01/15/21

“Developing a diversified workforce strategy is critical. That means having a full picture of your internal full-time, part-time and per-diem staff, as well as the contract labor component.” — Melanie Bell, MSN, RN, CENP, Vizient’s associate vice president, contract labor

As the COVID-19 winter and post-holiday surges continue across the country, the latest data from Vizient’s Contract Labor Management service reveals increasing contract labor staffing challenges for members across the country. Learn more about the latest trends and how to prepare.

The most recent data has revealed several important trends:

  • National surge and return of elective surgeries pressure supply of health care professionals—The COVID-19 surges during the spring and summer of 2020 were regionalized and elective procedures were placed on hold. Both helped to free up contract staff to be able to respond to the areas of a hospital or region with the greatest need. The current COVID-19 surge is affecting every region and most hospital are continuing elective procedures. This is placing significant pressures on hospitals to meet the demand for care.
  • Increasing census levels and patient acuity pressure hospital bed and ICU capacity and staffing—The increasing numbers of individuals testing positive for COVID-19 and being admitted to hospitals has resulted in significant increases in ICU admissions. Because ICU patients require more specialized care and higher staffing ratios, it creates additional staffing pressures for hospitals already pressured to meet care demands.
  • Hospitals assess operational needs for large-scale vaccinations—As hospitals continue to address day-to-day staffing challenges to manage the escalating COVID-19 impact on census, acuity and staffing, hospitals also are assessing their staffing needs for large scale vaccination efforts that will be launched later this year.

“With more COVID-19 patients being admitted to the hospital and into ICU units and an already tight labor market, we’re seeing hospitals across the nation having to play a huge game of musical chairs, constantly shifting staffing resources to meet changing needs,” says Melanie Bell, MSN, RN, CENP, Vizient’s associate vice president, contract labor.

Strengthening your workforce strategy

Bell expects hospitals will continue to see increased COVID-19 census volumes into the spring while also gearing up for large-scale community vaccination efforts. “The pressures on hospital staffing will continue into spring,” said Bell. “Developing a diversified workforce strategy is critical. That means having a full picture of your internal full-time, part-time and per-diem staff, as well as the contract labor component.” Bell notes that it’s important to create a plan that can flex for increasing and decreasing census, understanding where additional staff will come from and how they’ll be onboarding quickly. “You may not need to have all of the staff on hand, but it’s critical to know how you’ll respond when you have sudden increases in need,” said Bell.

Additional strategies to mitigate staffing challenges include:

  • Leverage team-based care—With ICUs being pushed up against critical care staff capacity, consider adopting a team-based care approach to critical care nursing. The Society of Critical Care Medicine developed a tiered-staffing model, which integrates experienced ICU personnel with reassigned hospital staff members who serve as extenders, handling more routine care tasks.
  • Strengthen staff retention—A nationwide nurse shortage has led to an unparalleled demand for travel nurses, especially those with ICU experience. And that high demand is luring some staff nurses away from permanent positions to higher-paying, short-term COVID assignments. It’s vital to devise solid, and even creative, retention plans that help employees feel valued and engaged. “We’ve seen members set up plans where employees who pick up an extra shift each week for eight weeks receive a bonus at the end of the eight-week period.”
  • Partner with nursing schools—Partnering with local nursing schools is an opportunity to bring high-skilled hands to the bedside. Bell says members have had great success augmenting staff through clinical affiliations with nursing schools. “We’re supporting them through Vizient’s Contract Labor Management program which has allowed individuals to onboard more quickly and removes the logistical burden for the health care facilities,” she says. In addition to caring for COVID-19 patients, nursing students may also be valuable in supporting mass vaccination efforts in the coming months.
  • Maximize use of assistive personnel—Certified nurse assistants, medical assistants, patient care technicians and other unlicensed assistive personnel provide additional hands at the bedside to do more activities of daily living and clinical support tasks. This allows nurses to focus on higher level clinical tasks.
  • Up the appeal of contingent staffing assignments—With nearly every part of the country hard-hit by the COVID-19 surge, traveling nurses have many choices about where to work. Bell recommends making contingent staffing assignments as flexible and attractive as possible. While pay rate is one decision point, it’s not always the most important factor. Make sure to market the strengths of your organization as well as the attractions of your geographic region. Fixed shifts and variable length assignments are also appealing to traveling nurses.

Tools and resources for members

Vizient provides members with a wide range of best practices, advanced workforce management technologies and tools to help better manage staffing and prepare for large increases in patient volume.

Vizient’s COVID-19 Surge Demand Calculator is a no-cost scenario planning tool available to members and nonmembers that calculates market-specific, age-adjusted projections of non-ICU bed, ICU and ventilator demand. The tool helps inform members’ surge response while also modeling subsequent surges and adjusting for impacts of social distancing in your market.

A clearinghouse of timely COVID-19-realated information and resources is available on the dedicated COVID-19 resources webpage.

Vizient’s offers a variety of workforce optimization solutions, including a Contract Labor Management service, labor consulting, and more, including a wide variety of best practices, white papers, and blogs.