minds of schedulers and decrease burnout. 
  • Investing in schedulers: Let’s pay schedulers what they deserve. Often, we’re short-sighted in controlling costs, but the cost to hire and train a new scheduler far exceeds paying and retaining your current amazing group of schedulers. It can cost about $14,000 to hire someone new plus the soft causes of losing key employees and the impact on agency morale and culture.
  • Enabling schedulers:  Scheduling of difficult shifts is often very manual.  There needs to be better technology offered to schedulers to help support and enable them to manage care more effectively. Most existing scheduling platforms need to be updated or complemented with how they fill last-minute shifts. They often rely on blast messaging or first-come, first-serve systems and rarely utilize automated or AI enabled matching technology.

Every day, I see the impact that investing in and improving scheduling systems can have for forward thinking operators. These changes mean significant time savings for schedulers, better work-life balance  and the ability to focus on higher value activities … rather than constantly fighting scheduling fires. They mean 1.5-2x improvement in employee retention — and they also mean improved patient satisfaction by fulfilling more shifts consistently with the best suited caregivers.

The critical takeaway for home care agencies: Your workforce is your most valuable resource and should be treated as such. This means investing in better staffing operations, better scheduler support and often better supporting technologies. These changes reduce the mental load placed on schedulers, thus decreasing turnover rates. 

The silver lining is this: Taking the stress out of scheduling is possible. Now is the time for providers to see these changes as the critical strategic priorities that they are.

Manpreet Singh Dhalla is founding partner at Reverence Care.