1. family and parenting
2. motherhood
3. artificial insemination

How to define the required number of
staff for the ART program?
Amparo Ruiz, MD.
Amparo.ruiz@ivi.es
www.ivi.es
PÁG.1
Task Force Management of Fertility Units
Symposium HHRR
Contents
• The need of staff definition
• Factors affecting the staff size
• Staff definition according to the company
strategy
• Practical examples
• Take home messages
PÁG.2
The need of staff definition
Right-size your staffing!
- Understaffing can cause patient
dissatisfaction, frustration, burnout and a staff
exodus.
- Overstaffing can cause lower productivity,
reduction in profit and never really getting to
the root of why some problems exist.
PÁG.3
The need of staff definition
• The staff issues are always the most timeconsuming for managers.
• Personnel costs are usually the largest of the
entire budget.
• The size of staff affects the quality of work,
perception of patients, working atmosphere,
economic benefits.
• When employees ask for more personal, it
is difficult to know when it is really necessary.
How to calculate how much staff is needed?
PÁG.4
The need of staff definition
Some formulas has been suggested…
X
PÁG.5
=
The need of staff definition
3 embryologists + 5 technicians / 1000 oocyte retrieval.
13 (10) embryologists / 1000 oocyte retrieval.
5 embryologists + 6 technicians / 1000 oocyte retrieval.
PÁG.6
The need of staff definition
ASEBIR (Spanish Society for Reproductive Biology) suggests, for IVF
Lab:
1 embryologist / 150 IVF/ICSI
cycles
/ year
But… What kind of cycles?
And… this not apply for other departments of a Fertility Unit
Other formulas are commonly used in health care staff calculation:
FTEs (full-time equivalents). FTE=1.0 is an employee working a 40hour week, or a provider working the number of hours considered fulltime for providers.
This may work well for employees, but it doesn’t always follow for
providers nor for IVF laboratory staff.
PÁG.7
The need of staff definition
There is no single magic formula…
Because the staff size depends on many factors.
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Factors affecting the staff definition
•
•
•
•
•
•
Complexity of the treatments offered
Complexity of each treatment: way to work
Patient attention timetable: possible shift work
Activities apart of pure healthcare
Full clinic vs Hospital unit
Strategy of the unit: “Philosophy”
–
–
–
–
–
Focused on costs
Focused on exclusive care
Focused on effectiveness
Focused on clinical outcome
…
PÁG.9
Taking into account all these factors…
Although there is no single magic formula…
There is a calculation way
… and it’s easy
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Staff definition according to the way to work
and strategy
…In 5 steps
→
PÁG.11
Staff definition according to the company strategy
& practical examples
❶
• List the main activities of a given practice
Eg. Standard IVF cycle in the IVF lab:
- Laboratory basics (oocyte retrieval, washing and score; decumulation;
fresh sperm preparation, fertilization checking; embryo score,
embryo selection…)
- IVF: insemination of oocytes
- ICSI: preparation and microinjection
- Extended culture
- Embryo transfer
- Set up lab
- Freezing embryos
- Use of frozen sperm
-…
PÁG.12
Staff definition according to the company strategy
& practical examples
❷
• Assign the average time for each, based on your own
measurement (n minutes)
Following the example…
- Laboratory basics
- IVF: insemination of oocytes
- ICSI: prep and microinjection
- Extended culture
- Embryo transfer
- Set up lab
- Freezing embryos
- Use of frozen sperm
-…
90 min
20 min
40 min
45 min
30 min
120 min
45 min
30 min
Note: Assigned times are fictitious and not real ones
PÁG.13
Staff definition according to the company strategy
& practical examples
❸
• Mark those activities to be performed in the majority of
cases in your practice
Following the example…
- Laboratory basics
- IVF: insemination of oocytes
- ICSI: prep and microinjection
- Extended culture
- Embryo transfer
- Set up lab
- Freezing embryos
- Use of frozen sperm
-…
90 min
20 min
40 min
45 min
30 min
120 min
45 min
30 min
Note: Assigned procedures are fictitious and not real ones
PÁG.14
Staff definition according to the company strategy
& practical examples
❹
• Calculate the sum of these times (n minutes)
Following the example…
- Laboratory basics
- IVF: insemination of oocytes
- ICSI: prep and microinjection
- Extended culture
- Embryo transfer
- Set up lab
- Freezing embryos
- Use of frozen sperm
-…
90 min
20 min
40 min
45 min
30 min
120 min
45 min
+
30 min
--------------------------------
=
PÁG.15
280 min
Staff definition according to the company strategy
& practical examples
❺
Give a point value to unity of time. Eg:
5 minutes = 1 point
Then
280 minutes = 56 points
One standard IVF procedure = 56 “IVF_lab” points
PÁG.16
Staff definition according to the company strategy
& practical examples
Now you know the real score of an standard
procedure in your unit (Eg:56)
Then define the points per year per employee. Eg: 3500
points per embryologist/year
Then, simple math:
- Look at the total amount of points in your IVF lab per year
(Eg: 17500), divide by the points defined (17500 : 3500)
and… voile! You need 5 embryologists!
- It can be applied for any department/activity in the Unit
(Physicians, nurses, front desk, non-clinical staff…)
PÁG.17
Staff definition according to the company strategy:
Other considerations
• Extra time is needed to do other activities.
• There are lots of downtime between the main activities,
which must be used for these other activities: “Slack time”
(Slack. By Tom DeMarco. Editorial Broadway Books-2001)
• Slack at all levels is necessary to make an organization work
effectively.
“If your company’s goal is to become fast, responsive, and
agile, more efficiency is not the answer_ you need more slack”
(DeMarco T, 2001)
PÁG.18
Staff definition according to the company strategy:
Other considerations
• Since there is not a magic formula, it is also very useful to
compare among different units/clinics with similar strategy
and way to work.
• This is essential and very helpful in fertility units with more
than one clinic (like IVI).
• Then, a staff size average for each activity can be taken as
the right one, and significant deviations must be justified.
PÁG.19
Cycles per employee/year: some examples at IVI
Nurses and Ancillary
Cycles
2007
2008
IVF Embryologists + Technicians
2009
Cycles
2010
160
2008
2009
2010
250
140
200
120
100
150
80
100
60
40
50
20
0
2007
01
02
03
04
05
06
07
08
09
10
11
0
01
02
08
03
11
10
05
04
07
06
09
Clinic
Clinics recently established, may be understaffed 1st year due to a minimum
staff needed for weekends and shift rotation as well as a rapid activity increase,
then overstaffed 2nd year, and must be right-staffed onwards.
PÁG.20
Take home messages
• Staffing your unit is essential for patient
and personnel satisfaction as well as for
productivity and profit.
• Maintaining the right size staff must be a
continuous balancing act.
• Number of staff formula must be defined
according to the corporate strategy.
PÁG.21
This presentation is thanks to excellent teamwork
Very specially:
Luis Saurat
General Manager Equipo IVI
Carlos Blanes
Strategy and IT Director
Llanos Micó
Human Resources Director
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www.ivi.es
Thank you !
PÁG.23
www.ivi.es