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Just-In-Time Production Is Not Good in Hospitals

Ascension Health uses a version of ‘just-in-time’ (JIT) production to their staffing model in hospitals — and it is not good. JIT is used in factories to staff to the minimum, keep no inventory and then use temporary or contingent staff when demand increases.

In contract negotiations at Ascension Providence Rochester Hospital (APRH), a key issue that is emerging is the overuse of contingent and agency staff in order to allow the hospital to staff to the minimum and then flex up with contingent staff when patient census increases and then flex back down to the minimum when the need declines. All in the name of reducing labor costs.

The problem is that JIT both undermines good full-time jobs at the hospital and leaves the hospital ill-prepared when a disaster or public health emergency happens. 

The problem is not unique to APRH, but an Ascension business strategy. According to the New York Times:

“As recently as 2019, Ascension was trumpeting its success at reducing its number of employees per occupied bed…. At one point [Ascension] executives boasted to their peers about how they slashed $500 million from the chain’s labor costs. In the years before the pandemic, they routinely refused requests to hire more … workers or fill open jobs, according to current and former hospital administrators and employees.

Ascensions and its executives have powerful incentives to be as profitable as possible. The more money the chain makes, the more executives get paid.” (New York Times 12/15/2022)

We are the watchdogs to hold Ascension accountable to good full-time jobs with good pay and benefits. We are holding Ascension accountable to provide quality patient care and service. And that’s what we are doing at the bargaining table.

“This JIT business practice isn’t working for our hospital when it comes to safe staffing levels. A strong healthcare system is supposed to be built in a way that allows us to take care of our community whether it be in our worst hour or on our best day. 

Rather than Ascension relying on JIT through overdependence on contingent and call-in workers, we need them to focus on providing livable wages for full and part-time workers. By doing that, we’ll increase staffing levels to the place where we need them to be so we can provide the necessary type of help and service that our community deserves.”

Alison Taplin – Union Steward ARPH