CrestView Health Network Success Story

CrestView Health Network operates 3 community hospitals (ranging from 120 to 340 beds) and 8 outpatient clinics across the greater Portland, Oregon metro area. The network employs 1,200 staff including registered nurses, LPNs, medical technologists, respiratory therapists, radiology techs, and support staff. Managing 24/7 shift coverage across this network was the single most time-consuming operational challenge, and it was failing.

Scheduling conflicts were endemic. The network's legacy scheduling system — a combination of Kronos for timekeeping and shared Excel spreadsheets for schedule creation — could not prevent double-bookings, under-staffing, or labor-law violations at the point of schedule creation. Charge nurses and department managers created schedules manually, often unaware of commitments that staff had at other CrestView facilities. The result was an average of 52 scheduling conflicts per month requiring last-minute resolution, typically through expensive agency staffing or mandatory overtime.

The labor-law compliance problem was the most alarming issue. Oregon's healthcare worker scheduling law requires minimum rest periods between shifts and limits mandatory overtime. CrestView had accumulated two state labor board investigations in 18 months after whistleblower complaints about nurses working consecutive 12-hour shifts with inadequate rest between them. The existing attendance management system had no mechanism to check compliance at the point of schedule creation — violations were only discovered after the fact, when they appeared on timesheets during payroll processing.

Overtime costs had spiraled to $3.1M annually — nearly double the budgeted amount. The primary driver was the text-message-based shift swap system: when a nurse called in sick, the charge nurse would send a group text to available staff offering the shift. There was no central tracking of who had already worked overtime that week, who was approaching the rest-period threshold, or which unit was most critically understaffed. The result was a reactive, chaotic process that systematically chose the most expensive solution (overtime or agency staff) because it lacked the data to identify less costly alternatives.