High patient volumes, an aging staff, and healthcare workers' growing demands for flexibility can be surmounted with a few strategic management moves.
Healthcare continues to grow to the tune of expected job growth of 2.3 million new jobs between 2014 and 2024, but there's a downside to that growth, says Susan Salka, CEO and president of AMN Healthcare, a healthcare staffing company based in San Diego, CA.
"Many organizations are at the highest vacancy and attrition rates ever seen," says Salka.
SSM Health, a St. Louis, Missouri-based health system with 20 hospitals in four states, is scrambling to meet these challenges, says Kathy Starnes, SSM Health's system manager of staffing.
"We've been pretty busy," she says.
Through careful recruitment, retention, training, and planning SSM Health has to not only remain competitive, but to continue growing.
These efforts have helped the health system avoid or minimize three causes of staffing gaps:
1. More Patients Seeking Care
"This all started about two years ago, with a surge in volume we thought was temporary," says Starnes.
The increase in patient volume came as a shock to Starnes and her colleagues.
What's causing it? First, unemployment is the lowest it's been since 2008. Patients who are covered by employer-based health plans may be receiving care they might otherwise have put off or gone without.
Also, the Affordable Care Act has reduced the number of uninsured Americans by 16 million. Not only can more Americans buy health insurance from the exchanges, but young people can now stay on their parents' health plans until age 26. And patients cannot be denied coverage due to preexisting conditions, which means more patients have the opportunity to seek care.
But the volume never dropped—it only continued to rise. It soon became apparent that higher patient volume was the new normal. SSM is not alone; most healthcare organizations are reporting an increase in patient volume.
Since high volume is apparently here to stay, SSM has started banking on it.
The health system is focusing on expanding community access through affiliated retail clinics and increased ambulatory staffing, which has helped keep hospital patient volume under control, says Starnes.
2. An Aging Workforce
In 2012, 43.1 million Americans were age 65 and older—that number is expected to more than double by 2050.
Older patients often require more care, both preventative and urgent, which drives volume up, but clinicians are retiring faster than medical schools can turn them out.
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"I've been in healthcare for many years," says Starnes. "Over the past two years, I've seen more of a gap, with clinicians moving out of the workforce as the baby boomers are exiting." The need for more OR workers is especially acute: "[OR] is not a [skillset] you come in to the workforce with," she says.
SSM has started offering training to workers with strong track records and an interest in OR work in a "grow-you- own" program, and has used staffing agencies to provide workers as needed.
Nurses are particularly difficult to replace, Salka says. "Every nurse counts. We need to do everything we can to optimize our nursing staff… [while] ensuring that they're appropriately scheduled," she says.
3. Workers' Demands for Flexibility
As younger clinicians and workers replace those who are retiring, they are demanding more flexibility in both responsibilities and hours than their predecessors.
"The newer generation wants a variety of work and new opportunities," says Starnes.
"I think, with multiple generations in the workforce, there are different perspectives on work and life balance. We're looking at how we will adapt to newer generations coming into the workforce."
3 Strategies for Retaining Millennial Employees
And it's not just millennials demanding increased flexibility. Some older workers aren't ready to retire, but can't work 12-hour shifts anymore, says Starnes.
SSM Health's in-house training program has helped the system retain employees who crave more opportunity. The organization has also started allowing workers to self-schedule using workforce management software.
Managers retain the ability to adjust employee schedules as needed the ensure proper coverage. "Flexibility is important," says Starnes.
Lena J. Weiner is an associate editor at HealthLeaders Media.