The impact from COVID-19 at companies and organizations everywhere has been astonishing and swift. Stay-at-home orders drove layoffs and shutdowns across the hospitality, travel and other industries. Remote work became a new norm for many who remained employed. And our nation’s students left classrooms to learn from home. Clinicians at our nation’s hospitals continued their work despite tremendous uncertainty about their and their family’s health, shortages of personal protective equipment and crushing spikes in the number of COVID cases and hospitalizations.
Even today, they relentlessly continue to give of themselves tending to the needs of so many at hospitals functioning in overdrive. While the dedication is unwavering, burnout combined with a lack of available caregivers is challenging hospital leaders to meet the continuing demand as wave after wave of a virus that endures.
As a result, “workforce management” has become the overarching daily support strategy. Here are three important areas for health care leaders to focus on during this challenging time.
When COVID began in 2020, caregivers needed access to places to quarantine from family, access to food and other essentials, and personal protective equipment was in short supply. Some 18 months later, many needs remain the same, but strategies to support their engagement and retention are especially important now.
“COVID’s impact on hospitals has revealed the complexities of clinical caregivers’ roles and what kind of support is required for them to bring their best selves to work and provide the best possible care for their patients,” says Robert Dean, DO, MBA, Vizient Senior Vice President, Performance Management.
Here are several ways that hospitals can support a resilient workforce as a part of their overall workforce strategy:
- Communication—Many organizations utilize ongoing, routine communication with staff to convey the importance of their presence as team members. Leadership communication, presence, visibility and willingness to listen are highly valued, especially during the pandemic.
- Support—Ensure that all staff is aware of support provided by the organization (such as employee assistance programs). Vizient’s Clinical workforce well-being playbook: Leading through the COVID-19 crisis and beyond outlines the four core universal needs of employees and a checklist of practical ways to meet these needs.
- Onboarding and role clarity—Clinical leaders have an important role to play with onboarding and role clarity. Ensuring the onboarding process is optimal and standardized for all clinicians in the organization can provide a clear foundation for a lasting relationship. In addition, clinicians need to have meaning in their work. How clinicians spend their time and ability to practice at the top of their license is critical to retention.
Organizational support for the newest nurses is critically important during this time as well. An already are a vulnerable portion of the workforce, we learned that while hierarchical structures were often broken down during the pandemic, peer support in stressful and overloaded daily schedules held teams together. The clinical care team, unit leadership and organizational support helped these nurses get through the last year and remain critical components going forward.
Contract labor management
The pandemic has created a vicious cycle for the health care workforce with across-the-board nursing shortages and fluctuations in patient volumes and acuity. Providers may have to pay overtime or bring in contract labor or travel nurses. The cycle adds stress to already strained resources and can increase turnover, which then leaves additional gaps in staffing.
“The most beneficial thing that members can do for themselves right now is to execute on retention strategies for their existing staff,” says Jack Datz, Vizient managing principal. “This can help hospitals to get through surges as they occur as we continue to battle the pandemic.” In addition to the resiliency strategies mentioned above, Datz notes that additional short-term actions can include pay increases, retention bonuses, extra incentives to work additional shifts and cross-training staff in low-volume areas to act as “helping hands” in high-volume areas.
When it comes to contract labor, members should work to be flexible in ways that don’t compromise patient safety. For example, consider allowing travel nurses to determine if they want to commit to 36 or 48 hours a week. You also can try to remove as many barriers to starting as possible. A longer window for a background check and drug screen—six months to a year instead of 30 days before start—can allow a previous report to be used and can shorten onboarding by seven-to-10 days. The use of data and analytics through Vizient’s Contract Labor Optimizer can help identify and fix bottlenecks in the processes of procurement of contracted staff.
Vizient’s Contract Labor Management program is a vendor-neutral management service that acts as a third party with clinical and non-clinical staffing agencies on contracting and managing contingent labor. The CLM program provides cost savings, efficiencies, and quality to health care providers. Vizient recently signed an agreement with Aya Healthcare, a leading provider of workforce staffing solutions, to acquire its Contract Labor Management service and transition it to Vaya Workforce Solutions (Vaya), a new subsidiary of Aya Healthcare. The agreement will ensure members have continued access to best-in-class technology as well as scalability and accountability in health care staffing services, with a focus on innovative technology and the ability to invest in enhanced digitization. The acquisition is expected to close by the end of September.
Labor cost management
Labor costs alone typically account for more than half of a health care organization’s operating costs, and the challenging cycle for the health care workforce due to the pandemic means that expenses likely will not decrease anytime soon. Managing labor costs is critical during these times of record staff shortages, increased competition for staff from healthcare & non-healthcare industries and skyrocketing labor costs. Organizations and their leaders at all levels need frequent and accurate visibility into the insights that drive labor costs.
“Over the next several months, hospitals are going to be continuously challenged to move at very rapid speeds in an effort to keep pace with market constraints and conditions,” says William Bowen, Vizient principal, advisory solutions, workforce optimization. “Hospitals will need to be diligent and creative in their efforts to overcome staffing challenges, while still ensuring they are providing high-quality care. Bowen suggests that it is more important now than ever that organizations staff effectively to patient demand, “resources are more costly and in short supply, you need to ensure you are utilizing staff in the most productive way”.
Bowen suggests that even though there is no silver bullet or action that will stem the current tide, there are critical elements that you will need in an effort to forecast, plan and sustain over these unsettled times.
- Secure an indispensable partner in the contingent staffing market, even with the current lack of availability & market constraints.
- Retention is the key, often times organizations have great programs, but fail to ensure your program is merchandising its benefits. Also reinforce that staff is valued and your leaders are living those values.
- Seek out an external source for peer benchmarking & insights, this will not only allow you to compare and contrast yourself to peer organizations but provide you with connections with peers for continued collaboration.
- Ensure that your system for managing productivity, utilization and staff needs has the ability to rapidly communicate across the organization, providing visibility and insights that allow leaders to quickly identify variances to plan and take corrective action.
Finally, engage with leaders at the departments level, where the work takes place. Engagement builds trust, uncovers limiting conditions and helps to collaboratively validate findings. “It’s great to have all the information and the insights, but you have to pair the data with what the situation on the ground is,” says Bowen. “The last thing you want to do is to optimize something that could have a negative impact on quality or erodes retention.”
If you need assistance in these areas, Vizient’s Operational Data Base is an excellent external source for insights that can pinpoint variances in your labor and supply expense performance and transparently benchmark against hospitals of your choosing. Additionally, Vizient’s Operational Vision platform offers an encompassing system for managing labor and non-labor costs, uses artificial intelligence and machine learning to determine realistic internal targets based on your historical performance, that can be married seamlessly with Operational Database peer benchmarking and be rapidly implemented across an organization in weeks.
Today’s workforce picture looks anything by rosy, yet hospital and health system members have proven their resilience given years of experience managing various reimbursement, staffing and resource challenges.