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Introduction

BACKGROUND

This report summarizes the 2-day Workshop on Resourcing, Workforce Modeling, and Staffing, hosted by the Committee on Facilities Staffing Requirements for Veterans Health Administration, held in Washington, D.C., in January 2019. This workshop is one of several data-gathering sessions to support the committee’s iterative study. The ongoing study was requested by the Office of Capital Asset Management and Engineering Support of the Veterans Health Administration (VHA) to identify and discuss the Facilities Management (Engineering) Program resourcing challenges faced by the U.S. Department of Veterans Affairs (VA).

The overarching goal of the study is to help the VHA assess the overall resource needs of its Facilities Management Program and to develop budget and staffing methodologies. Such methodologies can provide better justification for ensuring that local VHA programs are adequately and consistently staffed to accomplish the mission and meet all requirements.

The VHA is America’s largest integrated health care system, providing care at 1,250 facilities, including 172 medical centers and 1,069 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled veterans each year. This portfolio is spread across 18 Veterans Integrated Service Networks and includes 5,639 buildings (2,107 of which are historic), covering more than 150 million total gross square feet and more than 16,000 acres.¹ The VA also manages 1,665 leases that include more than 18 million net usable square feet. In additional to the physical characteristics of VHA facilities—such as size, age, and equipment—medical center variables include program scope, the complexity of health care delivered, magnitude, and performance requirements. On top of these considerations are the management, demographic, and social and political contexts in which the fixed facilities must continue to operate.

The workshop did not focus on the unique situations of the VA; rather, it broadly considered approaches in workforce modeling by examining methodologies and inputs for facilities staffing models. Both health care and non-health-care industries and organizations were discussed. The participants did not need to specifically address unique features of the VA, but instead to provide a survey view of modeling techniques and considerations.

The VHA itself will have to reflect on the material presented and integrate it with organizational knowledge and policies. Unique features of health care providers or the VHA, such as staffed hours, health care services

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¹ Veterans Affairs, “Health,” http://www.va.gov/health, accessed February 2019.

provided, and veterans’ demographics, may be addressed in a VHA-specific staffing model, the development of which is outside the scope of this committee’s task.

The workshop was designed using a set of questions that were developed by the committee workshop planning team: Colin Drury, Alberto Galué, Cheryl Paullin, and Fred Switzer. In order to answer those questions, a panel of experts was convened from various disciplines to inform the committee of the methods most often used in their professions for determining workload and to discuss how those methods might be applied for facilities engineering staffing at VHA medical centers. For the workshop agenda, see Appendix A.

The role of the committee for this data gathering workshop was limited to planning and convening the meeting. The views contained in this document are those of individual participants and do not necessarily represent the views of all participants, the committee, or the National Academies. The rapporteur prepared this document. The workshop was attended by almost 50 people (including committee members and National Academies staff): see Appendix B for a list of in-person attendees; in addition, many other people watched via a live webcast.

WORKSHOP ROLE IN COMMITTEE’S WORK

Committee member Cheryl Paullin opened the workshop by welcoming attendees and introducing committee Co-Chair Colin Drury. Drury summarized some key points from the statement of task for the work of the committee; see Appendix C for the full statement. He noted that the committee’s charge includes the development of a comprehensive resource planning and staffing methodology guidebook for the VHA Facility Management (Engineering) Programs; the identification of key variables that must be factored into the resourcing methodology; recommendations for staffing models; and the steps needed for the VHA to transition from its current staffing methods to the methods that the committee will propose. Drury stressed that the committee’s charge is not to produce a staffing model, but to provide inputs that will assist the VHA in producing its own staffing model.

Drury explained that the objective of this workshop was to gather data to support the committee’s work. He enumerated some areas in which data are needed, including the methods by which the VHA currently performs its operations and maintenance functions; details of the knowledge, skills, and abilities required to perform operations and maintenance; details about the complexity and diversity of VHA facilities; the way facilities staffing is currently performed; how modeling generally works for operations and maintenance functions; and the ways in which the VHA’s situation might change in the future.

Drury described some elements of the VHA’s scope that illustrate the complexity of the committee’s task. As noted, the VHA has 172 medical centers, which are spread across 18 regions in the United States. These sites not only differ in size, but they also range in age from modern buildings to historic, protected structures. The medical functions that are provided also differ among sites: every site has a “complexity index score” reflecting the medical complexity of the types of treatment provided.

At each site there is a chief engineer who, together with staff and contractors, must ensure that the facilities remain operable and meet the requirements of both medical staff and patients. Drury emphasized that the significance of the committee’s task is further highlighted by the general nature of facilities management functions. While some functions, like cleaning and routine maintenance, are predictable in terms of workload, much maintenance is not predictable, so that models are needed that can account for the unpredictable, stochastic nature of many maintenance functions.

Drury next detailed some of the skills and experience of the steering committee members, which include, but are not limited to, management, industrial and organizational psychology, human resources, staff modeling, and human-systems integration: see Appendix D for biographical sketches of all steering committee members and workshop presenters. Drury concluded his remarks by placing this workshop in the context of the work the committee will undertake to fulfill the statement of task, listing the topics for all of the committee’s planned meetings and workshops.

STRUCTURE OF THIS PROCEEDINGS

Following this introduction, Chapter 2 discusses staffing modeling methodologies and work measurement techniques, along with factors influencing the choice of appropriate techniques. Chapter 3 discusses workforce modeling in the federal government, the Federal Aviation Administration, and in health care. Chapter 4 covers options for outsourcing facilities management and tools that can aid in the workforce modeling process. Chapter 5 discusses additional considerations for facilities staffing modeling, including the role of artificial intelligence in modeling and the importance of implementing change management techniques as part of a workforce planning process. Chapter 6 provides a discussion of the major themes of the workshop.

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