Burnout, stress and overload have crippled healthcare workers for a decade. The pandemic only shined a brighter light on an already rapidly spiraling HR nightmare; a staffing crisis across the system’s most critical roles.
Overworked staffers are leaving the medical profession, according to a recent Washington Post-Kaiser Family Foundation poll, creating immediate gaps in coverage at hospitals, surgery centers and clinics. This only makes the country’s ongoing physician shortage more glaring, as the Association of American Medical Colleges report upped the anticipated shortage to 134,000 physicians by 2034.
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Craig Ahrens Craig Allan Ahrens, SVP of Strategy and Growth for CareRev, is an innovative voice in a traditional industry. His background and vision offer a fresh perspective on the relationship between the healthcare sector and technology investment. As a healthcare innovation/startup leader, consultant, and digital health transformation executive, he brings more than 20 years […]
Facilities in transition to telemedicine before Covid were hopeful it could improve the work environment and give healthcare workers the work-life balance they were seeking. But telehealth alone isn’t an answer to a much bigger labor model issue and it came with a high cost, a tradeoff that doesn’t actually work long-term for the system.
The pandemic forced the acceleration of telehealth adoption. In tackling the surge in care needs, healthcare systems needed to staff both in-person and virtual visits. Traveler agencies and large staffing organizations gained inordinate market power, resulting in increased labor costs. As the financial pressure reached a tipping point for many systems, some, but not all, have started to support going back to traditional full-time employment models. This strict, static staffing model reinforces the employee career dissatisfaction, operational friction, and burnout we’ve been dealing with all along.
There are lessons in the challenges that lead to better performance by clinical professionals and ultimately to better patient outcomes. The solution isn’t overly complicated. It all goes back to supply and demand. By creating a pool of ready skilled labor willing to work as needed instead of only full-time, healthcare systems can take advantage of professionals who want to work to tackle fluctuating needs.
Primary contributors to a stale labor model
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
There are fundamental challenges in the current system that limit the supply of clinical professionals and prevent maximizing the potential of healthcare workers. The system faces workers who are generally displeased with the status quo and simply want flexibility.
Red tape is bountiful and various pieces of it are holding up necessary labor model changes. The first piece of red tape is regulatory and licensing hurdles to practice. This is usually a multi-step process involving both organization departments and outside agencies. Decreasing these hurdles doesn’t mean eliminating credentials; it simply means eliminating excessive requirements to work in a different organization even though a worker or practitioner has already been “cleared” by another healthcare system.
The second piece of red tape is the onerous onboarding and credentialing processes that keep professionals in orientations instead of actually providing care. Some orientation programs last from three to six months to a year for those working in critical care areas. Obviously, there should be training specific to the facility, but there’s often excessive redundancy for experienced caregivers. Streamlining this tedious process can greatly increase the speed and access to work.
Overall, reducing the bureaucracy here is akin to doing a major house cleaning; everything works better when things are simple, yet comprehensive. Clinical professionals are dedicated to serving others but to thrive, they also require support that includes flexibility and attention to personal needs. This is especially critical when they’re working under unprecedented conditions, but realistically it’s needed all the time. People will be more productive when they make choices about their work and receive ongoing support. There are a wealth of resources available, but use and access must be promoted and supported by the healthcare organization.
A different perspective
Despite current circumstances, there doesn’t have to be a shortage of caregivers and physicians.
Some innovative healthcare systems realize that the old, stagnant way isn’t the best way. It’s no longer necessary or even prudent to proceed with traditional, archaic full-time centric staffing models to fight the ongoing and expensive clinical supply wars. It’s possible to find and attract qualified, trained professionals who require less rigorous onboarding and can step into existing situations to work how and when they want to work. And it can be accomplished while still managing costs.
There are five basic components to a healthcare system’s ability to successfully embrace a new approach:
- Develop a staffing philosophy that balances full-time with local on-demand per diem staff — Start with letting go of the traditional staffing construct. It’s cumbersome and not effective at handling contemporary patient loads. A system that facilitates the right number of professionals at the right time helps create balance in both patient care and caregiver satisfaction.
While many organizations focus on the cost of purchased labor and assume it’s all bad, developing a strategic plan to identify the right mix of full-time and per diem resources is a better alternative. Engaging professionals beyond money by focusing on flexibility is key. Marketplace platforms can be a proactive partner to develop complementary contingent and full-time worker platforms at a reasonable cost outside traditional staffing agencies and without traveler company overhead.
- Encourage corporate shared services (HR, legal, education, etc.) to creatively reduce barriers to accessing and onboarding labor —Streamlining procedures benefits the healthcare system through efficiency and those going through the process with a smoother experience. Fewer layers helps get the clinical pros into their jobs where they can ultimately better serve patients.
It can take weeks to recruit a professional then get that person working. Required in-person orientations or provisioning of IT system credentials creates artificial barriers. Simplified, more effective communication with a candidate will keep the recruit engaged and interested.
- Enhance change management resources to support the shift to new labor models — Engaging an expert to handle the transition could seem like an unnecessary expense, but it’s a move that pays off long term. Effective communication and planning minimizes resistance to change, bolsters morale and ultimately increases quality productivity.
With any new technology, especially those that engage a sophisticated clinical workforce, an executive sponsor and a team of workforce project managers should shepherd the solution across the organization and solicit feedback to improve buy-in for the solution.
- Partner with a marketplace technology platform to curate a direct, lower cost pool of local labor resources thereby reducing reliance on agencies or traveler companies — Technology can empower healthcare organizations to find, recruit and retain professionals who can work directly with the organization without layers of bureaucracy.
A range of technology marketplace partners offer national options for traveler nurses, but few offer locally curated labor marketplaces focused on becoming a long-term labor partner. An organization needs to identify potential partners and engage them in a reference check, understand the value proposition, and gauge the return on investment based on an implementation timeline. It’s often misunderstood that on-demand resources obtained through a technology partner can improve patient care and overall productivity. Measures should be developed to ensure alignment around patient care and productivity improvements.
- Foster continued adoption of telemedicine, automation, and logistic technologies to innovate and drive the inevitable shift toward more remote care options away from fixed sites — This includes multiple professional levels from physicians who can staff telemedicine video calls to skilled caregivers who are proficient in patient care skills as well as psychosocial awareness to report the full home care picture. That requires professionals to be trained differently and the reimbursement system to adapt to more realistic payments.
Instituting a customer service training program for clinical professionals that’s focused on virtual care interactions and developing clinical pathways that offer paths to in-person care when needed are critical to success. It’s also important to engage the finance department in negotiating payer coverage for virtual care.
Incorporating these basic tenets enables a health system to address the increase in off-site care, ranging from telehealth to in-home. For the process to work, providers must become accustomed to a more customer service-oriented model that’s a hybrid between in-patient care, primary care and traditional home care. That requires specialized training for the care professionals and a payment system to both incent them to participate and the technology to facilitate an on-demand staffing model. This enables both physicians to do their jobs and lower-skilled professionals to focus on specialized patient care outside the traditional on-site model.
The imminent evolution
Following this blueprint can substantially reduce labor costs while improving ability to serve patients. By reducing the necessity for middlemen and allowing technology to easily manage and optimize processes, organizations have the opportunity to cut ties to onerous bureaucracy. They can tap into a local labor ecosystem that’s more cost effective and more sustainable because professionals want to take part. Because they can choose how, when and where they work, they are more engaged, less inclined to leave and ultimately, inclined to provide better patient care.
This evolved model serves multiple interests. Healthcare systems spend less attempting to find, onboard and manage full-time staff and can put resources towards both meeting the cyclical needs of each healthcare segment and concurrently offering a superior professional experience.
This model also enables the growing tendency away from in-person, on-site care facilities. It positions care organizations to be able fill the gaps between more telemedicine and inpatient/ambulatory care. For that care model to succeed, it will require advanced telemedicine, transportation logistics and a labor pool willing to work outside traditional channels.
We’re no longer tied to landline phones with strict use constraints, and we have better communication. Why should we be tethered to old-fashioned healthcare delivery points? Technology makes it possible – and profitable – to do things differently if healthcare organizations are willing to adopt a fresh perspective. Providing a system that offers flexibility to both patients and caregivers while containing cost and rewarding professional skills ultimately benefits everyone.
Picture: marchmeena29, Getty Images
Craig Allan Ahrens, SVP of Strategy and Growth for CareRev, is an innovative voice in a traditional industry. His background and vision offer a fresh perspective on the relationship between the healthcare sector and technology investment. As a healthcare innovation/startup leader, consultant, and digital health transformation executive, he brings more than 20 years of experience in public and private institutions. His expertise in both healthcare startups and digital health innovation investments positions him as a leader in dynamic industry innovation. He’s worked with large health systems as well as academic institutions and resource providers to facilitate physician/hospital relations, develop strategy, and transform operations that resulted in tangible benefits to both providers and patients. Ahrens’ diverse skill set positions him to evaluate, address, and offer solutions to difficult healthcare industry issues. As an advisor to institution leadership and to private equity investors, he can communicate in terms that speak to both audiences.
