Live Webinar | Costing and Managerial Accounting
Save
Live Webinar | Legal and Regulatory Compliance
Save
Live Webinar | Health Plan Payment and Reimbursement
Save
Live Webinar | hfma:content/topic/behavioral_ethics
Save
Column | Leadership

Joe Fifer: Solving the nurse staffing crisis — We’re all in this together

Column | Leadership

Joe Fifer: Solving the nurse staffing crisis — We’re all in this together


As COVID-19 hospitalizations have ebbed, demand for travel nurses has decreased, and their ultra-premium wages also have gone down. The peak period of $175 hourly rates for travel nurses may be over. Does that mean fi nance leaders can stand down now? Nope. Not at all.

I’ll admit it: When I worked in a health system, I got complacent about the nursing shortage issue over the years, even though it was a perennial area of concern for our leadership team. We were always able to recruit enough nurses, no matter how dire the situation was said to be. But this time is different. The COVID-19 pandemic has taken long-standing nurse staffing challenges to a whole new level.

During COVID surges, hospitals have been forced to rely on external staffing agencies to supply travel nurses at rates that not only blew up hospital budgets but also led to dissatisfaction among permanent direct care nurses, who were doing the same work for considerably lower pay.

In response, some health systems launched internal staffing agencies, which allow nurses to float among different sites within the system, as needed, and earn higher pay, while still reducing costs at the system level by avoiding the middleman markup. You can think of it as a short-term strategy for addressing a complex societal problem at an organizational level. And there is a definite role for such strategies.

As a long-term strategy, the healthcare industry needs to strengthen the “narrow part” of the nursing pipeline — that is, nursing schools. In 2021, nursing schools had to turn away about 92,000 qualified applications for lack of clinical placement sites, faculty preceptors and classroom space. When health systems partner with nursing schools to supply some of these resources, which is happening on a small scale now, everyone benefits. Health systems may want to consider establishing alliances that would pave the way for more substantial investments in nursing education, filling the pipeline for all.

Of course, the pipeline is just one aspect of solving the nurse staffi ng crisis. We also need to address the root causes. HFMA is one of five industry groups collaborating on the Nurse Staffing Think Tank, which has worked to identify priority areas for taking action based on the root causes. The group recently published a solutions tool kit with recommendations to address these areas — healthy work environment; diversity, equity and inclusion; work schedule flexibility; stress injury continuum; innovative care delivery models; and total compensation.a A task force is continuing and expanding on this work.

As an industry, we always seem to claw back from the brink of disaster. But we must learn from these experiences, or, as the saying goes, we are doomed to repeat them. The nursing crisis was exacerbated by COVID, but it didn’t start with the pandemic, and it won’t end with it. Finance leaders have an important long-term role to play in solving this problem. There is no room for complacency. Collaboration between nursing and fi nance has never been more important than it is now. 

Footnote

a. Partners for Nurse Staffing, “Nurse staffing think tank: Priority topics and recommendations,” 2022.

About the Author

Joseph J. Fifer, FHFMA, CPA,

is president and CEO, HFMA, Westchester, Ill.

Sign up for a free guest account and get access to five free articles every month.

Advertisements

Related Articles | Leadership

Column | Cost Effectiveness of Health

New opportunities for renewable energy projects

A new direct payment option is now available for hospitals and health systems planning renewable energy projects.

Column | Cost Effectiveness of Health

A taxing opportunity for brave nonprofit health systems

Nonprofit health systems may find that they can actually benefit from paying taxes. Although this idea may seem like a nonstarter to many, making this move would give nonprofits an opportunity to create a new narrative, operate more efficiently, allocate resources more effectively and deliver higher value to their communities. 

Column | Cost Effectiveness of Health

Healing our healthcare system starts with valuing our healthcare heroes

In this commentary, Martin Bluth explores how U.S. healthcare’s administrative leaders can cultivate an environment of trust that encompasses not only patients but also caregivers. He also raises the concern that such trust has been dwindling and that efforts to foster it are needed to prevent our healthcare system from floundering.

Research & Reports | Leadership

10 Steps Toward Health Equity

HFMA's 2022 Thought Leadership Retreat brought together stakeholders from across healthcare to advance the dialogue in efforts to achieve health equity.