We continue to be inundated with news about the nation’s healthcare staffing shortages and our overburdened healthcare system. Even before the pandemic, hospitals and healthcare organizations were struggling financially and facing significant workforce challenges. Labor costs, nurse turnover, and employee burnout plagued the industry. The pandemic exacerbated these problems—and while government assistance programs helped hospitals weather the financial burdens, many hospitals and health systems still had to lay off staff. Employees who kept their jobs experienced increased burnout, exhaustion, and trauma.
Press Ganey research indicates that employee, nurse, and physician engagement is lower than it has ever been. Employee engagement—which assesses job satisfaction, pride in the organization, and the willingness to recommend and stay with an employer—has been trending downward since 2018, but it took a nosedive at the beginning of 2022. This downward trend continued at the start of 2023.
It should come as no surprise, then, that workforce challenges and staffing shortages in healthcare are a major concern for healthcare leaders. Many senior executives and other leaders are now looking at their organization’s existing staffing models and seeking alternative ways to balance workforce costs and healthcare staffing shortages without compromising quality and outcomes. Senior executives don’t have an appetite for delaying action and waiting for deep analyses and long reports. They want to get back on track quickly and sustain positive change.
Across the country, healthcare organizations are struggling with the same workforce challenges. Below, we discuss some of the most common challenges that our strategic consulting team sees—and what you can do to combat them.
What are the most common healthcare staffing models?
In acute care settings, the most common healthcare staffing model is “primary nursing care.” In this model, a registered nurse (RN) is responsible for all care for a specific patient cohort. Although technicians may provide some personal care or other support, the predominant duties are the responsibility of the assigned RN.
How have healthcare staffing models changed since the COVID-19 pandemic?
Many healthcare organizations are seeking ways to use resources that are available within their local communities to move forward in a sustainable way. For many hospitals, this means bringing licensed practical nurses (LPNs) back into the hospital setting to help RNs with basic medical tasks, such as checking vital signs and administering medication. For others, it means seeking creative ways to deploy specialized skill sets to take the burden from the bedside caregiver and enhance care delivery. For example, this may look like using virtual nurses to give discharge instructions or using a SWAT team approach—in which a nurse makes rounds throughout the hospital until called for assistance—to respond to falls or central line errors. We are also seeing more aggressive work from health systems to build systemwide staffing pools and to manage patients more strategically in alternate settings.
What are the key drivers for the healthcare staffing shortage?
Since long before the pandemic, we’ve known nursing is an aging workforce. The pandemic expedited many nurses’ existing plans to retire. Travel nursing also exploded during the pandemic. With such a high demand for nurses in cities that were known for being COVID “hot spots,” travel nursing became extremely lucrative. I’ve also heard from many new nurses who graduated during the pandemic that they left the profession because they didn’t really understand all that was involved in nursing—such as coordinating care with other clinicians and providers, long shifts, and attending to patients’ physical and emotional needs—as a result of their lack of clinical experience.
How can leaders think differently about providing care when experiencing staffing shortages in healthcare?
Leaders shouldn’t work in a vacuum when brainstorming new ways to think about staffing. It’s critically important for leaders to engage their team—including providers, nurses, and other caregivers—to co-design healthcare staffing solutions.
It’s also important that leaders understand their staff’s workload and align appropriate resources. Although that may sound obvious, you would be surprised at the number of unit leaders who don’t understand unit volume, are not predicting staffing needs based on history, and aren’t consistently scheduling based on employment status.
How can healthcare organizations reduce expenses without sacrificing quality?
During the pandemic, most healthcare organizations drifted from existing structures for frequently validating staffing needs, justifying position requests, and reporting historical staff productivity trends. To reduce expenses and maintain quality, it’s crucial to analyze these structures and roles with an eye toward value.
3 steps to a targeted healthcare staffing plan
Press Ganey’s strategic consulting team offers a solution designed to remedy healthcare staffing problems. Our three-step solution results in a targeted plan that can quickly be deployed to address deficits in unit or organizational structures and processes to help organizations quickly reach their goals. We understand that healthcare leaders don’t have an appetite for a long, drawn-out process—they need relief now. We try not to overwhelm leaders with data collection and unnecessary tasks. Instead, here’s what you can expect when you work with us.
Step 1: Validate the current state of your organization
Oftentimes, organizations focus on solving staffing problems in one department or unit, such as the emergency department or intensive care unit. Press Ganey’s healthcare staffing consultants start with a “current state validation,” a two-day assessment to understand organizational goals and objectives.
We do a gap analysis to learn about the organization’s or department’s existing challenges, how they’re operating on a daily basis, and what their expectations are. This often looks like a deep dive into the finances of the department, staffing models, and determining if staff are working at the “top of their license.” From there, we develop a set of recommendations specific to that organization or department.
Step 2: Work with key stakeholders to develop road map and co-design
After developing recommendations, we meet with key stakeholders—and often senior leaders—to review and determine what should be addressed in the short term, in the long term, or not at all. During this phase, we identify a leader at either the organizational or departmental level and other employees of the organization to champion the plan. We also determine key metrics to monitor progress and create standard work structures and processes for sustainment.
Step 3: Redesign and implement new or revised staffing and care delivery models
When it comes time to implement new or revised staffing and care delivery models, Press Ganey's team of strategic consultants creates targeted education to fill knowledge gaps and offers a 12-week 1-to-1 coaching style to co-design and implement change at the department level. Throughout the implementation process, we provide ongoing leadership and team support to ensure improvement and sustainment.
Delivering a healthcare staffing consulting solution that improves your bottom line
When healthcare organizations work with a healthcare staffing consultant to combat staffing shortages, they see improvements in areas including:
- Improving infection-related outcome data, such as CAUTIs and CLABSIs
- Reducing Serious Safety Event Rates (SSERs)
- Saving approximately $60 million in annual labor costs
Ready to transform staffing at your organization? Reach out to one of our staffing consulting experts.