The Impact Advisor July 2022
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ENTERPRISE STRATEGIES TO ADDRESS THE WORKFORCE SHORTAGE
Impact Advisors is helping healthcare organizations alleviate the challenges of the current workforce shortage. In this issue, we share several strategies that are turning the tide.
The longstanding and well-documented problem of clinician burnout has been further exacerbated by the pandemic. Many clinicians have left medicine altogether and several have been hired away by travel nursing agencies offering higher pay, schedule flexibility, and a more manageable workload. Meanwhile, increasing acceptance of a remote workforce and the lure of larger salaries has forced hospitals and health systems to compete with provider organizations across the country and companies outside of healthcare for talent spanning a variety of roles.
Enable Staff to Focus on More Rewarding Work
One of the key benefits of optimizing workflows, schedules, etc. and automating repeatable, high volume / low complexity processes is current employees are able to spend their time on more rewarding and gratifying work. Clinicians can work at the top of their license rather than performing administrative tasks, while IT staff can focus on new and innovative projects instead of routine requests.
Attract Traveling Clinicians Back from the Road
With the sharp increase in agency spending, leading hospitals and health systems are focused on new strategies to attract traveling clinicians back from the road. We are seeing clients get more creative with benefit packages for full-time employees to differentiate themselves when competing with agencies for talent. Another strategy that is now more important than ever is implementing the Magnet model. One of the model’s key components is Structural Empowerment, which is centered on offering clinicians a greater voice and influence on the direction of the organization.
Engage with Talent Early in Career and Develop a Career Ladder
Making long-term investments in talent is another lever being pulled by healthcare organizations. One example is developing “feeders” within local community colleges and other universities to engage people moving through an LPN track and/or going on to an RN degree. A similar process should be used to address the shortage of non-clinical resources as well. To attract non-clinical staff, demonstrating a career track that allows them to work their way up within the hospital while also getting better benefits, can be a differentiator. Communicating and implementing a structured, well-defined career progression can distinguish a healthcare organization from alternative employers.
Another critical aspect of maximizing the effectiveness of the health delivery workforce – especially amid a crisis like the current talent shortage – is standardization. These efforts, while significant, can reduce variation, improve efficiency, and ensure all staff know exactly what to do in any situation or location.
For health systems with multiple hospitals, process standardization across the enterprise is a key pathway to effectively flex resources. For example, if demand becomes significantly higher in one ED compared to another, a health system with well-defined standard processes will be able to readily adapt and respond by moving clinicians where they are needed in the system and be confident they know exactly what to do. That float pool and level of agility from standardizing processes across the enterprise is not possible without a strong understanding of how the business operates and an investment in the time and resources needed to ensure the right infrastructure is in place.
Align Supply Chain Strategy and Temporary Labor
It is important the health system’s supply chain and contracting teams are involved in setting the supplier strategy for temporary labor – not only to ensure that HR and/or clinical teams can bring in qualified candidates quickly, but also to ensure the business terms of any temporary labor contract are favorable to the organization and consistent with the organization’s overall supplier strategy. Partnering with a large (but not necessarily sole source) supplier of temporary labor that can provide resources across multiple clinical specialties (and non-clinical resources as well) can drive consistency and economies of scale. When a health system has a prime supplier for temporary labor, all the data is in one place, making it easier to run reports showing demand over time and prices paid compared to the market. By contrast, provider organizations that use many different suppliers for temporary labor lose any type of economies of scale and any kind of consistency in their agreements. Insight into key labor purchasing trends becomes challenging, as the health system needs to manually reconcile different types of reports from its various suppliers.
Provide Standardized, Comprehensive Training for New Clinicians
The unprecedented stresses and pressures on clinicians during the height of the pandemic resulted in a considerable amount of turnover. While hospitals and health systems continue to struggle to fill many of those gaps, there has still been a large net influx of new clinical staff in many organizations. To ensure all new hires are aware of how to operate in the health system, we have worked with clients to implement standard and well-defined policies, procedures, and processes that are effectively communicated as part of formal, standardized training and onboarding programs.
Initiatives aimed at ensuring a hospital or health system is making the most effective use of its existing workforce can take a variety of different forms, including optimizing clinical services, workflows, processes, schedules, responsibilities, accountabilities, IT systems, and even the data used to make informed decisions.
Optimize Case Management
Fewer hands mean heavier workloads, and, as a result, hospitals across the country are facing significant challenges managing patient length of stay. To help clinicians be more patient-centric despite staff shortages, Impact Advisors is carefully examining their workday, reassigning accountabilities, and finding ways to keep them focused on their top-of-license abilities. We are also enabling case managers to be more empowered and vocal leaders of the team that facilitates care and discharge progression.
Rationalize Service Lines
The workforce shortage is forcing health delivery organizations to carefully evaluate the tangible value and ROI of the clinical services they are offering. If service line volumes differ significantly among health system locations in a given market, consolidation to achieve economies of scale through service line rationalization can be beneficial.
Leverage Managed Services
Many hospitals and health systems are turning to managed services to enable more effective use of current IT staff by better aligning resources and skill sets with the work that needs to be completed. Impact Advisors approaches managed services as a partnership. We work with our clients to determine the specific set of services that best aligns with their unique needs and develop appropriate service-level agreements (SLAs) for the situation. The efficiencies we bring to the table result in operational cost savings, as issues are resolved more quickly and doctors and nurses can get back to work faster. Additionally, the client’s IT staff is more effective in the near term because they can focus on key project work rather than routine maintenance. Keeping this project knowledge in-house will position them to be more effective in the future, too.
Another alternative for health systems is to augment IT staff with outsourced temporary or contract talent to support new projects, like implementations, or to help keep up with existing tickets. Organizations can also benefit from outsourcing their revenue cycle operations. Outsourcing can augment the current staff or take over complete responsibility of functions in all areas of the revenue cycle at a fraction of the cost of hiring, training, and developing full-time employees.
A critical element of successfully optimizing hospital and health system labor is ensuring key operational and clinical stakeholders have access to the data that can best support informed decision-making. Historically, health delivery organizations have primarily looked at labor costs as just a byproduct of wages and hours. It is equally important to consider workload factors as well (e.g., volume fluidity; variation in patient type and acuity; workflow efficiency; etc.) now that better data is available for cost and workflow decisions. Impact Advisors’ Workforce Innovations framework – which includes technology-enabled workflows and elbow-to-elbow training – is helping our clients focus on cutting costs, not just hours, while allowing them to return to pre-pandemic (or better) staffing levels.
Decanting manual, repetitive processes from employee workload can reduce staff burnout and allow them to exercise critical thinking. Automation can also ensure processes are completed more quickly and at a reduced cost, as the team is free to manage by exception while the “bots” or devices run continuously in the background.
Remote Patient Monitoring (RPM)
An RPM solution can reduce up to 10 percent of the time spent on routine monitoring and serve as a real-time indicator for advance notice of Hospital-Acquired Conditions (HACs), while also reducing the disturbance to patients sleeping at night or napping during the day. RPM solutions allow providers to reallocate that time with more meaningful interactions with each patient on a more personal level.
Robotic Process Automation (RPA)
There has never been a better time for health systems to take steps to move forward with RPA to build out “bots” that can complete basic tasks and repeatable, high volume / low complexity processes. Corporate services areas (i.e., revenue cycle, marketing, HR, and finance) in particular have many repetitive processes that can be automated through RPA. For example, if a revenue cycle staff member needs to follow up on a claim, the first thing they would do is visit the payer’s website to look up the status of that claim. A “bot” can be programmed to pull that status from the payer’s website, so when staff members log in, all the information they need is already in the system.
THE BOTTOM LINE: A HOLISTIC APPROACH
Engagement, standardization, optimization, and automation are all critical, strategic components to addressing the workforce shortage but are not mutually exclusive. Maximizing the impact of virtually any initiative to improve the effectiveness and efficiency of existing staff will require careful and deliberate attention to all four of the concepts above.
For example, the potential benefit of optimizing a specific process or workflow will be limited if that optimized process or workflow is not standardized and implemented broadly across the enterprise. Similarly, the full efficiency gains and reduced variability from standardization efforts are only achievable if staff have been fully engaged, understanding not only “what” they need to do but also why they need to do it. Meanwhile, automating a broken, non-standardized process or workflow will at best exacerbate existing inefficiencies. Hospitals and health systems instead need to invest the time and resources to ensure a given process or workflow is fully optimized and standardized before it is automated.
Consider all available strategies to help your organization confront today’s workforce challenges.
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