Background of the problem: Floating may affect employee satisfaction and engagement negatively, yet floating is often essential to maintain department operations. Three very different units: family practice (FP), pediatrics and adult subspecialties, general pediatrics, obstetrics/gynecology (OB/GYN) and internal medicine (IM) faced the challenge of medical assistants (MA) voicing resistance to floating.

Literature review: Staffing needs may vary day to day, necessitating the need to float staff between 3 units to meet patient and organizational needs.1 The major criticism of floating is that each unit is a specialty requiring a different set of skills.2 If floating is viewed negatively by staff, then it can cause anxiety and this may impact safety and efficiency.1 Finding ways to make floating less anxiety producing may positively impact staff satisfaction and engagement; which in turn may enhance safety and efficiency of float staff.

Objectives/purpose: To initiate and implement a program to facilitate a positive floating experience for MAs by altering both our hiring and our orientation practices.

Methods
• Change hiring practices: finding the right “fit” for a position that will require floating as a major part of the job
• Orientation to all departments: that includes shadowing a resource person
• Assignments: adjusted considering MAs background, skill set, and feedback

Outcomes
• Productivity metrics prior to program averaged 107.5% for the timeshare and 94.3% for CFM.
• Productivity metrics during implementation averaged 101.6% for the timeshare and 96.4% for family medicine.
• Prior to implementation, the number of floating instances averaged 2.16.
• Post-implementation, the number of floating instances increased to 16 at the highest point.
• MAs were satisfied with the program and actually began to enjoy floating.

Conclusion/recommendation: Our floating model has not been met with resistance, and it has been a cost-effective way to assure all areas are adequately staffed. Most important change was assuring the person hired was a good “fit.” Culture will change over time as program is continued. We would recommend that floating only be required of the new MAs and that MAs hired prior to this program be offered, but not required to participate, instead utilizing them as the resource person or mentor.

Nancy Richards MSN, BSN, RN-BC

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