If you ask a hospital executive what issues are keeping them up at night, there’s a good chance staffing will be high on their list of concerns.
ECG associate principal John Budd did exactly that. John has spoken with 100+ senior hospital executives across the US to discuss biggest challenges they’re facing for 2022 and beyond. More than 70% of CEOs shared that staffing poses biggest threat to their mission going forward.
In fall 2021, John hosted a panel discussion on the topic of staffing shortages in hospitals and was joined by the following senior hospital leaders:
- Andrew Short, COO, Samaritan Medical Center
- Sheila Kempf, RN, PhD., VP of Patient Care Services & CNO, Penn Medicine Princeton Health
- Julie McGregor, Chief Experience Officer, Columbus Regional Health
- Lynn Caldwell Hawkins, Chief Officer of Special Initiatives, Arkansas Rural Health Partnership
The panelists’ organizations differ significantly in size, geography, and patient population. But the staffing issues they’ve encountered over the past several years are strikingly similar. All have been challenged to recruit and retain hospital workers—particularly nurses. All have seen those staffing issues worsen dramatically in the wake of COVID-19. And all have had to get very creative in order to survive.
With the Omicron variant spreading and hospital admissions continuing to rise, we revisit five key themes from the panelists’ discussion.
1. Hospital staff are exhausted.
Frontline healthcare workers have borne the brunt of caring for the public during the pandemic. Patient volumes during the height of the pandemic pushed hospital staff to their limits, and in some cases, to their breaking points. The panelists noted historically high vacancy rates among nursing staff and said that many nurses have left their hospitals for less stressful environments, such as doctors’ offices and schools—while others have abandoned the profession entirely. In some cases, financial pressures have resulted in layoffs, stretching hospital staffs even more thin.
2. Competition for hospital staff has intensified.
The entire panel agreed that hospital staffing shortages began before the pandemic, and that the public health emergency has only exacerbated the problem.
In rural areas, where recruitment and retention of hospital staff is a long-standing challenge, Lynn Hawkins explained that hospitals in the Arkansas Rural Health Partnership were losing nurses to lucrative signing bonuses offered by competitors, and that some neighboring states were even offering housing expenses.
Sheila Kempf found that many nurses in her area were opting for traveling positions, and that in the current environment, nurses could travel locally and double their salary without having to relocate.
And nursing is only one part of the equation. Andrew Short noted that when New York State implemented a $15 per hour minimum wage for fast food workers, it created new sources of competition for Samaritan Medical Center.
3. Short-term solutions may become long-term strategies.
The rapid progression of COVID-19 meant that hospitals had to make major operational changes on the fly, without the luxury of months-long planning and implementation processes.
But today’s contingency plans could be tomorrow’s standard practices. Sheila noted that Penn Medicine Princeton Health has made innovation central to everything they do. She praised her organization’s emphasis on education, quickly mounting a student nurse assistant fellowship program and a nursing assistant course. Both programs are aimed at developing a supply of nursing assistants and, more broadly, finding creative ways to get people into the healthcare profession.
Julie McGregor said staffing issues during the pandemic prompted leaders at Columbus Regional Health to focus more on tasks and less on traditional job descriptions, introducing short shifts of one to two hours for routine tasks that required little training (such as stocking patient rooms). This provided a structure for employees to pitch in where they could, as many had indicated a desire to do.
The panelists agreed that finding novel approaches to recruitment is essential. Andrew noted that leaders at Samaritan responded to the shortage by rethinking their volunteer program. Knowing that many college students tend to need volunteer hours to meet education requirements, Samaritan began filling out administrative shifts with college students to give the staff more flexibility.
Panelists also stressed the ongoing need for education. Lynn said her organization has been collaborating with universities in the area and instituted 42 apprenticeships in their hospitals. She explained that it’s important to give students a “day in the life” of a healthcare professional and show them that they don’t need to be a doctor or nurse to work in a hospital.
4. Efficiency is critical.
Time and again during the discussion, the panelists talked about the need for staff to work to the top of their licenses. Sheila said that amid a nursing shortage, nurses should focus on the specialized work they’re trained to do, while tasks such as admitting patients and stocking rooms should be directed to other staff. Julie mentioned that her hospital had transitioned many of its administrative functions to remote settings—a prospect that was unthinkable prior to the pandemic but has since proved efficient with the help of technology.
5. Staff who feel supported are more likely to stay.
While signing bonuses and other perks will always tempt staff to leave an organization, the panelists agreed that money isn’t the only thing that employees value. For starters, a little gratitude goes a long way. Sheila and Lynn both remarked on how much their workers appreciated hospital leaders coming to their units to thank them for their hard work during the pandemic and for staying with the organization throughout an impossibly stressful time.
Julie mentioned her organization’s willingness to invest in its workforce, citing the need to offer avenues for personal and professional development. Sheila noted that Princeton allows nurses to shadow peers in different units, giving them exposure to other types of work and opportunities to be promoted within the organization.
Andrew and Julie also mentioned that the pandemic prompted their organizations to examine their onboarding and orientation processes. While short-term changes were necessary to accommodate social-distancing protocols, the result was a more streamlined, candidate-friendly hiring process.
Staying Flexible for the Future
From telehealth to drive-up COVID-19 testing to hospital administrators working from home, the events of the past 18 months have proved that once-unfathomable practices in healthcare can be effective. The hospital staffing shortage predated the pandemic, and it won’t end once the public health emergency is over. But addressing staffing issues will require hospital leaders to embrace the same spirit of innovation they’ve demonstrated over the past 18-plus months.
Published October 28, 2021