Surviving and Succeeding Through Staffing Shortages

The coronavirus pandemic has helped drive staffing shortages in the healthcare sector. Experts offer advice on how to continue thriving in this type of environment.

COVID-19 has turned the healthcare system upside down, becoming the root cause of prolific staffing shortages.

An influx of patients suffering from coronavirus-related complications. Increased staff exposure—and, subsequently, increased illness among healthcare providers. And this is all in addition to the usual number of patients requiring care at the average facility.  

Meeting these demands has been a challenge for facilities everywhere. Consider a recent survey of 323 hospitals, conducted earlier this year by the U.S. Department of Health and Human Services Office of the Inspector General. 

In this study, the HHS found hospitals reporting “a shortage of specialized providers needed to meet the anticipated patient surge and raised concerns that staff exposure to the virus may exacerbate staffing shortages and overwork,” according to the organization’s report. “Hospital administrators also expressed concern that fear and uncertainty were taking an emotional toll on staff, both professionally and personally.” 

This HHS survey was conducted in late March, just weeks after the coronavirus pandemic first hit U.S. shores. Here we are, nearly seven months later, and healthcare systems still find themselves grappling with staffing issues. We asked experts to offer some tips on how your facility can not just survive, but thrive in the midst of a staffing shortage. 

What’s driving demand

Nine months since COVID-19 first hit U.S. soil in large numbers, hospitals and healthcare systems continue to be overrun, with healthcare professionals in high demand. 

The pandemic is obviously helping to drive this demand, but it’s not the only contributing factor. 

“Right now, we’re seeing a renewed focus on health. The pandemic has heightened the awareness of the importance of preventative care and focusing on health in general, driving an increase in demand for services,” says Antonia Hock, the global head of the Ritz-Carlton Leadership Center, a consultancy designed to help organizations enhance their customer and employee experience. 

“When you add that to the pressures of the COVID-19 environment, it’s leading to an increase in volume across all facets of healthcare,” continues Hock. “We are also seeing an increase in older patients who require more services, and as more and more of them enter the system, [pressure will] increase.”

And, as Hock points out, more than one million nurses are projected to retire by the year 2030.  

“And we aren’t replacing them at the pace required to meet the need,” she says. “Focus on nursing as a career, more nursing faculty in teaching positions and emphasizing a career in nursing at the high school level can help to increase nurses entering the profession.” 

Kelly Rakowski, group president and chief operating officer, strategic talent solutions at San Diego-based healthcare staffing agency AMN Healthcare, describes COVID-19’s effect on healthcare staffing demand as “mixed.”

“The pandemic created a high need for certain health professionals, particularly ICU and emergency room nurses, which spiked in COVID-19 hot spot areas,” says Rakowski. “It has also contributed to burnout among some healthcare professionals, causing them to leave the field, [which contributes] to worker shortages.” 

At the same time, however, the pandemic has suppressed demand for other types of healthcare professionals, such as physicians, because elective procedures were shut down for safety reasons, and to allow hospitals to create more capacity to treat COVID-19 patients, says Rakowski. 

The economic fallout associated with the pandemic has also inhibited the use of healthcare services and, thus, the need for healthcare professionals, she adds. 

“Tens of millions of people have filed for unemployment, and millions have lost their employer-based health insurance. This is leading to people delaying care until the economic situation becomes more stable, often to avoid high deductibles and co-pays.” 

As the economy recovers, says Rakowski, “we expect demand for healthcare professionals to rebound, and for the old status quo—in which healthcare professional shortages were widespread—to resume.”

Addressing the issue

Rakowski sees “two basic ways” for healthcare systems to address such staffing shortages, and offers advice on how to attract top talent to your facility, and what to do to keep them there. 

“One is to invest more time, resources and creativity into sourcing and recruiting healthcare professionals,” she says. “This includes broadening how you reach them, utilizing online job sites, social media, your own website, traditional direct mail and personal direct outreach by telephone. It may also include establishing relationships with training programs to secure new graduates. All aspects of these recruiting efforts should be regularly assessed, measured and adjusted to ensure effectiveness.”

The second approach, says Rakowski, is to create the kind of practice environment and culture that is attractive to healthcare providers. 

“Part of this, but only part of it, is offering a competitive incentive package. More important is establishing an environment that fosters teamwork, rewards results and allows healthcare professionals to do what they were trained to do—take care of patients.”

A positive work environment acts as a magnet, drawing candidates to your facility, continues Rakowski. 

“You just have to show that the grass really is greener on your side of the fence.” 

Organizations can also supplement full-time staff with contingent healthcare workers, she says. 

“Thousands of temporary nurses and other specialists have been working side-by-side with hospital staffs to meet current needs. They take on many forms—travel nurses, locum tenens physicians, local per diem staff and sometimes international professionals. These are vital and oft-used resources to help meet peak demand and critical needs.”

Hospitals have long neglected many of the perks and innovations of the commercial sector, adds Hock, particularly those in competitive markets such as technology. She urges hospital systems to focus on employee engagement as a core feature of the operation, especially team dynamics, gratitude systems, empowerment and employee care programs to address burnout. 

“In addition, hospitals can focus on marketing these programs and features as part of their recruiting plans, and be proactive with other features of their performance—like HCAP scores and positive outcomes,” says Hock. “High achievers always want to be at institutions where the quality of care and employee engagement as a priority are already high.” 

Ultimately, the same things that attract candidates — competitive compensation, a positive work environment — are the same things that will help keep them, says Rakowski. 

“To this should be added continual communication,” she says. “Don’t guess what your health professionals think about their jobs. Ask them, through both forming staffing surveys and informal conversations. Communication is the key to preventing shortages.” 

Now is also a critical time for hospitals and healthcare systems to fortify their culture in “real and authentic ways that drive a great work environment,” adds Hock. 

“This is a time when systems need to capitalize on these professions as a calling, but also to ensure that the care is 360, i.e., the employee is going to receive the same focus as the patient,” she says. 

“It’s also a time to emphasize the focus on teamwork. The old-fashioned hierarchies need to be de-emphasized, so that younger doctors, nurses and professionals know that their fresh perspectives will be equally valued and heard. Everyone wants to know that they make a difference and are part of building a great system.” 

References

  1. U.S. Department of Health and Human Services, 2020. Accessed Oct. 8, 2020. [https://oig.hhs.gov/oei/reports/oei-06-20-00300.pdf]
  2. American Association of Colleges of Nursing, 2017. Accessed Oct. 5, 2020. [https://www.aacnnursing.org/news-information/fact-sheets/nursing-shortage]
  3. Economic Policy Institute, 2020. Accessed Oct. 6, 2020. [https://www.epi.org/publication/health-insurance-and-the-covid-19-shock/#:~:text=Since%20the%20onset%20of%20the,measure%20of%20net%20employment%20change.]

SIDEBAR

Adopting Strategies to Combat Staffing Shortages

Mitigating the issue of anticipated staffing shortages requires a multi-disciplinary effort, involving organizational leadership, human resources and occupational health services. The Centers for Disease Control and Prevention offers some contingency capacity strategies to help facilities understand their staffing needs and the minimum number of staff necessary to provide safe patient care. For example:

  • Cancel all non-essential procedures and visits. Shift healthcare providers who work in these areas to support other patient care activities in the facility. Facilities will need to ensure these providers have received appropriate orientation and training to work in these areas that are new to them.
  • Attempt to address social factors that might prevent staff members from reporting to work such as need for transportation or housing that allows for social distancing, particularly if providers live with individuals with underlying medical conditions or older adults.
    • Consider that these social factors disproportionately affect persons from racial and ethnic groups also disproportionally affected by COVID-19 (e.g., African Americans, Hispanics and Latinos, and American Indians and Alaska Natives).
  • Identify additional personnel to work in the facility. Be aware of state-specific emergency waivers or changes to licensure requirements or renewals for select categories of healthcare professionals.
  • As appropriate, request that your healthcare providers postpone elective time off from work.  However, there should consideration for the mental health benefits of time off and that the burden of the disease and care-taking responsibilities may differ substantially among certain racial and ethnic groups.

Reference

  1. Centers for Disease Control and Prevention. 2020. Accessed October 5, 2020. [https://www.cdc.gov/coronavirus/2019-ncov/hcp/mitigating-staff-shortages.html]

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