PERSPECTIVE

Throwing Cash at Workforce Shortages Hasn't Worked, Here's What Will

Despite increased labor costs, hospitals are still understaffed. We need to address the root cause of staffing shortages with both short and long-term solutions.

Gregg Miller , MD

Chief Medical Officer

Published June 06, 2022

Providers sitting on the ground feeling the pressure of staffing shortages.

An alarming 13% of U.S. hospitals reported critical staffing shortages in January 2022. Most hospitals have scrambled to fill these gaps with short-term contracted staff. As a result, labor costs (which account for half of all hospital expenses) have skyrocketed nearly 20% above pre-pandemic levels.

Unfortunately, this avalanche of spending hasn’t fixed the problem. Many hospitals remain understaffed, and especially dire, as hospital-acquired infections are rising nationwide. And nurses are pressuring health systems to staff up for safety’s sake.

While short-term staffing will help solve the immediate problem, it’s rarely sustainable.

Two Challenges with Impacts on Quality of Patient Care

Low-level workforce shortages are the norm for many hospitals. However, the pandemic greatly aggravated the problem. Departments that were chronically short two nurses per shift before are now down five. This can strike a huge blow to quality as long wait times, slow lab turnaround, and delays in pain management take their toll.

This scenario has real-life costs to patients, hospitals, and communities. How can our industry curb runaway spending on contract labor and implement more sustainable solutions? To answer this question, I think we need to focus on both short-term and long-term fixes.

Short-Term Solutions in Healthcare Staffing Shortages

While short-term fixes don’t address the root causes of the staffing crisis, they do provide timely relief to the department’s pain points. Vituity clinicians have innovated several workforce solutions that hospitals can adapt in a staffing pinch:

Clinical Care Coordinators (CCCs). To meet the demands of surges and shortages, Vituity has been training nonclinical staff (usually senior scribes) to take on additional tasks. CCC duties include answering calls, assisting with paperwork, rooming patients, expediting lab and pharmacy orders, and restocking supplies. This frees nurses, techs, and unit secretaries to focus on higher-level tasks that require their training.
Provider in triage. Vituity clinicians often team up with triage nurses to expedite emergency care. When nursing shortages are acute, our advanced providers occasionally triage patients alone. This frees up one more nurse to focus on bedside care. We emphasize that this is a temporary solution that’s never intended to replace the nursing role.
Keeping patients vertical. The success of Vituity’s Rapid Medical Evaluation® in the emergency department has shown that lower-acuity patients can be effectively managed from the waiting room. This approach has been especially helpful during staffing shortages. A child’s ear infection, for example, can be easily diagnosed and dispositioned without bedding the patient. This not only saves staff hours—it often gets the family home faster.

Long-Term Solutions to Medical Staff Shortages

While quick fixes support hospitals through staffing crises, they’re just the beginning. It’s mission critical that hospitals not only retain current nurses but also find ways to work smarter.

As a physician partnership, Vituity usually has no direct role in hiring or supervising nurses, therapists, techs, or hospital staff. However, we can and do use our influence to impact the satisfaction of every team member at our practice sites. Here are a few of the ways we’re building more resilient workplaces (and hospitals can too):

Teamwork focus. Every member of the healthcare team contributes value, and healthy workplaces recognize this. Vituity leverages a multidisciplinary committee structure to drive operational improvement. This body is co-led by the medical and nursing director.
Learning collaboratives. Vituity regularly brings together 8-10 site leadership teams to master best practices and drive rapid improvement. Participants generally include nursing, medical, and executive leadership. In addition to learning new skills, participants engage in team building. At a recent ED throughput collaborative, sites competed to change tires in a pit-stop simulation. The activity got a lot of laughs and rave reviews from participants.
Educational opportunities. Nurses and allied health professionals love to learn but have little time for formal study. Vituity physicians fill this gap by offering on-site workshops, journal clubs, grand rounds, and on-the-job learning opportunities.
Efficiency improvements. The best way to mitigate the long-term effects of staffing shortages is to decrease demand while increasing capacity. At Vituity, we use every tool available to tighten up our workflows, so no one wastes time on unnecessary tasks. Examples include implementing provider-only discharges, nixing unnecessary orders, and keeping lower-acuity patients vertical. When planning care, we also consider human factors. There’s no need for a nurse to administer IV antibiotics if oral ones work just as well.
Culture of brilliance. For better or worse, workforce shortages amplify cultural values. Is your medical staff willing to answer call buttons and change sheets when the nurses are stretched thin? Vituity culture emphasizes going above and beyond to do what’s best for our patients and hospitals. For actionable insights on culture building, check out this Harvard Business Review article from our CEO.

Workforce Resilience or the Long Haul

While I expect the current workforce crisis to ease, staffing shortages will likely remain endemic across our industry. We must invest in intangibles like culture, engagement, opportunity, and efficiency. Engaged clinicians enjoying meaningful careers will contribute exponentially more to our organizations and the communities we serve.

Partnering to improve patient lives

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