Jackie Larson, President, Avantas
At the beginning of the year, I reflected on how looking into our past can leverage our vision on the future. At the time, I had no idea the coronavirus was lurking around the corner ready to disrupt everyone’s plans and cause devastation across the globe.
The majority of us have never lived through a public health situation like the current pandemic, and it has altered everything from where and how we do our work, to how we interact with each other, to how our children learn.
Once the threat of the virus has been lowered and we are able to more safely interact with one another, there are likely to be some things that won’t be removed entirely. The rise of telehealth appointments has brought a convenient way for people to access medical care and eliminates the risk of being exposed to illness of others in a waiting room.
The adoption of working from home has eliminated lengthy commutes that pollute the air, allowing cities around the world to see a significant improvement in air quality that they haven’t seen in decades.
While many of us have adapted to these changes, we will soon enter into new territory as we sail into flu season. Beginning this fall, the flu season will coincide with the continuing COVID-19 pandemic. Healthcare organizations will administer mass vaccinations for flu at the same time they are screening everyone for COVID-19 symptoms.
The Double Virus Dilema
While symptoms for COVID-19 and seasonal flu are different, the screenings during mass flu inoculations and the rise in people with seasonal flu symptoms fearing they have COVID-19 could increase the number of people seeking testing and treatment for coronavirus. The national focus on the pandemic also could result in many people overlooking the need for seasonal flu vaccinations. This could result in more people getting sick with the flu and winding up in doctors’ offices, clinics, urgent care, and emergency rooms.
The patient caseload for seasonal flu will be concurrent with the COVID-19 caseload. Healthcare organizations will need to deal with both at the same time, which could put a significant strain on the existing workforce.
To prepare for this situation the first course of action is to understand and solve issues that diminish the available supply of hospitals’ most valuable resources – core staff.
Core Staff Availability
Core staff is defined as full- and part-time employees who are assigned to a single department and are working within their designated FTE.
Initial improvement steps may include:
- ANALYZE factors that are impacting the supply of available core staff.
- INVESTIGATE further to gain a full understanding of trends especially damaging to staffing outcomes. The following are two examples of issues that may be uncovered:
- FTE leakage is particularly harmful. Hours dedicated within a budget for core staff FTEs but are not scheduled or worked have “leaked” from available staff resources.
- Same-day or near-time absences can derail any staffing plan. Carefully analyze past events by day of the week, shift, department, and individual to plan the depth of replacement staff that will be needed.
- PLAN improvements to address each issue discovered. Set goals and timelines and report results. Once initial goals are met, take actions to hold the gain and move on to the next set of improvements.
Improving core staff availability is a great first step, but it is not the full remedy to every staffing woe. Once these improvements are underway, it’s time to consider contingency staff availability.
Contingency Staff Availability
Contingency staff is defined as all those except full- and part-time employees who are assigned to a single department and are working within their designated FTE. This would include core staff members working above their FTE, including overtime.
Initial improvement steps may include:
- ANALYZE demand for contingency staff to fully understand the minimum and maximum required depth to right-size expansion and contraction capacity.
- DEFINE the purpose of each segment of contingency staff, assigning highest value and depth to layers with the greatest float attitude and aptitude. Seek adaptability.
- Limit unit-based PRN to extreme cases of clinical competency such as burn unit or high risk OB.
- Dedicate the highest volume of hours to an internal float pool tiered according to the needs of the enterprise.
- Include meaningful use of external agencies who have proven ability to supplement with high-quality staff in times of high need.
- Prevent burnout by reserving core staff working above the FTE, including overtime, to times of most extreme need.
- PLAN infrastructure needs, including selection and competency models, similar to other proven and successful models. Give contingency pools a distinct identity including leadership separate from core staff.
Begin to drive uncertainty out of your staffing plan by using these strategies and continue on the road to success by adapting more advanced methods. It’s a worthwhile journey out of potential chaos.