Healthcare organizations across the U.S. have grappled with healthcare staffing shortages since well before the COVID-19 pandemic. Contributing factors are an older workforce, limited capacity of nursing schools to meet growing demand, and an aging population experiencing more chronic diseases. The pandemic worsened these shortages, reducing the number of registered nurses nationwide by over 100,000. Many organizations view the healthcare staffing crisis as a long-term problem that requires more than temporary solutions. Read on for seven strategies that healthcare organizations are using to help mitigate the staffing crisis.
1 – Provide more incentives for healthcare providers to stay in their jobs
One of the best and most obvious retention strategies is to consider what more you can feasibly offer to current and prospective staff members. According to our 2022 Nurse Salary Research Report, nurses are clear on the top measures that will attract and retain them, including:
- Higher salaries
- More flexible work schedules
- Sign-on bonuses and relocation packages
- Loan forgiveness
- Tuition assistance
- Incentives for pursuing certifications and other career development opportunities
- Enhanced benefits, such as better retirement plans and childcare discounts
Healthcare leaders must weigh the financial impact of providing more of these incentives beyond what they already offer. Compare the risk of carrying a high number of vacancies, which could threaten your quality of care, to the financial impact of offering additional employee compensation or benefits.
Could your organization attract and retain more qualified staff who will provide a clear return on your investment of additional incentives? Improving staff retention could pay off in terms of an increased capacity to deliver care. Depending on your location, reducing turnover by just 1% can save the average hospital $262,300 per year. Adding a new employee incentive or two could cost considerably less.
2 – Provide more reasons for your healthcare staff to be at work
In addition to increasing headcount, consider tactics to increase daily capacity. It is critically important to allow staff to take time off for personal and family reasons to help support their health and well-being, but individual employees may have motivations for working more hours.
Overtime pay or the ability to cash in PTO could motivate some staff members to put in more hours on the job. The Centers for Disease Control (CDC) suggest asking staff to postpone elective time off to help mitigate staffing shortages while still allowing employees to take the time they need for mental health breaks, caregiving responsibilities, or social factors such as transportation or housing issues.
A larger concern is whether your organization provides an environment where healthcare staff members feel valued, engaged, and interested in being at work. Younger generations of healthcare staff members want to work for an organization that shares their values.
An organizational culture that goes above and beyond to reward employees cultivates loyalty and passion for an organization’s mission that translates to less absenteeism. Employees who want to be at work help ensure organizational success, especially in times of crisis.
3 – Maximize staff coverage through strategic placement and scheduling
As with any resource that becomes scarce, the value of your existing staff increases as it becomes harder to hire and/or replace employees. Healthcare organizations must cultivate their teams by working to understand the skills, knowledge, preferences, aptitudes, and potential for leadership of each individual team member.
Assess every staff member for knowledge and skills that could be underutilized. Look for ways to maximize each person’s potential to serve your organization in new capacities. A crisis could present opportunities for these staff members to advance sooner. Individuals could show potential for moving into areas or specialties that have the greatest need, benefiting both the employee and the organization. A good onboarding and assessment solution can help identify individuals who have the potential to serve your organization in new ways and help you place them in new roles appropriately.
Practical considerations involving strategic utilization include how you deploy your staff. In its guidance on responding to healthcare provider shortages, the U.S. Department of Health and Human Services emphasized monitoring staffing availability and needs frequently based on census and acuity, clinician-to-patient ratios, coverage within units, and staff on call. Monitor your numbers and teams during every shift to send resources where they are most needed and can make the greatest impact.
4 – Identify and continuously cultivate sources for supplemental staffing
During the height of the COVID-19 pandemic, New York City became an epicenter of the virus outbreak. Its public health system, the largest in the U.S., had to respond quickly to a crisis of a magnitude never previously seen. Tactics the city used to acquire more staff included redeploying existing healthcare staff but also reaching out broadly to find new sources of staff who could come on board to help fulfill the rapidly growing need.
The city recruited heavily and urgently through staffing agency contracts they already had and solicited additional staffing agencies, both public and private. The city also worked with labor unions and through its own health system to bring in practitioners from other medical fields, including dentists, pediatricians, primary care providers, and school nurses.
Administrative positions can also help take some of the non-clinical burden from your staff to free up more time and resources for patient care. Can you reassign any activities not directly related to serving patients to other individuals who could serve these functions? Think of workflow modifications that could support healthcare teams and allow them to concentrate on care activities.
“One consideration is to reach out to former colleagues who have retired from the organization to assist in mitigating a healthcare staffing shortage,” said Felicia Sadler, MJ, BSN, RN, CPHQ, LSSBB, Patient Safety and Quality Executive at Relias. “A nurse or provider who has recently retired, for example, could return to help see your organization through a crisis.”
While these individuals may not stay indefinitely, maintaining relationships with retired staff could make a difference and bring valuable skills and expertise back on an interim basis.
5 – Consider arrangements with other care facilities and organizations
Reaching out to your health system or other organizations to consider partnerships could be a way to develop a larger supply of clinicians to expand coverage. Some health systems have created their own staffing agencies for this purpose. For example, CommonSpirit Health developed an internal agency that gives nurses flexibility to travel while retaining seniority within their existing organization.
As an added benefit, nurses within an agency have the same foundation of training and know the policies and procedures of the larger organization. Patients receive the same quality of care even though these nurses may work at multiple hospitals within the system.
Working with an internal agency could also help a health system avoid unexpected market fluctuations that affect the salaries of travel nurses. During the pandemic, reports of price gouging by independent nurse staffing agencies caused U.S. lawmakers to urge the White House to investigate on behalf of hospitals.
6 – Selectively cancel non-essential procedures, visits, or services
While not ideal, if your healthcare organization foresees not being able to maintain the level of quality you’ve worked hard to achieve due to a staffing shortage, leaders may need to make the difficult decision to eliminate certain services. If patients have other options within the community, it may be best to focus your resources where you have the greatest impact.
During a regional or global crisis, it could be necessary to postpone or drop some services. In these cases, your organizational reputation might not be adversely affected, and core offerings could be streamlined for more efficiency. Doing only what you do best, for the greatest amount of public good, can be a sound business decision to ensure the long-term health of your organization.
As a general trend, cutting healthcare services within a community can signal difficulty for patients who can no longer obtain the care they need. However, organizations might have no choice to ensure their survival in a difficult economy.
In some cases, it could be possible to reduce care without compromising quality. For example, the state of Washington began discharging some patients who would have previously had longer stays, instead recommending recovery at a post-acute care facility such as a skilled nursing facility or long-term care center.
7 – Reexamine COVID-19 protocols to clear staff members to return to work earlier
With the steady production and availability of vaccines, organizations might be able to reassess their protocol for allowing healthcare providers to return to work after illness, whether from COVID-19 or other causes. A lower probability of outbreak, less severity of disease, and more familiarity with protective measures all mean that staff might be able to return to work sooner, resulting in less impact on the organization. The CDC published its guidance on return-to-work guidelines for healthcare providers who experienced illness or exposure to the virus and provides updates as these recommendations change.
Understanding the pattern of outbreak and containment of the COVID-19 pandemic also helps the healthcare field prepare to respond to other global health events, such as Monkeypox and flu. Returning to normal levels of staffing after COVID-19 provides relief to organizations, and the contingency planning measures they learned will help lessen the impact of the next crisis.
Reducing Turnover: Top Priority for Hospitals After COVID-19
The COVID-19 pandemic exacerbated an already pressing labor shortage for healthcare organizations, making the need to retain nurses to ensure consistent, quality care for patients — and stability and growth for hospitals and health systems — seem like a distant dream.Read the white paper →