By Eric Burch, Vizient Executive Principal, MBA, RN, FACHE
Respiratory illness season has always been a challenge for healthcare organizations with additional admitted patients who require isolation, respiratory support, and at times intensive care unit beds. This influx of volume also is compounded by staffing challenges that many organizations find themselves in after the COVID-19 pandemic. This past fall, Respiratory Syncytial Virus (RSV) surged in children across the country, Influenza cases also climbed and COVID-19 continued. This potential "tripledemic"— a term coined to explain how a combination of RSV, flu and COVID-19 might overwhelm hospitals and healthcare systems — worried some medical experts.
The good news is that as we begin 2023, these viruses aren't peaking simultaneously. According to Vizient Clinical Data Base (CDB) analytics, pediatric RSV hospitalization rates per 100,000 children younger than 5 spiked in late 2022 but have since declined closer to historical levels. Influenza hospitalizations surged this fall and the cumulative hospitalization rate per 100,000 residents has eclipsed at least five of the past 12 seasons. However, based on more recent data from U.S. Health and Human Services (HHS), the seven-day rolling average of hospitalized cases of flu has declined in recent weeks. While COVID-19 hospitalization levels remain far below prior surges, the trends currently remain stable.
Despite this reprieve, organizations are leveraging strategies to mitigate the burden that the tripledemic can place on staffing and capacity. Like the COVID-19 pandemic response to capacity, organizations have reacted by:
- Implementing policies to use existing nonclinical space in new ways and transforming previously nonclinical areas in the hospital into clinical care spaces for suspected or confirmed cases
- Holding administrative meetings to evaluate capacity, throughput and staffing throughout the day
- Evaluating and sometimes holding elective or nonessential procedures, services and visits
- Coordinating bed availability with other healthcare organizations and the community
Strategies to mitigate staffing challenges include:
- Maximizing staff coverage through strategic placement and scheduling, including assessing every staff member for their knowledge and skills and looking for ways to maximize each person's potential to serve in new capacities. For example, a mother/baby nurse may be able to assist on a medical/surgical unit with a limited scope that aligns with their competency and training.
- Preparing to get ahead of the demand. Planning can help organizations prepare with the necessary staff during these seasonal surges. It's important to collaborate with supplemental staffing agencies months ahead of time to submit requests for travel nurses, crisis response nurses and per diem staff. For those organizations already using supplemental staff, consider extending and rebooking those nurses through the season.
Patient surges require that organizations operate with as much efficiency as possible while carefully considering the capacity of their space, material resources and staff capabilities. Developing a plan in the middle of a surge is not ideal. Lessons learned from the COVID-19 pandemic as well as past respiratory seasonal surges are key to planning and preparing ahead of time.
Learn more about unique insights on nurse workforce challenges, as well as tactics for reimagining care delivery, in the recent Workforce Intelligence Report based on data from Vizient and Vaya Workforce.
About the author
As executive principal, Eric Burch MBA, RN, FACHE, leads operations and workforce at Vizient. His responsibilities focus on leading consulting and analytics team across the country focusing on efficiency, effectiveness and profitability of care delivery and workforce across the healthcare continuum. Burch has 30 years of healthcare experience spanning health system operations in both acute and ambulatory environments. His areas of expertise include strategic management of clinical and administrative services, analytic and financial competencies, strategic workforce optimization and clinical operations delivery. Prior to joining Vizient, he served as the chief operating officer and chief nursing officer for Oklahoma State University Hospital and the chief operating officer for Hillcrest Medical Center in Tulsa, Oklahoma.