Problem Solving During a Staffing Crisis (and the Importance of Supplemental Healthcare Staffs)

When an acute staffing crisis strikes, because of a fire, flash flood, hurricane, tornado, earthquake or a virus pandemic, whether you are a part of a standalone healthcare facility or a multi-hospital system, it can be challenging to meet operational demand in support of your patients. A rapid assessment of current available resources and staffing is the first step in a four-prong approach, as described by Rosemarie Aznavorian, DNP, RN, CENP, CCWP and CCRN-K, MedPro Vice President of Client Services and Chief Clinical Officer, who has extensive experience in crisis staffing management.

A recent report from Precedence Research estimated that the healthcare staffing market will surpass $47.5 billion by 2027, including a compound annual growth rate (CAGR) of 5.1%, starting in 2020. This new estimation comes on the heels of one of the most-unprecedented viruses in world history. The COVID-19 pandemic has spotlighted the nursing shortage that was realized even prior to the outbreak and has also foreshadowed just how much supplemental staffing is needed now, more than ever.

“It’s important to know that, back in 2010, the Institute of Medicine did a report on the Future of Nursing and it foreshadowed the possibility of a 1.2 million RN shortfall by 2024,” said Aznavorian. “It also outlined several strategies that needed consideration to meet operational demand. That was all obviously before the Coronavirus outbreak. Numerous scenarios led to the prediction of the shortage, prior to the coronavirus, one of which being nurses leaving the profession, whether due to retirement, burnout or in accepting assignments outside of frontline nursing. When these nurses do make their exit, they take with them, the clinical intelligence and the experience needed to care for patients. The other issue is on the academic side. There are not enough nursing institutions with the necessary amounts of professors to be able to meet the demand of the nurses that are needed. Plus, the cost of education is significant, depending on where you go to school. In essence, we have more people exiting the profession than we do those coming in.”

Safe patient care and ensuring they are in secure environments is dependent on prioritizing the following Aznavorian’s four-tiered approach. The first, a rapid assessment of currently available resources demonstrates the need to implement a centralized staffing command center. The second, a 360-degree view of both clinical and non-clinical staff calls for the optimization of internal staffing. A gathering of resources for floating staff is necessary in meeting the third requirement, considerations for staff deployment and, the final step, leveraging supplemental staffing partners, which is sought when internal resources are unable to meet demand.

Rapid Assessment of Currently Available Resources

Establishing a centralized command center provides a singular means for a deployment of resources, but also in where all necessary resources are currently being housed, making distribution easier and workflow less redundant. The command center needs to surround leaders who can make rapid decisions and can implement them in directing patient flow and care.

  1. Launching a staffing command center for a standalone facility should include the following employees: senior leaders, representatives from all nursing units, administrators, information technologists, security leaders, support services, supply chain and emergency management, as well as a staffing specialist and human resources professional.
  2. When establishing a staffing command center for a multi-hospital system, it should include: system senior leaders, nursing and support service representatives from each facility, system-wide human resources, information techs, security, emergency management, supply chain and centralized staffing leaders. There will also be a need for bed planning and transfer center representatives, if applicable.

“There are a lot of moving pieces in acute staffing during a crisis. The first component is the ability to assess who and what you have, where are the nurses geographically located, what competencies do they have and the status of the supply chain. Every hospital system is required to have an organizational and business continuity plan. So, when circumstances lead to an influx in patients, but not necessarily the room to house them, having a plan in place with surrounding institutions to allow for transfers, if needed, is critical. It is all about capacity and patient flow. It is important to have a line-of-sight for that,” stated Aznavorian. “This is where administrators come in and why a centralized number to the command center is important as well, to avoid miscommunication. This is also why staffing companies are vital to the healthcare system. Without a sold infrastructure, they would not be able to deploy.”

Optimization of Internal Staffing

Assessing the actual, physical location of all clinical and non-clinical staff provides a real-time line-of-sight for resource management, health tracking and infection-control surveillance. Based on acuity areas and competency, staff is then deployed at necessary volumes. In some extreme cases, per the National Council of State Boards of Nursing (NSCBN), an emergency declaration waiver by each state allows for floating staff from other states to assist in patient care, if they are not part of the compact licensure.

Considerations for Staffing Deployment

Assistance is sought from floating staff with numerous specialties and across different campuses of multi-hospital systems during a crisis or different units of a standalone facility. Each will need resources and access, per the command center, in providing optimal patient care, such as badges, supply chain support, electronic health records (EHR), infusion pumps, beds and other automated medication and resources.

Leveraging Supplemental Staffing Partners

When standalone facilities and multi-hospital systems are unable to meet demand, supplemental healthcare support is needed from staffing agencies. For instance, MedPro Healthcare Staffing, along with MedPro International, has nurses and allied health professionals, who are all readily deployable. Response to fill requests can vary, but a Managed Service Provider (MSP) agreement offers exclusivity to fulfill staffing needs. In conjunction with priority fulfillment, a single invoice for services, full credentialing and profile procurement are among the rewards of having an MSP.

“Hospitals have strategies for business continuity in preparing for these times. Some are proactive and others are reactive, based upon the crisis. In my experience, working for a multi-hospital system, one of the areas focused on was in supplementing our staff with nurses who are committed to the mission, vision and values of that organization,” Aznavorian said. “Utilizing supplemental staffing agencies is a strategy that should always be in place and, if done in alignment with internal resources, depending on the size of the hospital, usually breaks down as a 70-30 split, in favor of a core crew.”

The importance of utilizing a supplemental staff from agencies is apparent, given the current healthcare climate. There is tremendous value in partnering with agencies, like MedPro, that offer both short-term travelers, as well as long-term foreign-educated healthcare professionals.

“There are two important aspects which, for me, separates MedPro from the competition,” said Aznavorian. “I’ve worked with our CEO, Liz Tonkin, RN, for over 20 years in several engagements and have watched her take this startup company and shepherd it to where it currently stands today. There are not a lot of CEOs with the kind of experience she has, which includes both clinical and business acumen. The other, is that we are clinician led. That makes for a huge difference with both the candidates and client, alike. We are able to go out and speak to the benefits of both the business and clinical sides, which adds value.”

Please note: Additional information surrounding the Four-Prong Approach can be found in the forthcoming December, 2020, issue of AONL Nurse Leader Journal.

Consider Partnering with MedPro for an Overall Workforce Solution

MedPro is among the top staffing companies in the country and leading healthcare providers trust us to fulfill their staffing needs. We can help support you in providing a consistent and reliable service delivery, whether you are seeking qualified short-term travel nurses, allied professionals or long-term foreign-educated healthcare employees. To learn more, visit MedPro and MedPro International, Submit a Job Order or call us at (800) 866-8108.

Author: Michael Stagno

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