Optimizing Healthcare Supply Operations: A Creative Staffing Model for Efficiency and Reliability

Let’s be clear: staffing an effective supply chain operations team for a large healthcare medical center—ensuring quality 24/7/365—is no easy task. The work is physically demanding, fast-paced, and can directly impact patient care at critical moments. The best teams need to be in place at all times—who would accept a compromise on that?

Take a look at that large medical center and consider who might be working the Saturday evening shift, when only the sickest patients are admitted. Could it be a part-time worker? Someone who has already worked a full week and is now putting in extra hours at a second or third job? Does that person know the operations and can they effectively support the hospital when few leaders are around? Perhaps rotating staff members cycle through that weekend shift, and your current operations technician has drawn the short straw.

As a Supply Chain Executive, it might be time to reconsider antiquated staffing models and consider a more creative approach.  What if a creative shift model, and associated concepts, can help improve staff satisfaction and retention while building the most effective and resilient team possible to support hospital patient care? We are going to take a look at a 4+4+5 staffing model to see if it can solve some long standing problems.

A 4+4+5 staffing model utilizes three distinct teams. Two teams each work four consecutive days followed by three days off. The third team works a standard Monday through Friday schedule with weekends off. By staggering the shifts of the 4-day teams to cover Sunday through Wednesday and Wednesday through Saturday, this model ensures continuous coverage throughout the entire week—including weekends—while the 5-day team provides a stable anchor during standard business hours to support key operations and administrative tasks. These cycles are especially effective for large medical centers that require consistent support in high-acuity areas like the ED and ICUs, while also accommodating departments that do not operate on weekends, such as perioperative services, outpatient clinics, and receiving operations.

What? Skeptical? Two four day cycles? Why would a Supply Chain Executive consider such a thing? Given the 4+4 cycle, doesn’t that create a Wednesday with excess staffing? It sure does, and this is one of the factors that creates unique value for the institution. Let’s explore the positives.

By working four ten-hour days, you create two teams of workers that mirror each other. You have a strong team working each weekday, and this team carries that strong cohesion into the weekend, supporting critical areas like ICUs with the best possible coverage. Working a fixed weekend day is offset by the fact that team members receive three days off—a significant satisfier for the staff. Instead of flex team of workers covering Saturdays and Sundays, you have continuity going into Saturday and the fresh early week team starting on Sundays.  Issues reported on a Sunday can be communicated and tackled Mondays with clear continuous ownership.  This model works well for Health Systems running with or without a centralized service center as the approach focuses on establishing the best possible support for weekends regardless of the site of operation.

A ten-hour day allows for 24-hour shift coverage with just two shifts and minor flexing. By having a few key individuals start one hour early and others working just one hour later on each shift, you can provide continuous 24-hour coverage without running a third shift. This is beneficial for labor planning and communication.

In traditional models, comparing supply chain staff performance can be difficult, as the work in an ICU differs significantly from the demands of a busy Emergency Department. Performance metrics can become highly subjective. With the 4+4 model, a clear comparison can be made between Team Member A (Sunday–Wednesday) and Team Member B (Wednesday–Saturday) working the same assignment, highlighting best practices and encouraging strong performance across both teams.

This concept can be further developed into competitive teams, supporting the gamification of shifts on opposing weekly cycles. Enhancing this competition with performance recognition, employee-of-the-month awards, and incentives can improve performance while fostering a positive, hard working culture.

A dual-staff day can be a valuable asset for a busy medical center, ensuring seamless daily operations while providing support for special projects, onboarding, education, or process improvements. Clinical teams frequently require additional staff for efforts such as reorganizing PAR locations, rolling out new units, or conducting cycle counting and physical inventory tasks.

With a well-planned project calendar, the Materials Management team can be transformed into a proactive helpful force, deploying resources to assist nursing and surgical teams and increasing the value perception of Supply Chain Management. A Wednesday dual-staff day also provides a prime opportunity for education, training, process improvement initiatives, and onboarding of new staff. Additionally, this day allows leaders to better coordinate PTO scheduling and flex staffing without compromising high performance.

Like any staffing model, the 4+4 structure has its challenges. Any sports fan or parent knows that working a fixed Saturday or Sunday shift can interfere with youth sports leagues or favorite college and professional games. Conflicts with family or weekend social events can also be challenging. However, knowing one's schedule in advance allows for better planning, and the three days off more than compensate for these drawbacks, as confirmed by staff feedback from those participating in such a model.

Ten-hour shifts can be physically and mentally demanding, requiring focused shift supervision. Poorly planned project Wednesdays could lead to underutilized resources, creating potential financial drawbacks. Careful strategic planning and execution can mitigate these risks, ensuring smooth operations and optimized staffing.

Finally, five-day-a-week shifts that focus on weekday-only functions can be structured with a slightly different compensation model, helping to balance any perceived advantages or inequities based on staff preferences.

The 4+4+5 model has been proven effective in a world-class, large academic medical center. This particular institution struggled to retain talent on weekends, and operational deficiencies were impacting patient care. Part-time staff and rotational workers resulted in poor team cohesion, fostering finger-pointing and blame as weekend issues carried over into weekdays.

Canon Business Process Services was instrumental in the implementation of a 4+4+5 staffing model which helped to place strong teams on the weekends and provide much needed project resources for accelerated changes in supply management. The new model improved teamwork, education, and communication by moving from a 3 shift model per day to a 2 shift model.  Furthermore, the dual-shift model greatly reduced operational risks by cross-training two staff members per role, eliminating the historical reliance on a single individual for critical assignments.

This is just one example of a creative staffing solution that can support your journey toward operational excellence in a large medical center. Canon Business Process Services can be a strong partner in helping your organization adopt this model and implement other impactful operational concepts — such as proactive recruiting pipelines to build and sustain high-performing teams.