Big-picture solutions worth considering
Some of the most significant responses to labor trends aren’t necessarily designed to get hospitals and health systems through the next fiscal year. But the following initiatives can help ensure the same kind of workforce crunch isn’t felt during the next public health emergency.
Payroll flexibility. In many organizations, a cultural shift is underway in how finance leaders evaluate operations.
“Back in the day, it was all about productive hours per equivalent patient day on the inpatient side,” said Nancy Hoffman, director of financial operations analytics with Mercy health system. “And that’s not a metric we’re extremely focused on anymore because that just led to cost escalation and constrained our most expensive resources. Now we’re really looking at skill-mix models.”
Mercy would sign off on hiring two FTEs in support roles to fill what previously was a single, higher-level payroll slot “if that’s a better care model in the long run, and more cost-effective,” Hoffman said — regardless of the impact on productivity measures.
A robust pipeline. Sanford Health is working to expand partnerships with colleges to serve as a conduit for new hires. A year-long residency program helps put new nurses on a track to “become that high contributor and that professional leader at the bedside,” said Erica DeBoer, RN, chief nursing officer.
Mercy has worked to enhance its pro re nata structures and regional float pools. It also is collaborating with a vendor to establish an app-based gig employment platform that will serve as “the next generation of travel nursing,” Hoffman said.
“We’re very optimistic that’s going to open up some new kinds of labor sources and provide opportunities for more local resources to pick up shifts, provide some of that flexibility and fill some of those gaps,” she said.
Right-sized care delivery. Well before the pandemic, efforts to cut down on higher-intensity care were underway in response to the increasing prevalence of payment models that give providers an incentive to keep patients out of the hospital.
“We don’t foresee external factors in the labor market changing anytime soon, so we are very focused on what we can do differently,” Hoffman said. The endeavor includes utilizing the virtual care center that the health system opened in 2015 and looking at ways to expand telehealth and health management programs.
“Anytime we can serve our patients and avoid an acute care stay entirely or provide specialist care to our patients in a rural hospital setting in their community, that’s a win for everyone,” she said.