Hospital staffing involves a complex balance of patient census, acuity, bed availability, budgets, clinician schedules and specialty care coverage. Maintaining adequate nurse-to-patient ratios and access to diverse medical expertise around the clock poses continual challenges for hospital leaders.
Staff Shortages
Hospitals across the country grapple with higher clinician turnover and open vacancies they struggle filling. Reasons range from pandemic burnout prompting resignations to inadequate nursing school graduates entering the workforce. Staffing shortfalls pressure existing nurses, physicians and technicians into unsustainable patient loads and overtime. Unfilled shifts then decrease patient access and satisfaction when bed closures or service reductions occur. Hospitals often partner with hospitalist staffing companies like SouthlandMD who provide contracted travel nurses, advanced practitioners, and hospitalists. Bonuses and personalized support roles further empower internal teams managing heavier work obligations.
Scheduling/Census Fluctuations
Since hospital patient volume and acuity vary unpredictably day to day, assigning appropriate daily staff numbers poses challenges. Scheduled surgeries, clinics and discharge patterns influence morning patient influx before unpredictable urgent cases arrive later. Census ebbs and flows. Setting static clinician schedules unable to flex with volumes leaves some daylight hours over-staffed while nights and weekends starve for personnel. Savvy department leaders utilize acuity-based staffing models with dynamic scheduling options supported by supplemental staffing vendors to better match experienced personnel wider patient demands.
Specialty Imbalances
Many hospitals’ emergency departments bottle up from insufficient downstream bed availability when higher level patients get admitted. Staffing generally focuses more on medical units than equally important surgical, cardiac, neuro, pediatric and obstetric beds. Step-down and telemetry units also tend to suffer short staffing for new cardiac and orthopedic service lines. Executives work closely with staffing agencies providing short-term OB/GYN, psychiatric, or other specialty clinicians until permanent departments expand or pending recruitments achieve better coverage equity.
Staffing Solution Recommendations
Flexible Staffing Partnerships
Contracted travel nurse staff, per diem hospitalists and other agency clinicians seamlessly fill temporary or prolonged staffing gaps across specialties. National staffing firms deploy experienced staff versed in multiple state practices and hospital protocols from prior travel assignments. Supplemental teams expand hospitals’ capabilities, absorbing clinical and workload fluctuations.
Advanced Practitioner Empowerment
Hospitals expand patient access and better leverage physicians by granting nurse practitioners and physician assistants greater practice independence, managing lower complexity patients. Similarly, registered nurse first assistants (RNFAs) take surgical burdens off surgeons’ shoulders. Through credentialing and privileges aligned with competencies, advanced clinicians offset staffing deficits.
Creative Shift Options
Hospitals entice more applicants by promoting abundant shift flexibility and career pathways. Options like job splits, partial telecommuting/remote work, teaching opportunities and compressed weekend-only schedules attract talent. Current staff opting into 10 or 12-hour shifts often accept extra shifts for increased hourly pay thereby expanding staffing coverage.
Role Redesign and Cross-Training
Overlapping similar duties across roles allows hospitals to train certain staff across disciplines. Medical assistants checking patients in at clinics might also obtain EKG certification or phlebotomy training to assist nurses on busy floors if needed. Some hospitalists provide ICU coverage at nights or vice versa intensivists consult on medical/surgical units when census allows.
Staff Wellbeing Focus
Enhancing staff resilience and loyalty pays dividends in consistent staffing from lower turnovers. Celebrating diversity while connecting employees to the hospital’s broader purpose also inspires engagement amid stressful healthcare environments.
Conclusion
The number of solutions now available for smoothing hospital staffing deficits continues growing exponentially. Healthcare executives would do well in collaborating with hospitalist staffing companies and engaging frontline staff for innovative enhancement ideas. Tapping supple human capital sources within and beyond hospital walls means leaders secure the flexible staffing coverage and expertise needed to keep advancing community care quality this decade and beyond.
