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In 1999, the Institute of Medicine published its landmark report “To Err Is Human” about medical errors and patient harm. One proposed solution was to utilize technology in increasing amounts to enhance patient safety. More than 20 years later, patient care technology is rapidly changing and transforming healthcare. From electronic medical records to barcode medication administration and much more, there are numerous advancements enhancing patient safety and improving outcomes.  

The challenges to the healthcare landscape have meant companies are looking to how improvements in technology can enhance patient safety while also making the always-demanding jobs of nurses and allied health professionals easier. Keep reading to learn more about the next-gen advancements improving patient care, healthcare staff retention, and workforce stabilization with predictive analytics.

How Hospitals and Health Systems Are Using New Tech in the Clinical Setting

Companies are developing new tech seemingly every day—but for larger organizations, there are challenges to implementation, education, and safety in rolling these out. The following are some trends impacting healthcare systems in technological advancements.  

Reducing Medical Errors

Electronic health records can enhance patient safety through promoting safe medication administration, among other considerations. For example, electronic medical record use reduced medication administration errors by 53% in emergency departments, reports a study in the journal Einstein. Incorporating clinical decision support tools into an electronic health record (such as recognizing drug-to-drug interactions) reduced medication errors by 11.7%, according to a study from the Pew Research Trust.  

Another example of technology supporting medical error reduction is radiofrequency identification, which uses computer-based systems to trigger pharmacies or supply managers when medications and supplies have expired within the hospital. These “smart” labels contain ready-to-read data the manufacturer applies when sending the product. As a result, professionals can remove expired and potentially harmful stock from reaching patients more quickly.  

Advisory Board explains how medical error reduction has many other technological applications:

• Fall Prevention: Schedule staffing reminders for patient rounding for those at high risk for falls.  

• Infection Risks: Quality and safety updates, protocols, and rounding implemented into healthcare professional dashboards can help to reduce infection risks for central lines and catheter-associated urinary tract infections.  
• Surgical Complications: Utilize patient algorithms to predict risks for adverse events, such as blood clots or sepsis.  

Medication Safety

The Agency for Healthcare Research and Quality (AHRQ) states that the most common medication errors occur during the ordering or prescribing stage or when the provider enters the wrong dose. Computerized physician order entry (CPOE) systems have dramatically decreased these and other medication errors. According to the AHRQ, one study identified a 78% increase in necessary medication discontinuation after utilizing the CPOE.  

Healthcare professionals utilize advancements to enhance patient safety by receiving drug allergy alerts and medication interaction warnings. These alerts can act as a safety check but help professionals retain the power to override warnings using their knowledge and discretion. An AHRQ study of medication overrides determined only 9.3% were inappropriately overridden.  

An extension of the CPOE and next-gen step in medication safety is to develop algorithms that identify patients needing medication follow-ups, including laboratory testing, medication reconciliation, or continued education.

Improved Communication Between Staff

Because poor patient-to-provider and provider-to-provider communications can result in delays and poor patient outcomes, the AHRQ reasons that enhanced communication can improve patient care. However, HIPAA-compliant communications systems remain a challenge to many healthcare organizations.  

Companies such as Microsoft and Cisco have released HIPAA-compliant video communications and file-sharing platforms that allow healthcare professionals to consult with each other and even message for assistance with needed tasks. Messaging on electronic health platform systems delivered securely to a healthcare professional’s smartphone enables enhanced communication. These allow busy professionals to complete their current tasks and securely communicate. These platforms also cut down on the large paper systems at many nurses’ stations where professionals had to search for needed phone numbers. Providers can connect more quickly by accessing the right person with a simple search.  

Remote Patient Monitoring

An article from Insider Intelligence projects that more than 30 million patients in the U.S. will use remote patient monitoring tools by 2024. Continuous glucose monitors, digital blood pressure monitors, and pacemakers transmitting information regarding heart rhythms are just some of the remote monitoring examples. The latest challenge for this field is miniaturization, or making these wearables smaller and comfortable enough so the general public can better embrace them. This tech allows health professionals to connect with patients and obtain more information to make care management decisions.

To read more about the latest advancements in remote patient monitoring, check out “How to Suppport Your Healthcare Staff with Telehealth and Telemonitoring”  on our Health Carousel blog.  

Healthcare Facility and Staff Benefits  

Technology isn’t always synonymous with improvements for staff—learning curves for new tech and software, plus seemingly endless additional demands for charting, present challenges. The superior technologies save nurses and allied health professionals time while enhancing patient safety.  

While new tech provides the “how” healthcare innovations can improve patient safety, a “why” must also exist. Organizations and professionals must weigh the potential benefits with the training and risks.  

Facilities can experience the following benefits with patient safety technology implementation:   

• Improved Staff Retention: Keeping hard-working and loyal staff is challenging for any healthcare facility. When healthcare professionals know they are providing safe care and have support through technology-based safety checks and algorithms, they feel best equipped to do their jobs.
• Improved Planning and Staffing: Stabilize your healthcare workforce with predicitive analytics. You can forecast your future staffing needs and lower costs, by utilizing internal technology platforms or with strategic staffing company partnerships. These efforts ultimately translate to better control regarding finances and patient care management.
• Maximized Staff Talents: Talented nurses and allied health professionals with leadership skills should be able to work at the top of their abilities. However, staffing demands and frustrations about the need for increased support can keep those who love to provide patient care away from the bedside. By streamlining processes whenever possible with enhanced technology, staff can practice at the top of their scope.

Staff can benefit from using enhanced technology in the following ways:   

• Providing Avenues to Keep Veteran Nurses Employed: Embracing tech allows veteran nurses to use their skill sets in knowledge, leadership, and patient education to shift from physically demanding roles when possible. They can train new healthcare professionals or those new to particular processes or tech.
• Freeing Bedside Professionals: Enhanced tech can remove or outsource non-hands-on needs, so those who wish to engage in direct patient care can do so.  

• Enhancing Opportunities to Retain Employees: Offering nurses the opportunity to advance their careers as virtual nurses once they gain experience, provides a new employee pathway that can help retain nurses wishing to attain more flexible nursing options.  

Patient Benefits

One of the most significant potential patient benefits is risk stratification for patients using predictive models. A constant challenge for health professionals is prioritizing: who to assess first, who is most at risk for adverse outcomes, and what medications they must give sooner. Artificial intelligence and computer-based algorithms can add a layer of protection by flagging who is most at risk based on even small changes in laboratory values or vital sign readings.  

Healthcare professionals are also using risk predictors to closely evaluate surgical patients in determining a patient’s acuity and needed data to gather before clearing a patient for surgery. These predictors help health professionals identify who needs added monitoring and nursing care. According to one study in Frontiers in Digital Health, preoperative evaluation clinics that evaluate high-risk patients have shown improvements in 30-day outcomes compared to those who didn’t participate in the clinics.  

Embracing technology offers additional patient benefits that include the following:

• A better understanding of their treatment plan by providing follow-up support and additional reliable resources
• A greater sense of control over their care and the comfort that can come from knowing a healthcare professional is monitoring them  

Patients are at the heart of any healthcare organization’s mission. Organizations must keep patients at the center when evaluating new tech options.

How Health Carousel Can Help  

Health Carousel's technology gives healthcare facilities more control with full transparency throughout the entire staffing process, and scalable, customized solutions. It means better fill rates, improved patient care, and lower costs. We also track healthcare delivery trends, with key focuses on recruiting and placement, and uses these market insights to design effective solutions. Some of the ways we accomplish this include the following:  

• Digital Talent Acquisition: We use an innovative recruiting engine that captures the customer’s needs in regards to assignment lengths, skill sets, and geographic locations (including international placements). This enhanced process allows applicants to self-qualify for potential placements through our talent portal technology.
• Vendor Neutral and Sustainable Solution: We use a revolutionary technology created specifically for healthcare leaders with real-time reporting on performance and other key metrics. It’s customizable and intuititve, so healthcare facility leaders can keep the focus on patient care while lowering costs.  

Health Carousel constantly seeks technology that streamlines our health partner’s experience to get highly qualified healthcare professionals to the bedside where they can care for patients. Patients, professionals, and the healthcare system benefit overall when staffing gaps are filled, and Health Carousel proudly plays this strategic role in healthcare efficiency.  

Click here to learn more about Health Carousel’s workforce solutions.  

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* This blog is part of the Digital Trends and Transformation series.

As little as 50 years ago, the concept of meeting a telehealth provider on a video screen to consult for an illness would have existed only in science fiction. According to Fortune Business Insights, telehealth is a $62.72 billion industry in the United States that presents opportunities for health companies to establish themselves in a field that has seen growing patient demands.  

Where is the telehealth industry going? Research projects the market to grow by more than $545 million from 2021 to 2028. These growth estimates are backed by enhanced user confidence and research supporting the efficacy of telemedicine in diagnosing and treating illnesses. One recently published study in JAMA on clinician concordance with telemedicine revealed that 90% of telehealth assessments are as accurate as in-person visits.

Organizations that don't have a current telehealth growth strategy aren't behind yet, but they could be if they don't consider how the service impacts patients and professionals. Virtual services enhance access to healthcare on the patient-facing side, but still require educated and trusted individuals to (literally) answer the call. Understanding how telehealth and telemonitoring can improve service lines while providing growth opportunities for staff allows healthcare organizations to capture the most significant financial gains and improve retention for core staff.

How Health Systems Benefit from Telehealth  

While profits are always a central consideration, health systems must also consider the additional benefits telehealth offers to service lines and employees. Consider the following four telehealth advantages that answer "why" telemedicine should be a part of a system's overall strategy.

Stay Competitive with Non-Healthcare System Platforms

From CVS to Lemonaid Health, every company wants a piece of the telehealth market. While non-healthcare systems are building their presence in the space, they can’t have what hospital systems do, which is an established name and reputation for providing care.  

Patients not only come to a healthcare organization for one-time care, but they’re also often on a health journey for preventive care, wellness efforts, and chronic conditions management. At each step of this journey, the health system should position professionals who can represent the organization's philosophy and mission through in-person and telehealth care. The effect enhances consumer loyalty while preventing the need to shop around for outside telehealth services.

Add Flexibility for Core Staff

Blending remote and in-person work for core staff can offer retention and service diversification benefits. Remote can also help reduce burnout and dissatisfaction among core staff.  

In Health Carousel’s recent Nurse Retention Study, 1000 nurses were surveyed about their career plans.  

• 58% of nurses surveyed reported they were feeling burnt out in their current career
• 89% said they want freedom of choice and flexibility in their career
• 76% indicated they prefer to have consistent hours/schedule for their job, which is difficult when understaffed

While preventing all staff turnover certainly isn't possible, this study and previous research indicate autonomy, schedule stability with some flexibility, and overall job satisfaction are critical players in retaining core employees. Employers can more effectively retain loyal employees by increasing staffing ratios and offering variety to core staff whenever possible.

Increased staffing ratios mean the ability to offer new services or build up staff levels in existing services. Through this model, hospitals and healthcare systems can also create new  departments or move existing staff into leadership or remote positions based on their skills.

Expand Medical Borders  

Digital transformations have created new pathways to care in a wider world of medicine. Thanks to increased interconnectedness of the medical community and consumer-like nature patients have adopted, means patients can go beyond their area for needed procedures. They can seek out a highly specialized surgeon, a well-known hospital system, or a renowned recovery and rehabilitation team.

Health systems can also look outward to expand potential patient population. They can use telemedicine platforms to offer consults and virtual system visits, allowing patients to evaluate a facility before traveling for a procedure. Hospitals will need continual organization and coordination, including follow-up to answer questions and ensure the interested patient is not "lost" in the day-to-day shuffle. Patients can utilize telehealth services for post-procedure follow-up.

Retain Staff Looking for New Opportunities  

Not all healthcare professionals who leave a department leave nursing entirely. An estimated 90%of those who leave a particular job remain in healthcare, while 50%of those who quit one hospital unit simply move to another. With this knowledge in mind, healthcare administrators need to recognize that core staff may require additional opportunities that allow them to stay at an organization while engaging in different work forms to enhance their employee satisfaction.  

Enter remote opportunities: An estimated 70% of people worldwide work remotely at least once per week, and 53% work remotely most days. Healthcare professionals are the second-highest remote working industry (12%) after the professional services industry (17%).  

The potential applications for remote e-work are many and include the following:

• Case manager  
• Online nurse educator  
• Health coach  
• Patient advocate  
• Telehealth nursing  
• Telephone-based triage  
• Utilization review nurse  

Having available remote opportunities allows a unit to flex as needed during low and high census. Helping the organization run more efficiently and diversify staffs’ skills.

How to Apply Digital Opportunities  

Administrators or staffing departments looking to apply these principles can understandably be unsure where to begin. One approach could be a pilot program to expand your hospital's telehealth capabilities, using your core staff already familiar with the system's processes and philosophy. Senior-level nurses can remotely monitor departments across multiple facilities (if applicable), using existing plans, billing, and infrastructure as a base.

Healthcare organizations looking to expand digital services and improve staff support can o consult with staffing organizations to craft a strategy that offers cost savings in reducing overtime and turnover.  

A healthcare staffing partner should help organizations perform a workforce analysis, which includes examining current staffing goals and predictive forecasting. These create a roadmap for staffing needs that should consist of high-level or organization-wide staffing predictors and staff targeting for individual units in a facility.

One key consideration when expanding telehealth services and predicting staffing needs is that those who work in remote or telehealth positions also need to take leave. In the instance when the core staff member will return to the position, the role of a travel nurse can also be that of a remote travel nurse. While a travel nurse will physically be at the location, they can still cover the remote nurse's valued duties until their return. Maintaining these remote positions keeps a level of service that benefits a healthcare organization and its customers. In addition to leave considerations, healthcare organizations may wish to fill remote positions while a core staff member completes orientation or education processes to begin their assignment.

Closing Thoughts: How Health Carousel Can Help  

Health Carousel has assisted healthcare facilities worldwide in meeting their customized staffing solutions. The increasing use of telehealth, growing patient demands, and the need to value and nourish the work of core employees have created a new healthcare reality. Where healthcare organizations may have found the market for contingency healthcare professionals rarer a decade ago, contingency professionals are often a part of a company's staffing strategy, both for in-person and virtual opportunities.  

Multiple opportunities exist for telehealth and telemonitoring in service lines, including radiology, primary care, and physical therapy. Filling these positions with core staff looking for new opportunities can help retain long-term, trained professionals, while expanding a health system's capabilities and profit margin.  

And while turnover is inevitable in any healthcare organization, minimizing large staffing turnovers to prevent another “Great Resignation” is vital to the organization’s stability. We can act as a partner to healthcare organizations, helping plan for potential eventualities and needs in staffing, from managing employee FMLA to enhancing staffing matrixes. We do this through customized, managed services that can help reduce your overall administrative and cost burdens.  

It may seem unusual for a healthcare professional staffing agency to advocate for supporting core staff, but this support is central to our mission, which is to improve lives and make healthcare work better. Through creating new solutions for core staff, Health Carousel can be a valued partner in your organization’s success.  

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* This blog is part of the Digital Trends and Transformation series.

Virtual visits, wearable monitors, second opinions, and provider-to-provider consults are all part of the digital health ecosystem, a growing network of high-tech offerings designed to enhance access and provide the secondary benefit of reducing healthcare professionals’ stress and workloads.  

Electronic health offerings have become a billion-dollar business in the United States. Investments in U.S.-based digital health companies have increased from $1.1 billion in 2011 to $14 billion in 2020, according to an article in the journal npj Digital Medicine. But this statistic doesn’t tell you that while investments reached a whopping $29.1 billion in 2021, they more than halved in 2022.  

Here’s what we know: The challenges of the COVID-19 pandemic shifted healthcare professionals to electronic platforms when possible. But years later, is the digital health ecosystem as thriving as it once was? Let’s look at a few key indicators to assess the trends and opportunities and what’s coming up next.  

Tracking the Trends

Although many areas in the digital health ecosystem exist as patient-facing technologies, these have a secondary effect on providers. With this in mind, we’ve narrowed the digital health sector into its four most significant impact points for healthcare professionals.  

Virtual Visits

During the pandemic, virtual visits allowed patients to access healthcare professionals across many disciplines—including primary care, mental healthcare, dermatology, and more. In the post-pandemic world, does the demand for telehealth remain? In a recent survey of healthcare leaders, an estimated 27% of medical groups expected the need for telehealth to increase moving forward, while another 28% reported that it would decrease. The remainder projected telehealth demand to stay the same.

Just as these survey results indicate, the future of telehealth isn’t completely clear because the post-pandemic world brings both challenges and opportunities. The opportunities include the public being more willing to embrace telehealth’s acceptable use as a replacement for face-to-face provider visits. One survey published in Becker’s Health Review found 80% of Americans believed they could receive the same level of care via remote healthcare platforms, compared to 43% in pre-pandemic surveys. Telecare also offers the ability to increase access to care for those who may otherwise have difficulty seeing a specialty medical expert or leaving their home.

The challenges include continued concerns over the security of protected health information when transmitted over a phone or the Internet, and the loss of rapport developed between patients and their healthcare professionals. However, research regarding patient attitudes toward telehealth has revealed the opportunity to engage in virtual visits with their established providers helps to foster patient loyalty.

Telehealth has given professionals a sort of “safety net” should another health crisis or worker shortage occur. Ideally, this added agility could enhance needed care for virtual visits and reduce patient and professional frustrations for in-person visits. The results can be less burnout for nurses and allied health professionals because of increased patient satisfaction.  

Key Takeaways: Telehealth can provide enhanced access to reduce patient influx in emergency departments, and new outlets for health professionals across all disciplines to use their skills to reach patients. The digital health sector must continue to seek ways to increase patient data security to help participants feel more strongly about their decision to participate in a digital visit.

Provider 2 Provider (P2P) E-Consults

“Curbside consultations” have been an informal P2P practice for years. Two healthcare professionals see each other in the hall (or meeting room or parking lot), and one asks the other about their opinion on a patient. Now, there is an additional option: the e-consult.  

Enhanced telehealth options have extended beyond provider-to-patient to expand P2P e-consult opportunities. The ability to engage in P2P e-consults has allowed providers in locations such as emergency departments, intensive care units, behavioral health, and trauma settings to have rapid consultations with other specialists about complex conditions.

Larger academic medical centers have started to build their e-consult capabilities. One case study regarding e-consults found they reduced the total costs for care by, on average, $82 per patient each month. In a survey on satisfaction with the e-consult program, 89% of providers reported they were “highly satisfied.”  

Rarely in the healthcare sector are costs reported to decrease, but this is the case for e-consults. Savings for patients can enhance patient satisfaction and the healthcare staff’s confidence in the care they give. Patients can take a more proactive approach to their healthcare since there’s less chance of extended waiting or travel times to see a specialist. Those often engaged in patient education and care, such as nursing and allied health staff, may find their patients are better informed on their condition and its day-to-day management. The result is less overall stress and a greater sense of control for nurses and allied health professionals.

Key Takeaways: Delayed access to medical diagnoses impacts healthcare professionals and patients. Patients can benefit from increased access to e-consults in academic institutions and specialty groups. Healthcare professionals benefit from patients who are more informed and engaged in chronic health conditions management. Because patients are ideally less sick, nursing interventions and education are more effective. Healthcare professionals can feel more satisfied with their work because they will see an increase in positive changes due to their efforts.  

Telepharmacy

While hospitals and healthcare organizations can staff their pharmacy based on an expected ratio, what happens if an influx of patients suddenly occurs or pharmacy needs accelerate during the overnight hours? That’s where telepharmacy comes in. During the height of the COVID-19 pandemic, telepharmacy meant clinical pharmacists could conduct some of the following tasks via secure telehealth platforms:

• Medication reconciliation  
• Reviewing patient charts to make recommendations on initiating, adjusting, or stopping the administration of certain medications
• Verification of medication orders  

According to an article in the Journal of Clinical Pharmacy and Therapeutics, a qualitative review of healthcare professionals’ experiences with telepharmacy during the pandemic revealed challenges and opportunities. On the challenges side, pharmacists who weren’t onsite could not understand and evaluate patients’ clinical changes in real-time. Communication was sometimes challenging, as onsite pharmacists would participate in clinical rounds while telepharmacists usually would not. This meant already-stretched healthcare professionals had to make additional calls.On the opportunities side, telepharmacy has allowed healthcare facilities to rapidly expand their pharmacy staff to meet growing patient needs.

Telepharmacy also plays a vital role in community health, where the closure of rural pharmacies has impacted access to medications. Telepharmacy staff includes a remote pharmacy tech and pharmacist to verify orders and provide consultations. But not all states in the U.S. have authorized telepharmacy for use at community pharmacies. According to the National Association of Boards of Pharmacy, about half the states in the U.S. permit telepharmaceutical care.

Key Takeaways: In the post-pandemic era, telepharmacy has kept doors open in rural communities and made hospital-based pharmacies more agile. Staff have had to wait less time for reconciliation, allowing them to administer needed medications more quickly. Health professionals can also have patient medication safety questions answered sooner, speeding up care and reducing frustrations. While some communication challenges may exist, research studies have found that telecommunications are a safe alternative to a traditional pharmacy.

Second Opinions

Getting a second opinion can be time-consuming and challenging for patients. Digital health has expanded patient access to second opinions, which can lead to improved patient satisfaction and engagement in their care.One of the critical changes was the advent of electronic medical records. Having digital records, imaging scans, lab results, and more means that consulting providers can quickly and more thoroughly review a patient’s medical history while offering a second opinion.Many of the country’s largest healthcare systems (such as the Cleveland Clinic and New York-Presbyterian) offer fee-based second opinion services. However, restrictions may exist based on the patient’s state of residence.  

One study published in Surgical Opinions International found an estimated 40.6 visits to spine surgeons are to obtain a second opinion. Nearly 60% of neurosurgery second opinions do not match (discordance) the first opinion a patient receives. Of these opposite opinions, about 75% of the views recommend no surgery.

Expanding second opinions through telehealth platforms can lead to cost savings – for both patients and hospitals – by reducing unnecessary procedures. This can also reduce staff frustrations and streamline care. More time performing targeted procedures enhances patient and provider satisfaction, and trust in the healthcare system.  

Key Takeaways: An estimated one-third of those living in the United States don’t have access to primary care or specialty physicians. If having access to one physician is a challenge, having a second opinion can be even more difficult. Telehealth second opinions can improve care access. Healthcare professionals can then feel more confident that the support they provide is vital to the patient’s care.  

How HC Is Staying on Top of These Trends

Since 2004, Health Carousel has worked to improve healthcare staffing worldwide through recruiting, educating, and training healthcare professionals. To accomplish this, we must recognize the changes that impact how nursing care and, more globally, healthcare has and will change in the coming year. We’ve invested in academic healthcare platforms to help our professionals enhance their skill sets, and continue to evaluate the digital health landscape and the role we, our nurses, and allied health professionals play.  

To that end, our goal is to help transform the digital space with a continual feedback loop for our hospitals and healthcare systems. Driven by data, the information is targeted and real-time. Detailed reporting, analytics, and predictive analytics can forecast future staffing to help improve patient care and reduce reliance on premium labor. Clients can anticipate staffing needs and get healthcare professionals to the bedside sooner, which can further improve patient and staff satisfaction.

In the end, it’s impossible to completely predict where the digital realm is going and its impact on healthcare. Yet, while the future may be a mystery, it’s exciting to think about how technology will continue to improve lives and make healthcare work better for all.

* This blog is part of the Tackling the Biggest Healthcare Challenges series.  

Inadequate staffing can contribute to reduced job satisfaction, the inability to provide quality care, and lost revenue for healthcare facilities. The demand for nurses and allied health professionals isn't facility based or exclusive to the United States; it's gone global.

In addition to the staffing shortages, an increased focus on preventative care, nurses retiring from the profession, healthcare expectations of the aging baby boomer population, and value-based reimbursement have contributed to the need for additional nursing and allied health staff.  

A Growing Global Need for Healthcare Professionals

Maintaining adequate staffing to meet the increased demands for nurses remains ongoing. The nursing shortage has been around for a while, and the pandemic has only exacerbated it, keeping recruitment and retention foremost on the minds of healthcare leaders.  

Nurses comprise half of the global health workforce, and studies consistently highlight nurses expressing an increased intention to leave the profession, contributing to a growing nurse workforce shortage. Twenty percent of the National Nurses Associations (NNAs) indicated more nurses resigning from their positions. In addition, allied health professionals are in demand; 85% of healthcare facilities are experiencing moderate shortages, with radiologic technicians being the most significant need, followed by laboratory technicians and occupational therapists.  

Lessening Global Healthcare Staffing Shortages

According to the International Council of Nurses Policy Brief, before COVID-19, the World Health Organization (WHO) revealed that low and lower-middle-income countries experienced 89% of nursing shortages. In addition to an aging workforce that significantly strains the healthcare industry, overburdened medical professionals received even more patients with critical needs when the pandemic began. They struggled with insufficient resources, risks to personal health due to exposure to the virus, burnout, and stress. Countries scrambled to get more healthcare students, but the time between completing their education and real-world readiness still left a gap of inadequate staffing.  

Nurses and allied health professionals in some countries faced physical violence, were asked to volunteer, or were mandated to return to practice from inactive or retired status. These are not permanent fixes to a staffing crisis but have merely put a temporary Band-Aid on staffing shortages until other solutions are available.  

Research suggests the nursing shortage will continue to spread through 2030. The statistics for U.S. nursing shortages project the national demand for nurses to grow 9% annually from 2020-2030, amounting to 194,500 nurses needed yearly.  

A growing need for healthcare workers across the globe resulted in healthcare professionals immigrating to new countries. Health Carousel is committed to ethically recruiting health professionals to assist healthcare facilities with their staffing needs. To display the extent of our dedication, we've committed to being part of a global force addressing the sustainability of healthcare workers.

Our Light the Way initiative aims to lessen the shortfall of nurses globally by embracing the three social pillars of this initiative: sustainability, development, and ethical recruitment. Through this initiative, we offer scholarships, mentoring, and professional development. We focus on helping care for today's nurses and health professionals while developing and maintaining the future healthcare workforce.

The Cycle Contributing to the Healthcare Staffing Shortages

Nurses and allied health professionals often put their patient needs before their own and must adapt to the fast-paced and ever-changing healthcare environment. Still, they can only maintain that momentum for a short time. Passion isn't always enough to push through the exhaustion of the physical and mental demands of the job.  

Excessive overtime, inadequate staffing, staff turnover, limited time for patient care, fear of workplace violence, and an unsatisfactory work-life balance may contribute to some nurses leaving the profession. Moreover, inadequate staffing creates a cycle of job dissatisfaction, which can lead to burnout and further add to the nursing shortage.  

Key But the need for increased nurse and allied health staffing levels impacts more than retention. It can impair the ability to provide safe patient care and continuity of care, which can be costly to a healthcare facility's reputation and finances.

Inadequate Staffing Risks

The global nursing workforce is aging, and 17% expect to retire within the next ten years. This trend results in the need to educate and employ an additional 4.7 million nurses to maintain current workforce numbers, with a total demand of 10.6 million additional nurses by 2030.

Recruiting and retaining enough nurses is even more challenging with inadequate nursing faculty to educate future nurses. The gap between clinical and academic salaries, necessary experience, and education may have contributed to a nursing faculty shortage, forcing some nursing programs to limit their student capacity.

Inadequate healthcare staffing includes the following risks:

• Understaffing increases a patient’s risk of infection by 15%. The American Nurses Association (ANA) recognizes the importance of safe nurse staffing and emphasizes how nurse-to-patient ratios impact patient care. Medication errors, increased risk of patient harm and morbidity/mortality rates, and job dissatisfaction can result from a higher nurse-to-patient ratio. Many nurses still feel their units are understaffed. A recent study by Nurse.org, 71% believe that improving staffing ratios would significantly impact the nursing shortage.

• The rate of workplace violence is higher in healthcare than in private industry. Inadequate staffing levels and the need to perform uncomfortable or painful procedures for fearful or confused patients increase the risk of physical or verbal abuse. In addition, they can contribute to an undesirable, unsafe work environment.

• Job-associated environmental and physical injury risks increase due to the advanced age of the workforce. The hectic pace, fatigue, and long hours can decrease alertness and awareness. This can result an increased risk for injuries from patient care, needle sticks, or exposure to bloodborne pathogens.  

The Cost Of Healthcare Staffing Shortages to Healthcare Facilities

Since 2012, the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) has been pivotal in reimbursement through the hospital Value-Based Payment. Value-based care emphasizes rewarding healthcare professionals for value over volume, holistic and preventative care, reducing costs, and more collaboration across units/specialties.  

Having inadequate nursing and allied health staff is costly to healthcare facilities—well beyond immediate financial impacts. It can result in the following:

• Canceling appointments or procedures  
• Unfavorably impacting the facility’s reputation and potentially losing providers
• The possible adverse effect on the length of inpatient stays, intensive care unit (ICU) statistics, and emergency department (ED) wait times

• Reduction of overall facility ratings and rankings  

These factors contribute to providing less than quality care. Inefficient or ineffective recruitment and retention efforts may result in a loss in revenue, with the average cost of nurse turnover at $40k and up to 89 days to fill a vacant registered nurse position, making each loss of healthcare staff a significant expense.  

Caring for More Patients with Complex or Chronic Conditions  

When The Affordable Care Act (ACA) expanded access, some patients who may have never had healthcare and others with more diverse or complex needs acquired a care avenue. The surge in healthcare usage continued to rise as the baby boomer generation reached retirement age.  

An aging population, with typically more than one morbidity, has required increased medical care. Healthcare professionals now consider some once-terminal diseases chronic, requiring long-term treatment and straining the healthcare workforce.  

The shift toward a heightened emphasis on health promotion and holistic patient-centered care also requires a more extensive, diverse, and highly educated nursing workforce with the expertise to care for more patients with complex needs.  

Nurturing Nurse Educators Will Help Global Healthcare Shortages

Due to existing nursing shortages, the aging of the nursing workforce, and the continuing COVID-19 effect, ICN estimates up to 13 million nurses will be needed to fill the global nurse shortage gap in the future. We’re hoping that our efforts can help.  

The Light the Way initiative focuses on the ethical recruitment and global sustainability of nurses by funding nurse training and education programs in the U.S. and abroad. Our focus on nursing education aims to lessen the U.S. and global nursing shortage. We have provided over $10 million in scholarships, producing more than 100 nurse educators and 1,000s of new nurses. This effort is only one of Health Carousel's international nursing sustainability endeavors.

Another is building nurse educational capacity to increase the number of nursing faculty to support the profession. These investments can impact patient care, encourage health professionals to embrace lifelong learning, and assist healthcare facilities with workforce shortages.

Recruiting and Retaining Quality Healthcare Professionals

Workforce shortages affect everyone, but filling a staffing gap isn’t the solution. This short-term solution focusing on survival will only help the organization thrive in the short run. Healthcare professionals are crucial to shaping the reality of your healthcare facility for all staff and patients. After obtaining quality nurses and allied health professionals, the goal is to retain them. Adequate staffing helps to ensure that healthcare leadership can focus on other priorities beyond the recruitment cycle, which could result in neglecting current employees.  

Recruiting professional healthcare staff committed to quality patient care is vital for your organization, and Health Carousel can help. We are a Certified Ethical Firm that recognizes the value of promoting ethical leadership and recruitment practices. We recruit foreign-educated health professionals through the Alliance for Ethical International Recruitment Practices.

As a founding American Association of International Healthcare Recruitment (AAIHR) member, we embrace these business practices, striving to help healthcare facilities maintain adequate staffing levels. Our focus on supporting the nurses of today, future nurses, and other allied health professionals can help reduce the overall global health workforce shortage while assisting with your staffing needs today.

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* This blog is part of the Flexible Nursing and Allied Health Workforce series.

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It’s no secret that healthcare can be a physically demanding job, and until recently, many have not considered the significant effect working in the medical field can have on mental health. The global pandemic brought the already-present issue to the forefront. The strain on allied healthcare professionals to accommodate patient needs with a limited supply of necessary equipment and ongoing uncertainty has fueled mental health issues. As a result, healthcare professionals often experience burnout.

Some leaders believed that mental health issues were individual rather than systemic. Yet, reacting to individual mental health issues doesn’t address the underlying problems.

Burnout Has Become an Occupational Phenomenon

Until recently, many people considered burnout a stress syndrome, but the World Health Organization (WHO) now classifies burnout as an “occupational phenomenon” resulting from unmanaged, chronic workplace stress. The change in definition won't solve the problem, but it may increase awareness of the need to proactively address healthcare professionals' mental health.

Despite increased understanding, healthcare professionals’ mental health has not rebounded. In a recent Frontline Nurse Mental Health & Well-Being survey, 75% of respondents reported burnout, with 66% experiencing compassion fatigue and 64% indicating feelings of depression or a decline in physical health.  

Post-traumatic stress disorder (PTSD) is usually associated with active and retired military members. Still, nurses and allied health professionals who routinely deal with occupational stressors such as violence, trauma, and death can be at an increased risk. Critical care nurses reported significant levels of burnout and rates of anxiety and depression higher than the general population. These reports put them at an increased risk of having PTSD and leaving the nursing profession altogether.  

Caring for Our Most Valuable Resource  

Despite nurses reporting experiencing suicidal thoughts at twice the rate of the average American adult, many are reluctant to seek help due to concerns about job security.  

Our healthcare professionals are our most valuable resource. With them, we can provide the quality care that our patients deserve. But we must also consider that caring for our employees' mental health is even more essential. Being physically present at work while suffering from emotional strain can harm our staff, patients, and businesses.  

Healthcare professionals often work long hours performing physically and emotionally demanding tasks. Those who don't feel supported and push through their work while suffering from burnout or other mental illnesses can be an occupational hazard. The mental toll will impact them personally, making it harder to focus on patient care and negatively impacting your organization.

The Real Cost of Mental Health Disorders

Those who work in healthcare strive to provide compassionate, quality care. It's essential for job satisfaction, reimbursement, and patient satisfaction. Yet, providing patient care can be challenging if someone has a mental illness and struggles to care for their own needs.

Anxiety and depression, two of the most common mental health disorders, have been reported to lose one trillion dollars in global productivity, with $193 billion in lost earnings in the U.S. Depression is responsible for up to 400 million lost workdays. But lost work is not the only concern for healthcare professionals.  

Ignoring mental health can risk more than financial losses. For nurses, mental health issues can have significant and even life-or-death consequences for patients by risking the quality of care, leading to potential medical errors and patient dissatisfaction. In addition, mental health issues can lead to burnout and low morale, ultimately resulting in health professionals leaving the job or profession.

Stress Shouldn’t Be Part of the Job

While we're accustomed to screening our patients, we should remember to look at ourselves and our staff. Many healthcare professionals experience emotional exhaustion, depersonalization, and job detachment but often don't share their mental challenges.  

They may think they should be able to cope independently or that they'll get over it. Some  believe dealing with recurring, overwhelming stress is part of the job. Others may hide, deny, or not recognize the symptoms of burnout. Or they may imagine that admitting to a need for treatment would be viewed as a weakness. As healthcare leaders, it's our job to be aware of these symptoms and create a culture where health professionals feel comfortable speaking up and seeking help.

Recognize Burnout in Your Healthcare Professionals

Burnout is more than ordinary fatigue and can lead to physical, mental, and emotional exhaustion. Coping with daily stressors becomes a challenge, let alone caring for someone else’s needs when suffering from overwhelming feelings. This risk makes ignoring symptoms of burnout in health professionals more significant, as burnout may lead to other health issues. It may put patients at risk, if your staff members continue to work untreated.  

The symptoms of burnout and depression are similar. The connection may make some feel they have burnout when it's depression, and it may only worsen things if they receive the wrong or inadequate treatment.  

Having burnout doesn't mean that a diagnosis of depression is inevitable, but it can increase the risk. According to the WHO, burnout exhibits the following symptoms:

• Mental and physical exhaustion
• Mental distance from the job or cynicism about the job
• Reduced efficacy in the workplace

Avoid making assumptions since the cause of burnout and how the symptoms manifest can vary. Some may feel that the demands on nurses and allied health professionals, often the cause of burnout, are inherent to the job. These include working long hours due to staffing shortages, changing shift schedules, and increased administrative burdens.  

Other causes of burnout derive from the healthcare system's systemic challenges, the care needed for the aging baby boomer population, and the COVID-19 pandemic. A shortage of nurses has, in turn, led to more and longer shifts. This expectation has placed greater demands on individual nurses during each shift, which makes the need for increased mental health awareness imperative.

Prioritize Mental Health  

Wellness is about developing a culture and providing your nurses and managers with the tools to succeed. Knowing how to empower others can help make a healthcare professional's job more manageable and fulfilling while positively contributing to their mental health.  

Examine your workplace culture to determine if it provides support, encourages meaningful conversation, and builds positive relationships. Attempting to maintain unrealistic work standards of trying to do it all can leave staff feeling less engaged and may lead to exhaustion. This result may negatively impact workplace culture and create a continuous cycle of burnout. Healthcare professionals shouldn't have to choose between their work and personal life.

There are ways to help nurses and allied health professionals manage their mental health before issues can lead to exhaustion, inefficiencies, or burnout, like the following:

• Normalize conversations about mental health. Feeling mental health issues are socially unacceptable is a common belief, making them uncomfortable to discuss in the workplace. This stigma may cause some staff to hide their fatigue or frustrations while keeping their distress a secret. Encourage your team to express their concerns and listen to and learn from their feedback.

• Encourage managers to establish a debrief. Medical professionals experience intense, ongoing stressors. If staffing issues accompany these, there may be little to no time to process a distressing event. Scheduling a routine debriefing, or requiring one after an incident, can allow time to address concerns and identify issues.

• Provide internal resources. The American Nurses Association's (ANA) well-being initiative offers a variety of resources to help nurses prioritize their mental health care. These include creating a wellness room to decompress, offering employee assistance programs, and providing educational opportunities.  

• Promote self-care in the workplace. Healthcare professionals are caregivers, but often neglect caring for themselves. Encourage your staff to communicate overwhelming feelings to reduce multitasking, slow down to be present, and delegate tasks as appropriate. Accepting our limitations can give us more energy to devote to prioritized tasks while delegating to others.

• Educate your employees. Leaders who promote self-care can increase awareness of nurse burnout while proactively addressing it. Help staff identify the early signs of burnout or other mental health issues in themselves and their coworkers and encourage the implementation of early treatment. Consider bringing in speakers or looking within your organization to draw upon the resources you may already have in your behavioral health group.

• Offer opportunities for advancement. Incorporating cross training and encouraging professional development allows healthcare professionals to learn new skills and provide the potential for future progress. This change in environment may reignite their passion for the profession, and help convey each position's value in meeting the organization's goals.

• Provide coverage for workforce shortages. Communicate with your staff and address concerns and issues with their workload, work-life balance, and ability to find meaning in their work. If needed, allow for cutting back part-time or provide coverage through contract staff to cover emergency leave, short-term coverage, or planned extended leave. Consider the time spent as an investment in their retention that will save money in the long run.

Mental Health Support Today May Pay Off Tomorrow  

Offering support for the holistic needs of your nurses and allied health professionals is essential. Prioritize nurturing a work environment that normalizes conversations about mental health, gives resources, and strives to support healthcare staffs’ wellbeing. Supporting their mental health needs ultimately provides positive benefits for the organization.  

Start planning today to ensure adequate staffing during workforce shortages with a workforce strategy. Consider supplementing your staffing schedule. Staffing agencies can help support your healthcare workers’ mental health needs by offering them the opportunities to recover and maintain a better work-life balance. Taking the time to rest and recharge may do more than reduce stress and ward off related health problems. It may help your staff keep the passion alive that inspired them to pursue healthcare.

As a clinically led staffing partner, Health Carousel focuses on a global view of the healthcare workforce's sustainability. With a desire to invest in the well-being of nurses and allied health professionals, we are more than just filling a staffing gap. Using our ethical recruitment processes can help international nurses succeed in the work they enjoy and help hospitals practice prevention to cover unexpected leaves that could increase patient loads or prevent staff from taking time off. Drawing from and growing the global workforce supports healthcare professionals' mental health by creating happier employees who feel comfortable taking time off when needed while still maintaining quality patient care standards.

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* This blog is part of the Digital Trends and Transformation series. 

Spend any time in healthcare staffing, and you are acutely aware of the war for talent.

Traditionally, talent in the workforce has meant candidates with a higher skill level. In an expertise field like healthcare, that also means workers with the right mix of real-world experience and clinical expertise.

In a perfect world, with a stable workforce and a wealth of available healthcare professionals, you can take your time to evaluate your needs after an employee leaves. You can match the requirements to the available talent at your fingertips and then let the existing staff onboard and train the new worker.

But, as we know, the current situation is anything but perfect. It takes longer than ever to fill a position. Staffing managers struggle to find new employees, much less the needed skillsets. It’s a problem that seems to grow daily.

In a 2021 study by the Advisory Board, the average cost of RN turnover was $40K. That makes the estimated cost of turnover for just 30 RNs as much as $1.2 million – and that doesn’t account for future lost revenue if your hospital experiences reputation loss due to slow to no patient access.

Recruiting is a significant time and resource investment. But the cost of hiring mistakes can hurt operating budgets and continuity of care. Plus, recruiters and staffing managers are competing with other healthcare systems for a dwindling talent pool, adding to the complexities of patient care. It’s enough to raise the stress level of any healthcare staffing professional. 

The Healthcare Talent Crunch

The healthcare staffing shortage is creeping closer to dire levels. Turnover is occurring faster than many HR and hiring managers can manage. Many healthcare professionals are leaving the field, and at the same time, the global demand for healthcare professionals is increasing.

 ·   According to an article in The Lancet, 6.4 million additional doctors are needed in 132 countries worldwide to fill healthcare gaps, which burdens already taxed nurses and support staff.

 ·   In a recent research study by Health Carousel, nurses' feelings about the healthcare industry have changed since the pandemic. ​Of the surveyed nurses, 70% said they had a somewhat more or much more negative outlook on nursing after the pandemic, and 58% said they are feeling burnt out in their current careers.

·   The healthcare workforce is aging, with many specialties facing an imminent wave of retirements. Health Carousel’s research also found that 28% of the surveyed nurses reported a desire to exit direct patient care. Almost half of those nurses planned to retire or leave the workforce, creating a vacuum of acquired knowledge and real-world clinical experience.

·   According to the U.S. Bureau of Labor Statistics, national demand for nurses is estimated to increase by 9% annually between 2020 and 2030. That means the U.S. needs to find an additional 194,500 nurses annually.

·    A recent study from the Advisory Board reports that hospitals lose an average of$90K per day in revenue when the facility is understaffed.

 These factors, and a growing population with chronic conditions, have led to a global talent crunch. In the face of these market realities and the war for talent, the tactics of the past aren’t going to work.

New Tactics, Strategies, and Partners in the War for Healthcare Talent

In this new reality, recruiters and staffing professionals must shift their approaches. You can’t rely on what worked just five years ago because that’s not the reality we’re facing now and doesn’t address predicted healthcare staffing shortages. There’s too much risk, and the headwinds are too strong not to embrace new mindsets.

Start by partnering with a staffing agency that looks at your immediate problems and finds solutions to stabilize your future workforce.

A staffing agency can significantly expand the available resources you have in recruiting. Rather than working with a small team that only has access to nurses in your community, you have an entire business focused on your needs and finding the best available nurses or allied health professionals in a global marketplace.

Consider your business growth and future operating plans. Look for an agency that can customize their services to your requirements. Find one that is focused on a long-term partnership rather than short-term fixes. Your agency should provide customized workforce solutions and resources, providing necessary support to get you to long-term workforce stabilization.

Seek out an integrated nursing model to provide end-to-end total talent management, including rapidly scaling when needed with flexible assignments and start dates. The needs you have today may not be your future needs. You want a partner who can work with you through these changes.

Finally, make sure to find a staffing partner who has invested in technology.

Technology and Healthcare Staffing

Just as the market for healthcare talent has changed, so has the capability and functionality of digital tools.

The ideal partner has invested in the future with technology that can act as an automated solution to recruitment and staffing across all specialties, roles, and skill levels. You should be able to rapidly scale traditional recruiting services and manage your workforce in a way that’s efficient, streamlined, and simple for you. It’s about access to the largest, broadest talent pool to get healthcare professionals to the bedside sooner. For true efficiency, look for a staffing company with a digital platform that lets you leverage real-time data to find the right new hire for your patient needs and culture – as quickly as possible.

Technology gives you more options and a clearer path toward success to win the immediate and future war for healthcare talent.

Overcoming the War for Talent in Healthcare

The talent crunch in healthcare has reached crisis levels in recent years and shows no sign of slowing in the future. The risk has never been greater for healthcare systems and their patients.

Luckily there are tools and resources available for overcoming this crisis. The flexible resources and digital tools available with the right staffing agency can greatly expand the reach and effectiveness of your recruiting efforts. Rather than relying on blind luck in hiring, you have more candidates and valuable data at your fingertips.

Finding the ideal candidate with the best talent is possible with the right partner at your side.

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* This infographic is part of the Flexible Nursing and Allied Health Workforce series.

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Text from infographic

Cross-Trained Nurses Boost Retention and Save Money  

Hospitals across the nation are reassessing traditional workforce roles to ensure proper staff-to-patient ratios, retain their healthcare professionals, and get the largest returns within tight operating budgets. Cross training, or cross specialization as it is also known, is an ideal solution for hospitals struggling to fill specialty vacancies. This is a strategic redeployment of healthcare professionals with similar technical skills to multiple units or specializations.

• The cost of nurse vacancies – Average of 89 days to fill a bedside RN role and the average turnover cost can be $40K.*  
• Ideal for both experienced and newer graduates – Targeted roles will have 50% or more of aligned technical skills (like ventilator care support).    

How to Identify Cross-Specialization Opportunities  

Define the Need  

Ask veteran and newer graduates for their feedback. Not only will this increase engagement, but it will help you to temperature check their understanding of your system and culture.

Ask Other Experts  

Seek out insight from your network about their successes, failures, and latest research. Work with partners like Health Carousel with firsthand experience to help you maximize staff retention and performance – their clinically led and board-certified team has approximately 200 combined years of acute hospital and nurse leadership experience.  

Cross Unit  

RNs can be cross trained to alternate between different units or specializations like critical care, med-surg, PACU, and telemetry. Overlapping skill sets and patient needs make it easier to implement float pools or scheduled rotations. The change of pace may be a welcome relief for those nurses looking for variety or a break from the challenges of high-acuity patients.

Cross Specialization  

Nurses and allied health professionals rotate between in and outpatient settings within the same service line for high-volume/high-value specialties like cardiology, orthopedic surgery, GI, and select areas like inpatient oncology and outpatient infusion centers. This promotes a better understanding of the full spectrum of patient care and lets staff follow patients across settings.

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*Statistics from Advisory Board studies.

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* This blog is part of the Flexible Nursing and Allied Health Workforce series.

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It’s no secret the workforce has changed. People prioritize their time and worth differently now. Companies have redefined their work from home policies and younger generations are challenging traditional views on workforce flexibility. Leaders across America are taking a hard look at the “acceptable norm” and how their policies are impacting retention.

In the world of healthcare that means reassessing the standard shift mentality to retain nurses and get the largest returns within tight operating budgets. Let’s not forget, recent Advisory Board studies indicate it takes an average of 89 days to fill a bedside RN role and the average turnover cost can be $40K.

As a staffing manager and leader in healthcare, you need to start shifting your current and future strategy. Hospitals nationwide have found success in cross training nurses to fill the gaps.  

Cross Training and Cross Specialization in Healthcare

Cross training, or cross specialization as it is also known, is an ideal solution for hospitals struggling to fill specialty vacancies. In the simplest terms, cross specialization is a strategic redeployment of your nurses with similar technical skills to multiple units or specializations. Ideal for both experienced and newer graduates, targeted roles will have 50% or more of aligned technical skills (like ventilator care support).  

This provides your nursing team with more variety in their work, which can limit feelings of frustration or burnout. They have an opportunity to explore other career paths and areas in your healthcare system. Typically, implementing a cross-specialization program will increase employee engagement and improve the patient experience thanks to more engaged nurses. In addition, the nurse should see this as an opportunity to learn and grow on the job. While many employers will say they offer career advancement, you will be creating clear progression paths through the cross-specialization program – a huge value add for retention.

As a manager in a healthcare system, your organization will also see benefits of redeploying existing staff. You’ll have a better trained, more experienced staff who offer greater flexibility in fulfilling roles. Your team will have more confidence in managing an absence, because rather than scrambling or stressing, more of your nurses will have the skills to cover these shortage areas.

Overall, this is a win-win for your organization and can also provide long-term benefits. Simply put:

Organizational benefits: Cross specialization helps you address immediate and future coverage gaps while maintaining excellent patient care and continuity. Which in turn benefits value-based payments with improved patient outcomes, decreased (unnecessary) readmissions, and reduction in overall costs. Overlapping skill roles also helps to decrease the demand on physicians, nurses, and support staff.

Staff benefits: Nurses develop new skills which can create additional career paths. Flexibility of the cross-specialization program can be a great way to engage and attract new employees to your organization. It can create a buzz of excitement as your staff refers other nurses to your hospital’s opportunities.

How to Identify Cross-Specialization Opportunities

Before launching an integrated cross-training plan, take a step back to identify your current and future shortages. Also consider the national trends when it comes to nursing. In today’s market, nursing talent is at a premium. You’re not only competing to attract the best talent in your community, but nurses are now considering positions beyond their backyard. Even with a top-notch program and dedicated recruiters, you may not be able to fill every role. This is where cross training can provide a strategic benefit.

Assessing your staff’s technical skills helps you identify difficult-to-fill roles and plan a targeted workforce retention strategy. Accurately understanding your shortages helps you determine the total cost of those vacancies – cancelled procedures, loss of reputation, and possibly further alienating an already taxed staff. Once you’ve identified gaps, you can see the related experience and expertise of your existing staff, which will provide a boost in cross training.

That’s just a starting point in the process. As you investigate and plan, take time and work with key internal stakeholders and SMEs (Subject Matter Experts). This will give you buy-in for the project, help develop internal advocates for cross specialization, and ensure you are working with the best possible information. Here are a few additional steps to make sure you have a successful cross-specialization program.

• Define the Need – Look at all care areas, including beyond the traditional or obvious roles. Ask veteran and newer graduates for their feedback. Not only will this increase engagement, but it will help you to temperature check their understanding of your system and culture.
• Ask Other Experts – Cross specialization is on the mind of many experts across the industry. Seek out insight from your networking contacts about their successes, failures, and plans. Contact subject matter specialists like the Advisory Board about their latest research or case studies. And lean on your partners like Health Carousel whose clinically led and board-certified team has approximately 200 combined years of acute hospital and nurse leadership experience. Their firsthand experience will help you maximize staff retention and performance.
• Cross Unit – RNs can be cross trained to alternate between different units or specializations like critical care, med-surg, PACU, and telemetry. Overlapping skill sets and patient needs make it easier to implement float pools or scheduled rotations. The change of pace may be a welcome relief for those nurses looking for variety or a break from the challenges of high-acuity patients.
• Cross Specialization – Nurses rotate between in and outpatient settings within the same service line for high-volume/high-value specialties like cardiology, orthopedic surgery, GI, and select areas like inpatient oncology and outpatient infusion centers. This will promote a better understanding of the full spectrum of patient care and let nurses follow patients across settings.  

Launching Your Cross Specialization/Cross Training Program

Once you have the data and plan for launching cross specialization, role the program out in phases. Set clearly defined goals with benchmarks for activity and learning (for example, identify the key skills and experience to be covered, and the expected results for everyone involved).  

With the goals in place, start with a smaller, more focused first phase that includes a few nurses and limited departments. Roll it out over a few months and then collect data and feedback. Adjust the program as needed, maybe by starting the cross training with a team of mentors rather than a single cross trainer. Launch a secondary phase with more nurses and expand into more specialties or units. Once the program has fully launched, set regular feedback opportunities to assess the programs.

Simple in concept, this tactic can pay dividends in nursing retention.

Getting Started with Cross Specialization and Cross Training in Healthcare

While it may seem daunting, even frightening at first, there are clear and measurable benefits to cross specialization. In the current nursing workforce shortage, healthcare staffing managers can’t ignore these benefits, and should at least explore how cross training might work.

If you have questions or want to explore turnkey solutions and other clinical consultative services for healthcare staffing, then contact Health Carousel today to discuss your needs.

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* This infographic is part of the Flexible Nursing and Allied Health Workforce series.

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Text from the infographic

The Nontraditional Answer to Nursing Workforce Flexibility

Workforce flexibility has become a critical demand for nurses of all skill levels and age groups. Nontraditional staffing helps ensure proper staff ratios and engaged healthcare professionals.

• Retaining and attracting talented caregivers is a business imperative. -- Nationwide shortage of 450,000 nurses by 2025

• Nursing turnover has reached critical levels. -- The average cost of RN turnover was $40K per nurse.  RN nursing turnover rates of more than 25% in 2021*  

5 Paths to Retention and Sustainable Workforce Flexibility

Alternative sites give nurses an opportunity to gain experience and new perspectives

Increased job satisfaction for healthcare professionals and less burnout. Patient and family satisfaction also increased from the continuity of care.

Float positions or pools provide more worker and organizational flexibility

Roles beyond a standard shift give nurses and allied professionals more control over their lives to plan off time and feel supported in their personal growth. Nontraditional shifts also help leaders better plan operational budgets while possibly decreasing the number of part-time or PRN staff.

Health Carousel’s work-study programs upskill nursing talent while meeting patient needs

Health Carousel pays for the education of nurse alumni from the PassportUSA program to earn advanced nursing degrees while they’re working a required 36 hours per week (average). Includes RN to BSN through to MSN, DNP, and NP.  

Nursing leader roles help to keep veteran nurses on the job without being at the bedside

Patients can benefit from remote monitoring or education. Coworkers focus less on unnecessary, but unrelated to patient care tasks. Leaders will benefit from streamlined processes and collective knowledge.

Role flexibility leads to better scheduling and coverage

Creating flex roles with a clear understanding of department or specialty responsibilities makes it easier to cover acute and chronic shortage areas – ideal for covering short-term leaves and filling targeted openings.  

*Statistics from Advisory Board studies.

* This blog is part of the Flexible Nursing and Allied Health Workforce series.

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Healthcare staffing shortages are a global problem and the “new normal.” But when will new challenges stop being a normal healthcare practice? Experts predict a nationwide shortage of 450,000 nurses by 2025, which makes retaining and attracting talented caregivers a business imperative.  

Workforce flexibility has quickly become a critical demand for nurses of all skill levels and age groups. Flexibility no longer means our traditional concept of work-life balance. It’s also about finding nontraditional ways to ensure proper staff ratios and engaged healthcare professionals.

The Cost of Inadequate Staffing

We all know that maintaining proper staffing levels helps to reduce mortality rates, length of patient stays, and falls and infections.  Unfortunately, nursing turnover has reached critical levels as recent Advisory Board studies noted that the the average cost of RN turnover was $40K per nurse. Healthcare leaders were further whammied with RN nursing turnover rates of more than 25% in 2021, as reported by NSI Nursing Solutions.  These factors are creating tight operating budgets for facilities and placing additional demands on core staff. Training delays and hand-off issues spark genuine concerns about burdening already taxed nurses, which could lead to patient frustration and loss of facility credibility.  

It’s a cyclical problem contributing to millennial and experienced nurses leaving the industry. A study published in Health Affairs analysis noted that 100,000 RNs were no longer part of the nationwide nursing workforce in 2021. Fewer nurses mean asking core staff to do more with less resources. It means asking them to be responsible for more patients, which could increase the chance of medical error.  

Answers to retaining and attracting talented RNs to your facility may lie in finding creative solutions within your existing structures.

The Benefits of a Fully Staffed Shift

Groups like Advisory Board are working with healthcare systems across the nation. They have found aligning with nurses’ needs is one of the best ways to keep RNs at their current organization. The Advisory Board estimates that only 20% of a given workforce will consider options like nontraditional roles or shifts – and then only 5-10% will use those options. So, while it may not seem like a huge initial impact, it can pay volumes when considering the importance to those nurses on the fence. That can mean keeping up to 20% more nurses who might leave. Keeping experienced nurses at the bedside benefits everyone around them.

Organizational benefits: Staff retention means stable operating budgets. You can better plan for advancements, reduce spending on contingent staff, and meet fluctuating patient demands. Also, a veteran nurse’s skills and expertise can mean the difference between life and death.

Staff benefits: Proper staffing ratios make it easier for nurses to balance work and life priorities. Their engagement is more likely to increase, leading to a deeper commitment to your facility.

Explore Nontraditional Roles or Shifts

So, what are nontraditional roles?  

This can mean anything from nurse educators to multi-specialty/multi-department coordinators to patient advocates. Nontraditional shifts include short shifts across units or a senior RN leading a care team virtually.  

When considering non-traditional roles, look at areas that could benefit from your staff’s experience. Don’t focus on the normal work week or schedule. That nontraditional role could only take a few hours a week, but it can make a noticeable impact and give that nurse the experience they’re looking for.  

Nurses will feel seen and empowered.

The Path to Retention and Sustainable Workforce Flexibility

It may seem like a daunting task to begin or execute these strategies. The good news is that this nationwide-wide trend is being explored by hospitals, researchers, financial publications, and staffing companies alike. Ultimately, anyone connected to the healthcare industry is focused on the common goal of exceptional patient care. Below are a few examples of nontraditional roles and benefits.

• Alternative sites give nurses an opportunity to gain experience and new perspectives. Advisory Board’s case study with Seattle Children’s detailed a split work model in the oncology inpatient unit and outpatient clinic. Their nurses alternated care sites every six weeks. As a result of this model, they found increased job satisfaction and less burnout. Patient and family satisfaction also increased from the continuity of care.
• Float positions or pools provide more worker and organizational flexibility. Creating roles beyond a traditional 8 or 12-hour shift gives nurses more control over their lives. They can better plan off time and feel supported in their personal growth. Nontraditional shifts also help leaders better plan operational budgets while possibly decreasing the number of part-time or PRN staff.

• Work-study programs upskill nursing talent while meeting patient needs. Ideally, every nurse that applies to your organization will have the exact skills and experience your community needs. In reality, thousands of nurses may not meet those criteria. That’s why Health Carousel partnered with Chamberlain University on a work-study program to attract future nurse leaders and educators to client organizations. Health Carousel pays for the education of nurse alumni from the PassportUSA program to earn advanced nursing degrees while they’re working a required 36 hours per week (average) at your organization. Program offerings range from RN to BSN through to MSN, DNP, and NP. This benefits the nurse/employee and improves your staff's skills and experience.
• Nursing leader roles help to keep veteran nurses on the job without being at the bedside. As noted above, nurses have numerous opportunities to step out of direct patient care and share their skills with more people. Patients can benefit from remote monitoring or education. Coworkers can focus less on unnecessary, but unrelated to patient care tasks. Leaders will benefit from streamlined processes and collective knowledge.
• Role flexibility leads to better scheduling and coverage. Even if you don’t create a specific float position, establishing practices to allow staff to flex within department or specialty needs creates a better understanding of roles and responsibilities. This is especially key when covering sabbaticals or short-term leaves and filling targeted openings with contract professionals. Understanding capabilities creates a clear path to covering acute and chronic shortage areas.

No matter where we go next in the world of nursing workforce, the demand for increased flexibility will continue to be at the forefront. Understanding that answers may come in nontraditional forms is key to making staff feel invested in their facilities. Creating those opportunities will also help us keep more nurses in the industry.

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* This blog is part of the Flexible Nursing and Allied Health Workforce series.

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It’s a new age in healthcare. But it’s an age not driven by new technology or advancements in medicine, but by workforce demands and labor shortages, especially for nurses.

A new facility, neurotechnology, or 3-D printing for presurgical planning can’t hide the fact that there aren’t enough nurses on the floor. Diagnosing diseases with artificial intelligence isn’t going to shorten a six-hour wait for a patient in need because you don’t have the available staff. This new age is feeding frustration for patients, burnout for staff, and increased turnover that only exacerbates the problem.

The Nursing Shortage is Here

The truth about the nursing shortage in the United States is complex. According to a recent study by the Advisory Board, increased turnover is behind the current staffing shortages. In 2020, the average RN turnover was 18.6%, even higher (24.6%) for nurses with less than one year experience.

The problem is made worse by the time and difficulty in filling open positions. It took an average of 89 days to fill an open bedside RN position in 2021, according to the Advisory Board. That’s time where patient frustration grows, and staff burnout increases.

Behind these healthcare challenges are several other factors:

• Increased Need for Healthcare: A confluence of external factors means that more people need healthcare. This includes the continuing aftereffects of a pandemic and an aging population with increased medical needs and complex chronic conditions.

• Current Demand Gap for Nurses: It’s widely accepted that there aren’t enough nurses to cover current needs. Healthcare leaders are already behind in implementing staffing solutions even as they look ahead to addressing future needs.

• Staff Exhaustion and Burnout: As turnover increases in conjunction with increased need, there is more pressure on current staff. Exhaustion and burnout become a factor as your staff struggles to cover the gap and provide exceptional care.

• The Education Pipeline is Taxed: A solution to the nursing shortage isn’t available in the U.S. education pipeline. Nursing education isn’t designed to rapidly recruit and place new students to fill the need, and the existing pipeline isn’t adequate.

• External Pressures on the Workforce: The labor shortage isn’t just impacting healthcare, but other industries including manufacturing and retail. The U.S. Chamber of Commerce has found that 3 million people have left the workforce since February 2020. The competition for new workers is fierce.

• Additional Staffing Challenges. Along with a nursing shortage, healthcare leaders are also struggling to fill other positions, including physicians.  These challenges put additional strain on staff already stressed to the breaking point.

Experts predict that the current labor crisis is only going to grow worse, as patient rooms fill and fewer nurses and other allied health professionals are available to care for them. It’s a problem that feeds itself, one that will get worse if it’s not addressed now.

Healthcare leaders need a solution. For many, healthcare workforce flexibility is that solution.

The New Normal: Workforce Flexibility

For healthcare, workforce flexibility recognizes that the current labor demands require innovative, customized solutions. Workforce flexibility is about providing resources for your current staff so they can better perform their duties and increase your staff retention. It’s also looking at other options to deliver those resources, which can include cross-specialization, automation, rethinking the traditional shifts and their responsibilities, or working with a staffing partner.

To address nationwide workforce flexibility, facilities are exploring ways to provide and implement it without compromising the quality of care. A single, one-size-fits-all solution isn’t adequate for an issue as complex as providing workforce flexibility to address the labor shortage. Rather companies need to develop a customized solution.

For example, rural facilities may need a solution that addresses longer-term staffing needs as recruitment capabilities are limited. Whereas an urban facility may require amore adaptable staffing solution to provide the workforce flexibility that improves overall retention.

Finding a staffing partner that can provide a spectrum of solutions, customized to meet your strategic needs, is the only way to adequately address the current nursing shortage.

A Partnership Solution to the Nursing Shortage

Healthcare leaders are actively working with Health Carousel to implement customized and strategic solutions to address the nursing and allied health shortage.

The spectrum of services offered by Health Carousel provides a depth and breadth of critical resources that few other companies can match. It’s based around a leading, transformative healthcare technology platform that connects you to a deep pool of staffing resources – solutions are literally at your fingertips.

That includes short-term travel nurses and allied health professionals that can take pressure of current staff to long-term international nurses and allied health that provide staffing stability even during these challenging times. You’ll also work closely with a member of the Health Carousel team to develop a customized long-term strategy that addresses not only current needs but looks to the future to build a foundational solution that focuses on patient care and sustainable staffing answers.

The new normal in healthcare staffing is workforce flexibility. It addresses the needs of staffing through partnership and innovative solutions and looks beyond your immediate hiring market to a global talent pool. Flexible support helps already overworked nursing staff so they can provide better care. And last, but never least, it’s about leveraging a technology platform to quickly address needs as they happen and working side-by-side with a leader in healthcare staffing solutions.

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‍The following article is based on a panel discussion hosted by Health Carousel and the National Rural Health Association. To listen to part of the candid discussion on the go — Including additional content from this conversation —  download The Workforce Solution, available in iTunes, Spotify or wherever you listen to podcasts.

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What will your hospital administration do differently in a post-COVID pandemic era?

That was a critical question at a recent panel discussion hosted by Health Carousel and the National Rural Health Association called: “'Mind the Gap: Managing Your Workforce Efficiently.”'

“COVID has hyper exposed the vulnerabilities of how we approach workforce strategy, planning and management, and I'm reading every day in Becker's where hospitals are shutting down or being acquired. It's every day, and it's multiple organizations,” said Alan Dial, president and creator of Staff DX, a cloud-based workforce solution software.

“If you're a senior leader at a hospital: What are we going to do different tomorrow and the next day?  What are we actually going to do different? … And if I don't know the answer to that question, who am I partnering with to craft the right response for my organization?”

The panelists identified the top trends facing the industry — including staffing shortages, recruiting and retaining talent, provider burnout and fatigue, technology and more.

Read on for 7 key issues and solutions the panelists discussed.

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1. Introduce more rigor and science to your nurse recruiting campaigns.

Recruiting quality talent begins far before the job posting, said Earl Dalton, a healthcare innovator and Chief Nursing Officer at Health Carousel.

It starts with more rigorous research into the available employment pool within your local community or your digital reach.

Who is available for hire, and what are they looking for in employment? How has that shifted over time?

“If you looked at your benefits package, it mostly aligns to a Gen X, if not a Boomer, generation. It is about your medical plan, your dental, your 401k and all these things,” Dalton said. “It doesn’t really speak to a Gen Z’er who is 19 years old and getting ready to come out of nursing school.”

Consider everything from employment benefits to workplace policies (like the use of technology in the office) to flexibility in scheduling.

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2. Consider empathy and work/life balance to prevent burnout and turnover in the first place.

One of the keys to retaining talent is more empathy and understanding for employees, said Michele Sexton, a 25-year industry veteran who is currently serving as CEO for hospitals during COVID and is the owner of Mission Health Care and Mission Physician Partners.

Currently, only 19 percent of nurses under age 35 feel their organization cares about their well-being, according to a recent survey from the American Nurses Federation.

Sexton credited former hospital CEO Brian Paratis, author of the book “Lead with Love,” for shifting her perspective on this.

“His approach was well ahead of his time in that we are going to have to, again, lead with love as leaders, lead with empathy and understand what’s going on in people’s lives,” Sexton said.

It’s a proactive way to avoid burnout in the first place, she said.

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3. Seek opportunities to work nursing to the full extent of their license.

Both rural and urban administrators could be more creative and efficient in managing their workforces, Dial said.

“We need to be more creative in how we maximize our resources,” he said.

Among his recommendations: Remove non-clinical tasks that consume a nurse’s time by adding in more support roles, and seek out and create bimodal nursing resources.  

“The position of nursing across the country is not changing in the near term, so we have to react to that and unburden them so we can kind of control the bleeding.”

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4. Invest in smart technology that goes beyond reporting of data.

One more example Dial gives of how to remove time-consuming tasks from a nurse: Eliminate or reduce the time spent on administrative tasks like scheduling.

“I talk to directors all the time who say they spend 10 hours a week in scheduling. Why? Why do we need to spend 10 hours a week scheduling? It's ridiculous,” he said.

Technology can play an important role — but too many technology tools are really just reports that regurgitate data that you input, Dial comments.

“Reports in themselves do not change and sustain behavior,” he said.

Dial referenced his platform, StaffDX, that supports planning, budgeting and analyzing staffing strategies. It supports scheduling and even considers day-of-week variation in patient demand.

“Choose technology solutions that eliminate the paper, mundane administrative tasks associated with being a clinical leader,” Dial said. “I mean, as much of that as we can eliminate — again, in the spirit of maximizing our resources — I think that's going to go a long way. Then we can be put in a position where we’re proactive vs. always looking in the rearview mirror.”

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5. Move beyond transactional relationships with vendors to create true partnerships.

One of the keys to a post-COVID hospital administration, the panelists agreed: Create partnerships and relationships, rather than transactional exchanges with vendors.

Hospital administrators, by nature and training, tend to be leaders who make independent decisions, Sexton said.

Moving into the post-COVID era, it’s more important than ever that hospitals consider things like grants available or Carts Act funding that could cover products, services or COVID-related staffing.

“There's no way to understand all of those things. We need to have partners that are calling us up and saying hey, did you understand that new Cares Act funding?” Sexton said. “It's going to take a village to continue to be able to take care of our patients.”

Dial agreed on partnering with experts, in part because: “I don't always know what I don't know.”

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6. Hiring a staffing partner to support short-term and long-term solutions to the staffing shortage.

As she built successful partnerships, Sexton and Mission Group went so far as eliminating their internal recruitment department several years ago.

Her new model, working successfully with staffing firm partners, has been somewhat novel and highly effective for business, she said.

“Is it possible I know everything? And if it's not possible, which it's not, what am I going to do to surround myself with the team, and with my partners, who can help me move forward and solve my issues?” Sexton said. “And that's a real gut check for us in the hospital C suite.”

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Dalton offered four key checkpoints for vetting potential staffing firm partners:

1. Learn about the firm’s true recruiting capability. How many people will specifically be assigned to help your hospital?
2. Ask about their marketing strategy. How do they plan to reach selected audiences?
3. Do they have clinical competency? How important is that to their firm?
4. What is their digital presence and reach? It’s incredibly important in today’s world to have access to nurses 24/7.

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7. Proactively monitor for burnout at all levels — including in you and your team.

Dalton recently attended a Staffing Industry Analysts conference where a presenter asked: “Where does your personal team sit for burnout?”

The question “hit me square in the face,” he said. “Burnout is everywhere … but have we been the change we need to seek in the world? How are you doing in your own house?”

Back at Health Carousel, Dalton promptly kicked off a series of quarterly reviews around burnout for his management team to assess and evaluate their own burnout levels.

“Can my team identify burnout in themselves? How's your relationship with your mate, your kids, your God? How are you taking care of yourself physically?” Dalton said. “Can you even identify some of the problems related to burnout yourself?”

He challenged the panelists to look at themselves and their own team and to do so in an intentional, measurable way.

“Our hospital partners require of me and my team more than ever to be on our A game,” he said. “ And I really think … you’ve got to have it to give it.”

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This article was based on a panel discussion hosted by Health Carousel and the National Rural Health Association. To listen to more of the candid discussion, download The Workforce Solution, available in iTunes, Spotify or wherever you listen to podcasts.

What happens to a nursing unit in crisis that is already short on staff — and then a nurse takes PTO or goes on leave?

Situations like this can lead to a decline in quality measures, workflow disruption and patient dissatisfaction, as well as low morale among employees and increase in turnover rate.

“There’s pretty much a cascade of events that happens almost like clockwork,” said Earl Dalton, Health Carousel’s Chief Nursing Officer. “I see this play out literally every single day around the country.”

One simple strategy can help facilities better prepare for staffing shortages, Dalton said: Plan based on your unit’s operational vacancies, rather than only true vacancies.

True vacancy looks at simply how many positions exist in the budget vs. how many of those positions are currently vacant.

However, operational vacancy factors in not only vacant positions, but also the employees who are unavailable to work a shift for various reasons — like vacation, maternity leave or training.

“If you can predict yet another road bump that’s coming into your future, you can be ahead of filling that with temporary labor or, if it makes sense, full-time labor,” Dalton said.

Dalton discussed predictive staffing models on a recent episode of The Workforce Solution podcast. Listen to the episode now on iTunes, Google Play, Spotify, Stitcher and iHeartRadio.

How to calculate true vacancy vs. operational vacancy

True vacancy looks at simply how many vacant positions you have on your staff.

For example: If your unit has 10 nurse positions in its budget, and only 8 nurses currently on staff, then the unit has 2 vacant positions, or a 20 percent true vacancy.

Operational vacancy dives a layer deeper. It factors in the people who are on staff but not operationally available to work shifts.

Here’s how to calculate operational vacancy to better predict nursing shortages:

1. Review historical staffing data for the last 3 years.
2. Review the total use of FMLA by month and determine the unit’s average FMLA usage by month.
3. Repeat for average PTO usage by month.
4. Repeat for orientees who are on staff, but still in training and not working at full capacity.
5. Now add the unit’s true vacancy + average FMLA + average PTO + average trainees, subtract any contract labor = operational vacancy.

Dalton recommends reviewing these numbers at least 3 months ahead.

A quarterly review is also the time to take note of any known upcoming absences — like a nurse who will be on maternity leave, on vacation or recovering from surgery.

Why a predictive staffing model helps with nursing shortages

A predictive staffing model creates time to consider solutions like a temporary travel nurse or a permanent position, Dalton said.

“Rather than be in that situation and raise the red flag for help, you can be ahead of the shortage and have someone scheduled to come in, simply by staying on top of it,” Dalton said.

Benefits of predictive staffing models include:

• Improves staff planning and scheduling
• Allows hospitals to staff to patient need
• Ability to run “what if” scenarios

About Health Carousel

Health Carousel is ranked among the top healthcare staffing agencies in the nation.

Unlike other travel staffing organizations, we can rapidly scale marketing and recruiting efforts to meet critical needs and offer flexible start dates, shifts and assignment lengths.

Our experienced, in-house clinical team serves as an extension of your team to assess, interview and onboard top talent. See our Health Carousel Travel Network for more about travel nurses, or contact us below.

The Institute of Medicine recently released its “The Future of Nursing 2020-2030” report, a comprehensive analysis on the state of the industry that lays out a blueprint for the future of nursing.

“Nurses are powerful in number and in voice and the world needs their actions now more than ever on how individuals, families, and communities might best be served in a more equitable fashion,” wrote Dr. Victor J. Dzau, president of the National Academy of Medicine.

The report is a “navigational beacon” for healthcare and nursing leaders, said Earl Dalton, Health Carousel’s Chief Nursing Officer with more than 25 years of industry experience.

One big theme, Dalton said: Broadening access to care for underserved communities.

“This report would certainly validate and backup that ... the efforts our hospitals are putting into this should continue,” Dalton said.

Listen to the related podcast episode now on iTunes, Google Play, Spotify, Stitcher and iHeartRadio.

Dalton and the clinically led team at Health Carousel read through the 500-page report and pulled 10 key takeaways for nursing and healthcare professionals.

1. To build a nursing workforce that meets the growing needs of the U.S. population will require a substantial increase in numbers, types and distribution of the nursing workforce.

Meanwhile, in 2030, an estimated 73.1 million people, including all baby boomers, will be older than 65, according to the U.S. Census Bureau data from 2020. That’s 21 percent of the U.S. population.

To meet those needs will require an increase in the nursing workforce, as well as an education system that better prepares nurses for practicing in community-based settings with diverse populations.

“These improvements will occur more rapidly, more uniformly, and more successfully if programmatic, policy, and funding opportunities can be leveraged by health systems, governments, educators, and payers,” the report authors wrote.

2. Anticipate long-term impacts of the COVID-19 pandemic on the nursing workforce.

In the face of the COVID-19 pandemic, many nurses will experience more stress, feeling of inadequacy, compassion fatigue and physical exhaustion.

Some of these nurses may leave the profession. Many will need more help.

3. It is necessary to place more intentional focus on providing models and opportunities for the emergence of more diverse nurse leaders.

“The nation cannot achieve true health equity without nurses, which means it must do better for nurses. They must be supported in charting a path for themselves while they work to serve others,” the authors wrote.

A particularly critical role for nurse leaders is hiring and mentoring nurses from traditionally underrepresented communities to build a more diverse nursing workforce.

The report calls on organizations that employ nurses to provide nurses with ample opportunities, resources and mentorship to realize their full leadership potential.

4. The average age of the RN workforce has decreased to under 44 for the first time in years.

That’s because a large number of RNs from the Baby Boomer generation — estimated at 1.2 million — have retired, and younger nurses are entering the workforce.

Those changing demographics could impact everything from how patients are treated to how the industry markets and hires new nurses to hospital policies, Dalton said.

5. The number of first-time internationally educated candidates taking the nursing exam has dropped.

Internationally educated nurses (IENs) make up 8–15 percent of the nursing workforce in the United States, with a majority coming from the Philippines.

However, the number of first-time internationally educated candidates taking the NCLEX-RN exam dropped by more than 50 percent between 2007 and 2019, from 33,768 to 15,053.

The decreases in IENs can be attributed to factors that include visa retrogression and the economic recession of 2007 to 2009.

6. Fewer RNs are working in rural areas today than in the past (17 percent in 2005 versus 14.4 percent in 2018).

The decrease in rural practicing RNs occurred more rapidly among younger RNs (under age 40) than among RNs over age 40 (from 16.4 percent to 14.9 percent).

If this decrease continues, it will threaten access to care among the nation’s rural population, the authors write.

7. Because nearly one-third of LPNs are over age 55, their impending retirement over the next decade raises concern about a potential shortage of these nurses.

Such a shortage could mean that home care, long-term care, and care for individuals with disabilities and otherwise vulnerable groups will increasingly have to be provided by the RN workforce.

8. FTE NPs will more than double from 157,025 in 2016 to 396,546 in 2030.

That’s a projected growth of 6.8 percent annually for the NP workforce. It will be useful to overcome projections of primary care and specialty physician shortages over the decade.

9. In the longer run, the pandemic may lead to fundamental shifts in the demand for and supply of nurses.

On the demand side, there may be a substantial restructuring of care delivery, such as a shift toward telehealth or permanent staffing reductions in hospitals. On the supply side, the pandemic may either increase or decrease entry into nursing.

10. Nurses will play a pivotal role in health care equity in the future of healthcare, but this will require an expanded role using the full extent of their education and training.

It will be necessary to revise scope-of-practice laws, public health policies and reimbursement rules for Medicare and other payers, the authors wrote.

“If health care equity is to be fully achieved, nursing schools will need to focus on ensuring that all nurses, regardless of their practice setting, can address the social factors that influence health and provide care that meets people where they are,” the authors wrote.

To purchase the complete “The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity,” click here.

Is your facility searching for more healthcare professionals amid the national shortage?

Health Carousel gives you access to an unmatched nationwide network of highly qualified nurses, specialists and allied healthcare professionals when and where you need them.

For more information, contact us now.

Nurses are experiencing unprecedented care fatigue and burnout — but there’s one action nursing leaders could take that costs little to nothing.

“Everybody needs to feel a sense of accomplishment in the work that they're doing. It doesn't matter what you're doing, that's important,” said Earl Dalton, Health Carousel’s Chief Nursing Officer. He has more than 25 years experience in nursing.

“There are too many nurses …. that just have to stop and lay things down. They can’t get them to it all,” he said. “Their sense of completeness and their sense that they got things done aren't there.”

Over time, that can affect the fulfillment and satisfaction of the nurse. If left unchecked, care fatigue leads to burnout. Burnout leads to higher call out rates, turnover and declining patient satisfaction.

“What is incredibly common in healthcare is that the negative stuff is sticky and sticks to people. It tends to weigh on people’s minds,” Dalton said.

One simple way to help support nurses, increase morale and ultimately protect patient care: Consistently recognize and show appreciation for the good work of your nurses.

Recent research shows that symbolic awards -- like congratulatory cards or public recognition -- can significantly increase morale, performance and retention, according to the Harvard Business Review.

Recognition is powerful, Dalton agrees. Nursing leaders can get creative in how they express this, but it can be as simple as a handwritten note or thank you card.

“Those things are worth their weight in gold and really cost nothing, but are so incredibly impactful and powerful to a nurse,” he said in a recent interview for Health Carousel’s podcast, The Workforce Solution.

Listen to the related podcast episode now on iTunes, Google Play, Spotify, Stitcher and iHeartRadio.

Dalton recommends adopting a scorecard model, where nursing leaders track how often they’re recognizing nurses daily or weekly.

Below are 5 ideas for healthcare or nursing leaders to recognize and show appreciation for a nurse.

5 Ways Nursing Leaders Can Recognize a Nurse

1. Say “thank you” or offer a compliment daily.

A simple kudos or verbal compliment can go a long way. Things like “I’m so glad you’re part of the team” could be well received.

Timely and specific feedback is best, Dalton said. So mention something specific you noticed the nurse say or do that day, even something as simple as a procedure done correctly.

2. Deliver a handwritten note.

The HBR researchers suggested personalized letters to the employees that start with a sentence like: “Your work has consistently had a positive impact on the patients you work with.”

Dalton said he’s also seen nursing leaders who leave a thank you card or Post-It note on a nurse’s desk or even on their windshield.

“Now nurses feel like they've got a leader who cares, a leader that's watching their performance specifically,” Dalton said.

3. Bring the team together for non-work meetings.

When you bring the team together, it creates a sense of community and builds social support. Take advantage of opportunities to celebrate achievements or special occasions.

Examples:

• Celebrate a birthday, work anniversary or achievement together with lunch, a treat or coffee.
• Invite the nursing unit to a baseball game or a community event.
• Schedule a team-building event just for fun, like mini golf, an escape room or a DIY craft.
• Start a book club.

4. Show you care about their interests.

Do you know the interests, hobbies or personal passions of your nurses? Show genuine interest. The personal touch can go a long way.

For example: If one of your nurses loves gardening, grab a copy of Home & Garden magazine for him or her.  If you and one of the nurses both love a specific sports team, share an interesting article you read.

5. Create a list of award opportunities in your city or state.

Individual nurses or entire units may qualify for awards at city, state, regional or even national levels. Common awards include nurse of the year, local heroes and women in business.

Search Google, check with your state nursing association or ask your local Chamber of Commerce.

Create a list of awards that might apply, now or in the future. Then set a calendar reminder once a quarter to review that list and consider if you have any nominees.

Examples of state-level awards:

• The Ohio Nurses Foundation hosts an annual Nurses Choice Luncheon.
• The Colorado Nurses Foundation hosts the Nightingale Luminary Awards.
• NYC Health + Hospitals, the largest public healthcare system in the U.S., hosts an annual Nursing Excellence Awards.
• The state of California launched the Skilled Nursing Facility Hero Awards.

Featured national awards:

• The DAISY Foundation is one of the most prestigious awards in the nation to recognize extraordinary nurses. Learn more here.
• Women in Healthcare celebrates women in the industry with several awards, from rising star to making a difference. See award categories here.
• The National Rural Health Association (NRHA) honors outstanding individuals and organizations in the area of rural health. See more about the Rural Health Awards here.

Dalton and the board-certified clinical team at Health Carousel have more than 100+ combined years of hands-on clinical experience. They leverage that first-hand experience when they screen and interview candidates for you, accelerating the placement of high-quality providers.

They provide onboarding and training and continue to be available 24/7 to provide coaching or resolve any clinical issues that may arise.

For more information about Health Carousel’s world-class recruiting and staffing solutions, click here.

Today’s corporate atmosphere is changing to reflect some emerging values of our world. Social awareness and corporate social responsibility are considered must-haves by some job candidates and when consumers need services. Companies that promote and understand a “give back” mentality tend to attract and retain more qualified candidates for their positions and build stronger business relationships.

Nowhere, perhaps, is this more relevant than in the healthcare industry. Most physicians and other providers initially entered their field with a desire to help others. So, healthcare companies with solid volunteerism values tend to rise to the top in terms of staff loyalty, elevated employee morale, and an optimized business bottom line.

Volunteering as a company practice offers many benefits to the community, the employees, and the business itself.

Community Benefits of Volunteerism

From children’s programs, food banks, schools, animal shelters, or other non-profits, every community has underserved populations needing support. With a few keystrokes — or phone calls — your company can identify local organizations seeking volunteers. By partnering with an organization that aligns with your company values, your organization can make a huge difference in your community.

Consider the impact if each of your employees volunteer yearly — to some degree and even for just a few hours — and how that could make a difference in your area. Building strong communities supports the general infrastructure, which includes the healthcare system, so by adding your resources into the mix, you can significantly improve the community right outside of your doors.

Some hospitals support a more global outreach and encourage employees to volunteer in national disaster situations or overseas. By promoting a global vision of volunteerism, your hospital or practice can make a massive difference to the world in which we live, bringing resources to areas that are genuinely struggling.

Employee Benefits of Volunteerism

You can create a culture of compassion within your organization as the benefits of community service reap rewards.

First, colleagues tend to form bonds and friendships while working on projects outside of work. People who volunteer together often find they share common interests. When workplace relationships improve, increased productivity and job satisfaction follow.

Additionally, most employees welcome the opportunity to try something new during their day. Employees can learn new skills and strengths that can be applied to the regular working day, improving the overall flow of the workday and the efficiency of the systems.

Also, volunteering is good for your health. A 2018 study described the positive benefits of community service to self-esteem, blood pressure, life satisfaction and depression.

How Volunteerism Affects the Company Bottom Line

Certainly, organizations that promote volunteerism and support their employees develop a more positive brand image and attract new relationships. By celebrating the volunteer work of your staff in a public way, you can create a market presence known for compassion, care and community — three values that are in alignment with medicine.

Increased staff productivity, improved staff retention, bringing in new patients and building a positive image in the community all work to increase revenue and improve your bottom line. This helps to support further growth and develop innovative programming for the future. Ultimately, the positive feedback cycle of company volunteerism is endless.

How to Support Volunteerism in Your Healthcare Company

There are many ways you can create a company culture that supports volunteerism. The first is to provide paid time off for volunteer hours. Some companies build several paid days off per year into the benefits package so that employees can support an organization that personally matters to them. Employees feel respected, supported and individualized when their organization provides this generous benefit.

Also, reward service within your organization by spotlighting volunteers and recognizing the charitable contribution of others. When employees see your facility’s support of service work, they are more inclined to build that virtue in their own lives, realizing it aligns with their work values.

Some medical groups send teams of people to other countries — or underserved regions of the U.S. — to work in areas of extreme need, offering people exceptional care to which they may not usually have access. This kind of experience can be life-changing for medical professionals and transform their practice and priorities upon return. By widening the scope of care, hospitals can show they reflect their values worldwide, which is inspiring indeed.

How Locum Tenens Can Help Support Your Volunteer Program

Because medical providers are so essential within the hospital system, filling a slot may be necessary to allow your physicians or staff time off to volunteer. Locum tenens providers are the perfect solution for this situation.

Short-term professionals who can step into a vacant role will support the flow of patient care so that you can allow your doctors, nurses and other practitioners time to volunteer. While it is a financial outlay to hire a locum tenens provider, the rewards of the decision can far outweigh the cost.

Remember, your doctors and other providers will feel personally and professionally supported by your hospital. Additionally, the positive morale, teamwork and company image will likely draw more revenue over time than the amount you are paying for a locum tenens provider.

You will likely have less staff turnover and attract top-tier, loyal staff into any new roles that arise. The benefits of company volunteerism cannot be overstated.

By thinking outside the box — in fact, by thinking outside of the four walls of your facility — you can be sure to create a positive company culture that transforms your employees and your community. Find out more about how locum tenens can help support your specific company volunteerism and start the program. Your employees, your patients, and your community will thank you.

No shows can have a serious impact on healthcare staffing, resource allocation and the facility’s bottom line. 

Christine Luckie is the Director of Operations at UCHealth Medical Group in Colorado Springs, Colorado. She said the staff recently stumbled upon a solution to help drive higher patient attendance. 

The COVID-19 pandemic forced the expansion of the hospital’s virtual health platform. It was “a bit stressful but has really broadened our ability to bring health care close to home,” Luckie said. 

And, it turned out with teleath options, the push toward a digital environment helped with no shows. 

There were fewer reasons to skip an appointment: No COVID-19 concerns, no transportation issues and fewer scheduling complications.  

“So it's allowed us to actually reduce the number of no shows that we have and increase our ability to touch base with patients in a way that is convenient for them,” Luckie said. 

It’s helped the facility with everything from staffing allocation to a more proactive approach to caring for patients’ health. 

“We're not just taking care of you when you are at your sickest. But how do we also care for you across the continuum and make sure that you have all of the resources that you need to be as healthy as possible?” 

Luckie spoke in an exclusive interview more about the rapid shift toward telehealth and virtual platforms. 

Listen to the exclusive interview below, or read the transcript here. 

Nursing homes struggled with staffing even before the pandemic -- but jumped to a 23 percent shortage in the USA by the end of 2020.

That shortage means resident care can suffer, workers face more stress and COVID cases can spread faster, 

U.S. Public Interest Research Group warned in a January 2021 report.  

It took a toll on some nursing homes. 

“Other nursing homes, I will call it the mom and pop nursing homes, did not make it. They were struggling to the point that they had to close,” said Marissa Varney, assistant administrator at St. Marys d'Youville Pavilion in Greene, Maine. “Other facilities really could not help them because they are on the same boat of staffing challenges.” 

St. Marys d'Youville Pavilion was able to continue serving its patients — thanks, in part, to international nurses. 

They stepped in, including to fill shifts that would otherwise be difficult to hire, like nights, weekends and holidays. 

“The nursing staff that we have selected are very passionate about the patients. They're very dependable. They never complain,” Varney said. “We just tell them this is your assignment. This is where we need you. Okay.” 

Through our international recruitment brand, PassportUSA, we have the largest network of highly-qualified and credentialed global healthcare professionals available for interview and selection available anywhere. 

They have on average eight years of experience and education and training that exceeds common standards or practice in the United States.

“This nursing staff that we have received from Passport, you know, I can't thank them enough for working in this building,” Varney said.

Varney spoke in an exclusive interview about why she was drawn to working in a nursing home and what changes they made during COVID-19 to help both patients and providers. 

Listen to the exclusive interview below, or read the transcript here.

Even before the COVID-19 pandemic hit, CHRISTUS Health had a staffing problem — a mass exit of ICU nurses in their Corpus Christi region. 

The talent and recruiting team knew they needed to do something fast to stabilize. 

CHRISTUS Health is a faith-based, not-for-profit health system that includes more than 60 hospitals and long-term healthcare facilities and 175 clinics and outpatient centers. 

When its nursing shortage began, CHRISTUS initially relied on hiring short-term contracts to fill the gaps. However, the facility needed a reliable solution. 

That’s when international nurses became an integral part of their recruiting strategy. 

“We need to be able to shift and move with the needs of our populations, with the communities that we serve,” said Manuel Acuna, director of talent acquisition at CHRISTUS. 

“And what this does, it truly allows us to have that buffer, that safety net, we can fall back on and know, within the next 12 to 36 months, this is what we have.”

CHRISTUS partnered with PassportUSA, the largest network of highly-qualified and credentialed global healthcare professionals available for interview. 

The PassportUSA relocation and resettlement process includes helping healthcare professionals to establish households near the assigned work location and supports their family unit.  

“With other organizations, I used to be the one with the boots on the ground and picking them up from airports and worried about, you know, car seats for kids and things like that,” said Talent Acquisition Executive Corrian Nwankwo. “So it's taken a load off of me personally. We're not doing those things anymore, and I'm freed up to do other things.” 

In an interview with Health Carousel, the recruiters from CHRISTUS spoke more about international nurses and what helped to make them a great “cultural fit.” 

Listen to the exclusive interview below, or read the transcript here.

Thousands of healthcare workers at hospitals across the country were laid off in 2020, as healthcare facilities struggled with the COVID-19 pandemic and the sudden decline in most patient cases. 

Not the Cleveland Clinic’s Euclid Hospital.

“One thing that the organization did do, which is unbelievably commendable, is no one got laid off,” COO Leonard Stepp said. “If you got sent home, you got paid. And no one took a pay cut, no benefits, nothing. It was unbelievable.”

The Cleveland Clinic is a non-profit American academic medical center based in Cleveland, Ohio. Their reach is national with 66,000 employees across the entire healthcare system. 

Stepp spoke to Health Carousel recently about the first days of the COVID-19 pandemic and how healthcare teams like his scrambled to make quick changes. 

“One thing the organization did a really nice job of is that they looked at their pool of resources and their employees and said: ‘We're going to upskill,’” Stepp said. 

Surgeons were taught how to manage basic medical patients, and respiratory therapists were taught how to support the medical-surgical floors. 

Other caregivers were sent to major facilities across the USA to help during COVID-19 surges. 

In the interview, Stepp dived into more detail about how the Cleveland Clinic trained staff on new skills, as well as what worked well to communicate with healthcare staff during rapidly evolving situations. 

Listen to the exclusive interview below, or read the transcript here. 

Long before becoming a leader at a South Carolina hospital, Leah Ramos was an international nurse. 

She was born and raised in the Philippines. She initially wanted to become a math teacher, but ended up choosing nursing school and fell in love with it. 

“It's really the opportunity for a better life, not just for me, but for my family,” she said. 

Ramos now works as executive director of nursing  for the Adult Hospital at Medical University of South Carolina. 

Like many hospitals, they have staffing gaps with the nationwide nursing shortage — but MUSC has found a solution they love: International nurses. 

“I knew that international nurses will be hard workers,” Ramos said. “I know that they'll be able to adapt, because they really want to excel and they want to be perceived as an asset to whichever organization will hire them.” 

International nurses also bring different experiences and ideas into the facility. “It just really adds diversity in the mix, which is an important value for us as an organization,” Ramos said. 

Through our international recruitment brand, PassportUSA, we have the largest network of highly-qualified and credentialed global healthcare professionals available for interview and selection available anywhere.

The PassportUSA relocation and resettlement process includes greeting healthcare professionals at the airport, helping them to establish households near the assigned work location and supporting their family unit.  

Christy McEachern, the clinical director at MUSC, said the international nurses have been a relief for staffing.

“Before, we had such a hard time recruiting,” she said. “The other option would have been a traveler, who we have to renew their contract every 13 weeks. And so there's a lot to be said for that knowing that we have these individuals here for sure, for three years, but hope they will want to continue to stay with us forever.” 

Ramos and McEachern spoke to Health Carousel more about international nurses and the other innovative staffing solutions they introduced to MUSC.

Listen to the exclusive interview below, or read the transcript here.

Few places are experiencing the nursing shortage more than rural Alaska. 

The state ranks No. 1 on a list of nursing shortages projected by 2030, with a predicted shortage of 22.7%, according to the National Center for Health Workforce Analysis.  

Foundation Health Partners is the largest healthcare system in Interior Alaska, serving an area of approximately 250,000 square miles. 

“There is a staffing need that comes on the back of that, and that is the elephant that sits on my chest every day,” said Jennifer Hoskins, talent acquisition and development director at Foundation Health Partners.  

Local nursing graduates fill only 10 percent of the positions, at best. Then there are the nurses who don’t want to work full-time. The biggest challenge is the remote destination and finding nurses willing to relocate long term.

“What our world typically looks like is a never ending cycle of travelers,” Hoskins said. “So we have this sort of mountain every year of these positions we have to fill.” 

Until Hoskins hired Health Carousel’s PassportUSA brand to bring in international nurses. 

PassportUSA is the largest network of highly-qualified and credentialed global healthcare professionals available for interview and selection available anywhere. The growing pool of candidates has, on average, eight years of experience and education and training that exceeds common standards or practice in the United States.

“We had heard from some other leaders who had joined our organization that said, ‘We can't believe you guys are not doing this,’” Hoskins said. 

The PassportUSA team quickly helped the system identify 25 nurses who would be a good fit — more nurses than the local school graduates in an entire year. 

“I was just relieved because nursing leaders, I think, could be a tough group to satisfy just because they're by nature skeptical, which I love,” Hoskins said. 

In a recent interview, Hoskins spoke more about the surprises of hiring international nurses, as well as a behind-the-scenes look at how COVID-19 impacted Alaska differently than most states. 

Listen to the exclusive interview below, or read the transcript here.

More than half the healthcare facilities in the US now partner with a managed service provider (MSP), and that number will likely continue to climb as the industry learns from COVID-19.

The movement toward MSPs started long before the pandemic, with a push toward needing to have expenditure controls and a centralized source of credentialing for contingent staffing. 

“And when the pandemic hit, if a hospital didn't have some sort of centralized source like an MSP, they were truly at a loss, and so they had to create these haphazard war rooms,” Health Carousel VP Ariella Gottlieb said. 

A typical healthcare HR team manages relationships with as many as 100 different vendors. 

A key lesson of COVID when it comes to contingency staffing: If an urgent or critical need pops up, the internal team may not have the time or resources to quickly hire top talent. 

“So the timing is right for a lot of these systems to say, we really need more than just a transactional relationship. We need a partner,” Gottlieb said. “We need somebody who has all of these services and can take this off of our shoulders.” 

Think of the right MSP as an extension of your HR department, there to recruit top talent and to help streamline the management of all temporary staff under one umbrella -- from hiring to credentialing and beyond. 

“Then the staffing office is relieved of a lot of those duties, and can go in and out -- depending on their schedule -- of interviewing, selecting, confirming, checking, credential, so on and so forth,” Gottlieb said. 

Gottlieb spoke in an exclusive audio interview in more depth about MSPs, as well as how to address the growing demand of an aging population.  

Listen to the exclusive interview below, or read the transcript here.

What happens when you’re a recruiting staff of one and in a small rural community, but you need to replace providers and launch a new service line?

That’s what happened to Madison Health, a small hospital located in London, Ohio — a rural town located around 25 miles southwest of Columbus with a population of just under 10,000 people. 

Over the last few years, the hospital saw major changes in how they operate and treat patients. 

Three of the providers left via for personal reasons, like retirement and maternity. 

During the COVID-19 pandemic, the hospital introduced its patients to MyChart and telehealth options. It also decided to hire a pulmonologist for the first time. 

“We've always said we're small, but we like to think big,” said Allison Wenger, primary and specialty care clinical coordinator for Madison Health. “And I think this allowed us to do that and to show others and show patients and the community members that we can do it just like the big guys do.” 

Wenger knew she needed to find permanent providers, not a short-term contract, who could get the job done.

Patients are loyal to Madison Health and want someone who’s going to stay for the long run, not a short-term contract, Wenger said. “They hate that inconsistency. They want somebody who's going to come here, who’s going to love it and who’s going to stay.”

She’s a recruiting department of one, though, and would need additional support to find the right fit.

That’s when she decided to partner with Health Carousel. 

“They wanted to get to know Madison Health. They wanted to know what we needed and what we wanted,” she said. “I felt like we were having an impact on both sides. You're not just a number. You're not just a place and that's what we try to do at Madison Health. So I really liked that connection.”

In an exclusive interview, Wenger spoke more about the rise in telehealth and about seeing a rise in patients who are taking a proactive interest in their own health. 

Listen to the exclusive interview below, or read the transcript here.

An alarming 76% of healthcare staff reports exhaustion and burnout, according to a recent survey from Mental Health America. 

The burnout is nothing new, of course, but the numbers spiked in the last year due to the COVID-19 pandemic. 

Like many healthcare staff, the providers at Coxhealth — a locally owned, not-for-profit health system based in Springfield, Missouri — have been working long days. Many worked five 12-hour shifts for months without a break. 

“With a lot of employees having to take leave of absence with themselves being sick or their family being sick, we required a lot more,” said Rachel Westervelt, the administrative director of nursing at CoxHealth. 

Coxhealth tapped its healthcare staffing partners to send in extra help — increasing from about 50 agency staff to an incredible 400. 

These short-term contracts not only helped with increased patient need among shortages, but also provided a much-needed relief to permanent staff.

“We've been trying to tell them that they're not taking your jobs. We want you long term. So I need you to rest. And it's important to rest and take care of yourself,”  Westervelt said. 

“We're encouraging them to take time off. I want you to schedule a vacation, even if you just stay home, you need to take time off. And it's okay to do that and giving them permission.” 

In an exclusive interview, Westervelt also spoke about how her facility has been more creative and proactive about real-time research in the clinic.

Listen to the exclusive interview below, or read the transcript here.

As COVID-19 began to ravage communities across the country in early 2020, hospital sand other healthcare institutions stepped up to the challenges of the pandemic in extraordinary ways, drawing from their institutional knowledge and experience in responding to health crises.

Nurses, physicians and respiratory therapists worked around the clock to stabilize patients, save lives, and comfort families. Patient transporters, cleaning staff, food service workers and maintenance folks kept hospitals humming through the crisis. The pandemic also spawned innovations like a hospital supply trading platform set up by Stanford Health and the supply chain company Resilinc. \(^1\) Health systems forged new partnerships in an effort to defeat COVID-19. Health Carousel and other staffing companies pivoted quickly to deploy ICU nurses and respiratory therapists to pandemic hot spots.

Health Carousel also played a role in advancing the understanding supply elasticity of nurses. In an analysis of our staffing data during the pandemic, Joshua D. Gottlieb of the University of Chicago and Avi Zenilman, RN, of Yale University showed that nurses were ready to take on assignments far from home out of a sense of duty to help. The nurses’ commitment to help increased the elasticity and allowed U.S. hospitals to respond to the ups well in demand for ICU nurses when the virus surged in communities across the country. However, the elasticity of supply was not infinite. One of the factors that suppressed elasticity was state-specific licensure requirements.

The findings lend support for expanding the Nurse Licensure Compact (NLC) to all 50 states, making way for a national licensure model. Currently, 34 states are participating eNLC,(Enhanced Nurse Licensure Compact) an agreement that allows nurses to practice in other participating states without having to apply for licensure in each state. Non-participating states like New York and California temporarily relaxed licensing requirements to support struggling hospitals. In fact, in addition to the eNLC, 18 states issued executive orders to allow nonstate licensed nurses to practice in their state.

National licensure makes way for a larger country-wide pool of nurses with the ability to practice anywhere in the country without the need for emergency legislation. The value of a national pool, echoed in a white paper by Health Carousel, became apparent during simultaneous surges of COVID cases in multiple states and the resulting sharp increase in demand for qualified nurses. During the first period of ups well in COVID-19 infections from January-April 2020, travel ICU nurse jobs in Massachusetts and New York increased by 612% and 1,038% respectively. States not yet designated as hot spots during this time such as Arizona and Texas had increases of 265% and 59% respectively. \(^2\)

Health Carousel and other large staffing companies are perfectly positioned to manage large national talent pools and deploy nurses quickly to places where there is an immediate need, whether it’s an epidemic, pandemic, riot or natural disaster. Staffing companies have protocols in place to identify, screen and credential qualified candidates. They also have the logistical expertise required to speedily deploy qualified healthcare professionals to where they are needed nationally.

The nurse shortage that healthcare systems have struggled with for decades and the pandemic experience, underscore the importance of contingent workforce planning and staffing for hospitals. The need to identify and build strong partner relationships with staffing companies such as Health Carousel well before surges in demand for clinicians has never been greater. This is likely no greater indicator than the fact that according to Staffing Industry Associates (SIA), the US healthcare staffing industry has ballooned to an estimated $17.8 billion. Such relationships allow hospitals to continue to provide high quality care without the head aches and interruptions in care that result from understaffing. The strength of such collaborations will play a key role in how in how hospitals respond to meet the needs of their communities  in the years and decades to come.

As the pandemic has unfolded in the last year, it has tested our country in unimaginable ways. While COVID variants still pose a threat, the good news is that the worst of the crisis is receding. Multiple vaccinations have been approved for use. Infection, hospitalization and death rates are declining in many parts of the country. What can we do as a nation to prevent the great loss of lives and livelihoods that we experienced and witnessed during COVID-19? How can we prepare for future perils?

A strong public health system:

The pandemic has brought to the forefront the need for bolstering staffing and funding of public health agencies at all levels of government. A strong public health system is critical for the country’s ability to prevent disease, and respond to healthcare crises like pandemics, regional outbreaks of disease and natural disasters. Well-staffed public health agencies at the federal, state and local levels also play a central role in addressing ongoing concerns such as clean air, clean water, nutrition, children’s health and access to healthcare.

Clear public health standards:

Establishing clear public health standards and communicating them consistently are both essential in avoiding missteps in containing a pandemic. It’s encouraging that there are discussions and efforts now underway on the national, state and local levels about the need for clear protocols that will inform the country’s response to future outbreaks of disease.

Coordinated resource allocation:

As we have seen in the past year, infectious diseases do not recognize state borders. A centralized pandemic response strategy for allocating resources such as ventilators, disinfectants, thermometers, and personal protective equipment (PPE) for nurses, doctors and other care providers will eliminate what happened in 2020 when states were competing against each other for supplies, and driving up prices. A streamlined system of allocation will allow hospitals to focus solely on patient care.

Healthcare equity:

It’s widely recognized that social determinants of health including economic, social and environmental factors impact the health of individuals and communities. Low income, unemployment, lack of health insurance, lack of private transportation and language issues have limited healthcare access for people of color. The pandemic has displayed in sharp relief the persistent and widening health and other inequities faced by Black and Hispanic communities across the country. This is evident in the disproportionate number of infections, illness and deaths from COVID.

A study of selected states and cities with data on COVID-19 deaths by race and ethnicity showed that 34% of deaths were among non-Hispanic Black people, though this group accounts for only 12% of the total U.S. population.\(^1\) In California, Hispanics make up 39.3% of the state’s population but account for 55.4% of COVID cases.\(^2\)

Experts ascribe the higher prevalence of infections and death from COVID in minority communities to the fact that they often work in frontline jobs such as food service, landscaping and janitorial services that require a high degree of contact with other people. They also utilize public transportation and tend to live in crowded households.

A coordinated effort by a broad coalition of federal, state and local governments in partnership with community organizations, healthcare institutions, business and academia is needed to develop policy and build programs to make healthcare as accessible and as equitable as possible for communities of color.

Embrace telemedicine:

Prior to COVID-19, the use of virtual care nationwide was limited. However, the pandemic has demonstrated the immense value of utilizing telemedicine. Both doctors and patients are recognizing its convenience and effectiveness for behavioral health, prenatal care and other specialties. Telehealth is being utilized across the country by institutions such as UCSD Health in San Diego to provide continuing care for “long haulers,” COVID survivors who experience prolonged and sometimes debilitating symptoms from the infection. There is growing recognition that virtual care is not an inferior substitute for in-person visits. The Centers for Medicare and Medicaid Services has committed to reimbursing providers for telemedicine visits during the pandemic and private insurers have followed suit.\(^3\) It is expected that this will be expanded beyond COVID as more providers and patients embrace telemedicine.

Support for clinicians:

The pandemic has taken an incredible toll on providers — physical exhaustion, intensifying psychological stress, burnout, infections and yes, even death. Some have chosen to retire earlier than planned. Others have quit the medical profession altogether. As a result, those who are still in the profession are finding themselves working harder than ever before. In a survey by Medscape,\(^4\) an online resource for healthcare professionals, more nurses in every specialty rated themselves as very or somewhat burned out compared to pre-pandemic levels. In another Medscape survey of U.S. physicians, 64% of respondents reported intensifying burnout after the onset of the pandemic. Some healthcare experts are advocating for a plan to track the psychological well-being of medical professionals at the organizational level.\(^5\) They are also calling for a national plan similar to the World Trade Center Health Program created by Congress for monitoring the wellbeing of those who responded to the 9/11 terrorist attacks.\(^6\)

Staffing matters:

One of the most urgent needs that emerged very early on in 2020 was the need for ICU nurses in COVID hotspots across the country. As cases began to surge in New York, a long term care facility was suddenly faced with an overwhelming number of sick residents. That’s when Health Carousel stepped in, interviewing 50 to 75 nurses each day, and trimming the normal recruitment cycle of 12 days to less than 48 hours on an average. This is just one example of the critical role that healthcare staffing companies have played in supporting hospitals and other facilities during the pandemic. The importance of the hospital-healthcare staffing company partnership cannot be overstated. Healthcare institutions that fared well during COVID-19 had well established relationships in place with staffing companies that had access to nationwide talent pools, and the experience to quickly find and onboard workers during challenging times.

National licensure of nurses:

Currently, 34 states are part of the Enhanced National Licensing Compact (eNLC) that eliminates the need for nurses to obtain licenses to practice in other eNLC states. States that are not part of the eNLC such as New York and California temporarily lifted their licensing requirements to support hospitals facing the urgent need for nurses.

The pandemic has been a long-drawn out crisis that has taken a toll on every segment of American society — almost five million people sickened, more than 500,000 dead and thousands of jobs lost and businesses shuttered. It’s now time to reflect on what we have experienced and learned, and to come together with renewed purpose and commitment to become better prepared for the challenges that lay ahead of our country.

Precisely sourced and prepared for their assignment

NATHO average as reported in, “SIA NATHO Travel Nurse Benchmarking Survey – 2020 update"

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Delivers high clinical quality and high patient satisfaction

Performance surveys on 1000+ from 200 unique clients across 30+ specialties

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Feels supported and likely to commit to staying after assignment

Internal analysis based on question. "If available, would you offer an extension to this healthcare professional?"

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My recent and past experiences of highly qualified nurses in our organization has allowed us to continue optimal delivery care to our customers.

-Martha W., Clinical Nurse Educator, St Joseph’s/Candler

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Choosing the Right Staffing Partner

There’s little argument that a hospital’s ability to provide high quality patient care is a function of its nursing workforce. Engaged nurses — competent, caring, compassionate and satisfied with their jobs — are key to a hospital’s success, whether it’s a small rural institution or a large university-based facility. Nurses make an impact on patient outcomes, patient satisfaction, on how the hospital is perceived by the community at large, and its ability to attract and retain talent.

The Highly Engaged Nurse

Numerous studies have shown the link between nurse engagement and positive patient outcomes.(1) According to Gallup research, higher nurse engagement is linked to lower complication rates and mortality indexes, and 41% fewer patient safety incidents. Gallup research has also shown that hospitals with the least engaged nurses pay $1.1 million more annually in malpractice claims than hospitals with highly engaged nurses.(2)

The degree of engagement plays a pivotal role in the job satisfaction of nurses themselves. Nurses who are highly engaged are more likely to stay longer in their jobs. They are also more likely to stay for the duration of the contract, and transition from temporary to permanent roles.

Selecting the Ideal Staffing Partner

Hospitals today are in the midst of a perfect storm. They are grappling with the many challenges posed by a global pandemic. In addition, they are also dealing with the chronic shortage of qualified clinicians, a problem that’s been exacerbated by COVID-19.How do hospitals find highly engaged nurses in these unprecedented times? How do they ensure that they have access to qualified healthcare professionals when and where they are needed most?

Healthcare institutions are increasingly relying on staffing companies or MSP providers to find skilled, competent and dedicated healthcare professionals from a range of in-demand specialties. These staffing enterprises have shown how they can make healthcare work better by sourcing and placing nurses who are highly engaged in their profession, in the wellbeing of their patients, and the institutions they serve. The ideal staffing partner supports hospitals in providing high quality care, and in meeting their clinical, operational and financial goals.

Hospitals value travelers sourced by staffing companies for their dedication to patient care and the determination to go above and beyond in their nursing practice. Surveys of clinician performance and client satisfaction by Health Carousel, a preeminent staffing partner serving hospitals nationwide, offer proof of the many advantages of partnering with a staffing company.

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Health Carousel survey results show that about 95% of the company’s nurses either meet or exceed expectations of hospital managers and leaders. Hospitals offer contract extensions to 4 out of 5 of Health Carousel’s domestic nurses. About 75% of the company’s international nurses continue in their jobs after completion of their initial assignment, which makes a huge difference for nursing units with chronic turnover and hard-to-fill positions.

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How to Choose the Right Staffing Company

A hospital’s staffing partner should have the ability to provide the right nurse the very first time, so that patients can receive the best possible care on day one of the staffing engagement. Does your staffing partner source the most capable, competent and committed in the profession? What does the company do to ensure the continued engagement and success of nurses on the job and within their units? Here are some guidelines for hospitals in their search for the right staffing enterprise.

• Choose a partner with the highest standards of clinical quality and a stellar clinical team that is engaged in every stage of the hiring lifecycle and beyond.

• The clinical team should be led by a Chief Nursing Officer or Chief Clinical Officer who has the qualifications and commitment to connecting the right nurse to the right hospital.

• The ideal clinical team should include master’s-prepared and board certified leaders with a diverse set of qualifications, backgrounds and clinical experience. To fully understand and help solve the needs and complex challenges faced by hospitals, the clinical team should have direct experience leading clinical delivery teams in the hospital setting, establishing practice standards, directing complex clinical care systems and hospital operations.

• The company should have a robust and thorough candidate vetting process to ensure the sourcing and placement of highly qualified professionals.

• The clinical team should play a crucial role in every aspect of the company’s relationship with the client including sales, solution design, candidate screening, onboarding, coaching and performance management throughout the life of the contract.

What to Expect from the Right Staffing Partner

The staffing partner’s work begins with the clinical discovery process to gain a thorough understanding of the clinical needs and the culture of the hospital. The team conducts a workforce assessment and shares its learning with its recruiters so that they can identify candidates whose skills and experience align with each hospital’s unique needs.

The next step is the verification of education, licenses and credentials of candidates. Staffing companies that adhere to the highest clinical standards approve candidates only after a thorough background check. The clinical team should provide learning opportunities for recruitment, account management and support staff so that they stay informed and educated about nursing in order to provide the best service to clients.

Support for Clinician Success

The ideal staffing partner should support the success of its clinicians by ensuring that they adhere to the quality standards of hiring hospitals. The preparation for selected candidates begins before the start of an assignment with a robust onboarding process and coaching. Nurses gain a clear understanding of the hospital’s culture and what is expected of them. The company should prepare international nurses for their assignments with a transition to practice program prior to their assignment start date.

Once the assignment begins, the clinical team should check in with the nurses periodically and continually monitor their performance on the job to identify opportunities for ongoing improvement. If they see problem areas, the clinical team should provide remediation with enhanced coaching and access to individual learning resources, and access to an on-demand learning management system.

The clinical team should be available around the clock to resolve clinical issues that may arise with travelers on assignment, whether it’s bedside care or problems in the nurse’s working relationship with colleagues and managers. Data from hospital partners should be captured and analyzed to continuously improve the quality of the healthcare professional.

Recognition and positive feedback are strong motivators for high performers. Nurses who go above and beyond should be recognized by the Chief Nursing Officer for their exceptional service. Clinically-led staffing companies also support healthcare industry-wide programs honoring outstanding nurses such as the DAISY award for nursing excellence given to those who have made an impression on patients and their families.

Transparency and Ethical Standards

A staffing partner’s alignment with nationally recognized independent compliance and clinical organizations provides further proof of the company’s commitment to clinical quality.

One such organization is The Joint Commission, the nation’s oldest and largest standards-setting and accrediting body in healthcare that certifies clinically-led staffing companies.

The American Association of International Healthcare Recruitment (AAIHR), is another organization that represents the interests of the international healthcare recruiting industry. The group promotes legal, ethical and socially responsible professional practices for international healthcare recruitment. A clinically-led staffing company that offers international nurse staffing should follow the standards and guidelines set by AAIHR to ensure the fair treatment of international nurses.

A Most Important Decision

In conclusion, choosing the right staffing partner is perhaps one of the most important decisions that a hospital makes, one that has a profound impact on patient care, on the hospital’s reputation, and the satisfaction and engagement of its clinicians. The decision should be driven by two requirements — an unwavering commitment to the highest standards of clinical quality and delivering clinical staff who are engaged with their patients, hospitals and the nursing profession. Hospitals should make the choice with the utmost care to ensure that they partner with a staffing company that will support them in their important work to advance the health and wellness of patients and communities across the country.

Talent shortage is an issue that plagues every industry, from education to event planning, auto manufacturing to airlines. While organizations might benefit in the short run by having an excessively lean workforce, not having enough employees limits their ability to grow and thrive. It strains their relationships with clients and customers. It leads to low employee morale and productivity.

However, when it comes to healthcare, the problem of inadequate staffing is of an entirely different magnitude and the consequences far more serious. A shortage of nurses in a hospital unit sets off a chain reaction – declining quality of care, medical errors, patient dissatisfaction, plummeting quality scores for the hospital, high stress and low nurse morale, and ultimately, high nurse turnover. Chronic short staffing also exposes the hospital to risk if a sudden unexpected spike in patient volume occurs such as seen in natural disasters, riots and the COVID-19 pandemic.

Why are hospital units understaffed?

First, there’s the nurse shortage. With an aging baby boomer population requiring more healthcare services and with large numbers of baby boomer nurses retiring each year, the demand for nurses at hospitals and other health centers is far outpacing the supply. The Bureau of Labor Statistics projects 175,900 openings for RNs each year through 2029 when nurse retirements and exits from the profession are factored in.(1)

Second, hospitals tend to be focused on true vacancy, the number of approved FTE positions that are unfilled. However, relying solely on this statistic can lead to poor planning because it does not take into account other factors that impact nurse availability. A more accurate indicator of staffing need is operational vacancy that takes into account the number of unfilled positions as well as the number of nurses unavailable for scheduling because of extended leave, illness, training and orientation.

Then there is an issue that’s endemic to healthcare, one that can throw a wrench into the most carefully thought out staffing schedules – a sudden influx of patients that can happen without much warning, leaving nurse leaders scrambling to find coverage. Today, the COVID-19 pandemic is a telling example.

Impact on patient care

Adequate nurse staffing is critical to ensure optimal care for patients. Many research studies have documented how nurse shortages in hospital units can negatively impact patient outcomes.

A unit-level nurse staffing study conducted by Columbia University School of Nursing(2) and published in the Journal of Nursing Administration found an association between nurse understaffing and Healthcare Acquired Infections (HAIs) in patients. HAIs included in the analysis were urinary tract infections, bloodstream infections, and cases of pneumonia. According to the study’s authors, when a unit is understaffed, nurses experience excessive workloads and are not able to devote the time and attention to recognize the signs and symptoms of infection, and carry out infection prevention practices. HAIs are responsible for increasing healthcare costs by billions annually. Another study(3) by researchers at 161 acute care hospitals in Pennsylvania found fewer urinary tract and surgical site infections in hospitals where nurses cared for fewer patients.

Safe staffing can be a matter of life and death, and achieving the right staffing levels requires nurses and management working together. Adding additional Registered Nurse (RN) hours to unit staffing has been shown to reduce the relative risk of adverse patient events, such as infection and bleeding. Reducing medical errors is also important from a financial perspective, as the Centers for Medicare & Medicaid Services (CMS) has begun to implement value-based care models that incorporate risk-sharing with the potential to withhold payment for preventable hospital-acquired injuries or illnesses; private insurers are expected to follow suit.

—R N Action, advocacy arm of American Nurses Association (ANA)(4)

Impact on nurse morale, wellbeing and turnover

Inadequate staffing in units imposes excessive workloads on nurses. It impacts their physical health and emotional wellbeing. Overworked nurses are likely to experience chronic stress on the job and develop health conditions such as anxiety, depression, hypertension, and musculoskeletal disorders.

In a 2010 study by the University of Pennsylvania,(5) 29% of nurses in California, the only state to pass legislation regulating nurse-to-patient ratios, reported high burnout compared to 34% of nurses in New Jersey and 36% of nurses in Pennsylvania, both states without minimum staffing ratios during the period of research.

Another fallout from inadequate nurse staffing is high turnover rates that leave hospitals grappling with a myriad of problems. On the one hand, there is the economic impact. The annual fiscal impact of nurse turnover for the average-sized hospital ranges from $5.2 million to $8.1 million.(6) It costs $36,567 for a hospital to hire and onboard a new nurse. Equally significant is the impact of turnover on patient care. When nurses leave, hospitals are left to provide safe care to patients with fewer resources. Avoid overburdening existing staff with excessive workloads and the challenge of recruiting quality candidates to fill vacancies. In 2019, the nurse turnover rate in U.S. hospitals was 15.9%.(7)

Forecasting staffing needs: The role of predictive analytics

Like in other industries, forecasting nurse staffing needs has grown increasingly sophisticated with the advent of AI-enabled predictive analytics. Based on historical and real time data, predictive analytics enables hospital leaders understand future demand for healthcare services and nurse staffing needs. It allows them to ensure optimal coverage by making data-driven plans and shift changes to correct staffing inefficiencies.(8)

Three ways to deliver optimal nurse staffing

1. Permanent staff overtime:

Nurse overtime is a well-established practice in U.S. hospitals. Working beyond normal shift hours boosts income for nurses and gives them more flexibility in managing their shifts. However, this is only a stop-gap measure and far from ideal. Research has shown that nurse overtime is tied to lower levels of collaboration and higher levels of burnout. It has a negative impact on patients as well. A 2011 study of more than 500 hospitals in California, New Jersey and Florida(9) found that patients were less satisfied with their care when there were higher proportions of nurses working shifts of 13 or more hours and were more satisfied when there were higher proportions of nurses working 11 or fewer hours.

2. Unlicensed Assistive Personnel (UAP):

Also known as nurse aides, orderlies, nursing assistants, home health aides, and patient care technicians, UAP support the healthcare team under the supervision of the RN who is ultimately responsible for the coordination and delivery of care. It is estimated that there are more than two million UAP working in the U.S.(10) Employing unlicensed healthcare workers saves money for hospitals as they are typically paid 55%-77% of an RN’s salary. Another benefit of employing UAP is that they perform basic patient care tasks and allow nurses to focus on the more complex patient care activities.

However, UAP are not substitutes for hiring professional RNs as they lack the education, licensing and training to provide independent patient interventions and take on a larger role in patient care. How and when RNs can delegate work to UAP is defined by guidelines developed by the American Nurse Association(11) as well as individual hospitals and health systems.

3. Flexible staffing, the optimal choice for hospitals:

The use of contingent workers allows hospitals to focus on providing high quality patient care. Flexible staffing has demonstrated its value in a variety of situations – while hospitals await the hiring of a permanent staff member; during increase in census; for staff coverage when nurses are out sick or on vacation; and to reduce the costs associated with the use of overtime. Flexible staffing companies give hospitals access to a qualified talent pool. They also offer other benefits such as robust screening, onboarding and ongoing support for clinicians once they begin the assignment. Many contingent nurses end up extending their contracts and even become permanent staff nurses. International nurses, an integral part of the contingent nurse workforce in the country, are educated and highly skilled. They deliver high quality care at rural hospitals and other hard to-staff healthcare organizations, and are more likely to accept long term and permanent position.

Flexible healthcare staffing companies have shown over and over again their ability to respond to changes in the healthcare landscape and evolving client needs with innovative solutions. In recent decades, contingent staffing providers have significantly expanded and streamlined their services. Known as Managed Services Providers (MSPs) these companies offer customized staffing services tailored to the unique needs of hospitals. By taking on the complete responsibility for the hiring of temporary, temporary to permanent, direct hires and vendor management, MSPs allow hospitals to focus on their primary mission – providing the best care to patients.

Conclusion

Adequate nurse staffing is critical in ensuring the best outcomes for patients, as well as nurse morale and satisfaction. Maintaining optimal nurse staffing is a complex task. However, innovations such as predictive analytics have made it easier to forecast demand for healthcare services and make staffing plans for the future. Forward thinking staffing companies have stepped up to fulfill the need for contingent nurses with flexible and innovative solutions so that hospital units can maintain optimal nurse staffing to ensure the best patient outcomes and reduce nurse turnover. Managed Service Providers (MSPs) have become staffing partners of choice for hospitals as they provide the full array of screening and hiring services for permanent, contingent, and temporary to permanent healthcare workers.

A UNIQUE PERSPECTIVE FROM WORKING WITH, HIRING, AND SUPPLYING NURSES

Healthcare in the U.S. has struggled for years to recruit and retain enough staff to cover its needs. The system is not built to handle a surge in patient load or quick reductions in staffing due to turnover. When care facilities and hospitals are overwhelmed, nurses must juggle an unmanageable load of patients who all need essential care.

There are two clear themes emerging in the USA. First, it’s clear that hospitalized patients are the sickest they have ever been. Patient acuity, as measured objectively by case mix index (CMI), is up considerably. Secondly, the nursing shortage is expanding. As we watch an aging nurse workforce inch closer to retirement, our country faces a nursing shortage the likes of which hasn’t been seen in decades.

The gap between available and necessary nurses becomes even wider when you take into account the expanding scope of requirements and executive role consolidations impacting nurse leaders. This is a problem in the best of times, but it becomes untenable when outside forces further stress the system. Enter the COVID-19 pandemic.

Stretching an Already Stressed Care Delivery System

The COVID-19 crisis stretched the country’s healthcare delivery model so much that it has been unable to handle any type of surge capacity. Whether it’s natural disasters, COVID-19 hot spots, or a simple patient surge, many people struggle to get the care they need and deserve.

New York is a perfect example of this struggle. The facilities in this part of the country were trying to care for people in an area devastated by COVID-19 to the tune of 90,000-plus hospitalizations and more than 25,000 deaths. Our existing healthcare system is simply not capable of handling that sort of a surge in patient needs.

The resources and capacity of healthcare facilities are limited. Hospitals might only have 25 to 30 beds in their ICUs — the part of the hospital that houses patients on ventilators and those who are struggling to breathe — during regular times. But as the coronavirus hit, some facilities had to increase that capacity to 80 in a matter of days. The Wall Street Journal quotes that the peak of the pandemic caused NYC to see three times the number of ICU patients it would have during a busy flu season.

In addition to a lack of beds, ICUs grappled with a lack of nurses. Like medicine, nursing is broken into specialties. Just as medical-surgical nurses and labor and delivery nurses concentrate on those areas, ICU nurses have specific skills and training that help them meet the needs of that unit.

That specialized training makes ICU nurses in heavy demand. As most ICU nurses are gainfully employed, the virus made it nearly impossible to find permanent ICU nurses on short notice — particularly for ICUs that had just tripled in size. To maintain a consistent level of quality care, hospitals needed more staff to handle a daily load that had ballooned tenfold. Healthcare organizations needed nurses — and they needed them quickly.

A True Partner in Patient Care

The urgency of addressing critical staffing gaps requires a balance of speed and diligence. Often, too much time passes between the moment nurse managers recognize staffing needs and when nurses arrive at their facilities. In the case of COVID-19, census volumes were nearly impossible to predict. Internally finding nurses, assessing their skills, and then placing them can take a lot of time — valuable time that’s necessary for quality patient care. This is where a staffing partner with an experienced clinical team can make an impact in a hurry.

Through a unique blend of attention to detail, agility, and clinical competence, a staffing partner can dramatically shorten hiring time by doing the work on behalf of the hospitals and care centers that need help. This starts with a clinically led understanding of the unique needs of the facility and applying hands-on clinical experience to address the root cause.

Given the spread of COVID-19, even healthcare providers that traditionally like to interview and vet their staff members before hiring required help to address the immediate need. Many healthcare facilities and managed service providers turned to Health Carousel’s clinical team to interpret the situation and ensure they were able to get the nurses they needed. During the coronavirus pandemic, these nurses were successful additions to many organizations and played integral roles in helping thousands upon thousands of patients heal.

“Our ability to interview and place nurses at a rapid pace earned us the trust we needed to make the impossible possible,” said Health Carousel CNO Earl Dalton. “My team was proud to get the call from New York to help. We could see that our nurse brothers and sisters needed support to continue caring for their patients and communities, so we worked day and night to meet that need and answer that call. My clinical team understands that on the other end of their efforts are patients who needed care, and we take that responsibility very seriously.”

Help When It’s Most Needed

For a long-term care facility in the New York area that serves as home to many elderly patients, COVID-19 created an overwhelming need for additional nurses. This facility had nowhere to send patients because every hospital was overrun, which meant that the strength of the nursing team determined whether people lived or died.

Health Carousel immediately stepped in to help by taking complete control of the hiring process — identifying nurses who matched the organization’s culture and then onboarding them as quickly as possible. This took work, especially during an unprecedented pandemic that flipped normal processes and timelines on their heads. But Health Carousel’s clinically led teams embraced the challenge and worked harder than ever to provide quality care to patients whose lives were hanging in the balance.

“The facility had an extraordinary need for nursing staff and not a lot of extra resources to help facilitate the transition,” said Health Carousel CNO Earl Dalton. “Our efforts with this care facility illustrate the value Health Carousel provides. We supported an organization that needed top-notch and talented traveling nurses, and everyone was able to pull together to save lives.”

Health Carousel was able to fill our needs extremely fast with qualified nurses who had wonderful customer service and worked well with our current staff during a crisis. They were able to jump in quickly and efficiently when we needed it the most! I am truly grateful for their services!” - Nursing home administrator

Time Saved, Placements Made

For some major health systems, Health Carousel serves as a subcontractor to fill needs as they arise. During the COVID-19 pandemic, it was critical to place nurses in a matter of hours instead of days.

Health Carousel’s clinical teams interviewed 50 to 75 nurses a day, with an average turnaround time of one day between an offer being submitted and accepted. From a recruitment perspective, the typical 12-day turnaround was reduced to less than two days because recruiters prioritized offers vetted by Health Carousel based on their quality.

“We’re proud to have earned this level of respect in the industry,” said Health Carousel CNO Earl Dalton. “Other agencies partnered with those companies but didn’t get that opportunity. We have worked to prove our value, and the numbers show it; Health Carousel nurses are hired permanently 60% of the time.”

A Foundation of Trust and Support

In addition to serving clients more effectively, Health Carousel worked with client partners to ensure nurses placed received the support they needed to do their jobs.

Health Carousel doesn’t believe in a cookie-cutter approach to onboarding and training. We give each facility partner attention for its uniqueness. For example, many nurses working during the pandemic didn’t have enough PPE to stay safe while treating their patients. Serving as an early advocate for hospitals, Health Carousel shared training and campaigned for nurses to get the protective equipment they so desperately needed.

In addition to advocating for proper equipment, Health Carousel worked with nurses who had to self-isolate for two weeks after contracting the virus. They were far away from home in some cases, so finding them places to quarantine where they felt safe and protected was important.

About Health Carousel’s Clinical Team

Ultimately, the success of any staffing partnership boils down to trust.

At Health Carousel, we take our work seriously because we have been there: short-staffed with patients who needed us to do better for their care. Our unique perspective comes from working with nurses, hiring them, supplying them, and — more than anything — being in their shoes while caring for patients. We understand the immense responsibility healthcare professionals have to their patients; this is something we don’t take for granted.

“Together, we have close to a century of experience on my team,” said Health Carousel CNO Earl Dalton. “I’m always amazed at how much wisdom they have to share when we are collaborating on an issue for resolution.”

That knowledge allows us to be true partners to the hospitals and care centers that we serve. Recruiters are phenomenal, but they will struggle to handle some issues without firsthand nursing experience. In contrast, our clients can lean on us to understand what they need. We’re able to handle anything from clinical questions to issues with a nurse who might not be meshing with a hospital’s work culture.

If clients need help to create a staffing plan or address a staffing shortage, we have the resources and expertise to help them build a successful strategy. Not only do we promise to communicate quickly and thoroughly, but we also resolve issues within 24 hours — whether the nurse or the hospital generates those issues — and then follow up to ensure that resolution holds.

While other companies staff nurses, we go beyond. For the same cost, our clients are part of a relationship, have access to unparalleled education and expertise, and know they always have advocates in their corner.

A strategic workforce partner controls costs while improving quality

Since the 1970s, when hospitals began using nursing staffing agencies to fill occasional vacancies, contingent staffing has become the norm for healthcare facilities across the country. Today, supplemental staff accounts for over 30% of total nursing hours1 and hospitals in all 50 states use locum tenens physicians.

The demand for contingent workers is not going away anytime soon. Contingent workers play a critically important role in ensuring quality and continuity of care. Based on findings from a 2019 Workforce Solution Buyers Survey from Staffing Industry Analysts (SIA), companies project the contingent share of their workforce to be greater two years from now, and greater still 10 years from now.

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While contingent staffing has helped solve staffing shortages and maintain patient care, its cost burden can’t be ignored. Over the past decade, the cost of labor as a percentage of total hospital costs increased from 50.6% in 2008 to 54.9% in 20182. Additionally, managing a blended workforce of permanent and contingent staff contributes to higher administration and overhead costs.

The advantages of having a strategic workforce partner

While there are numerous advantages to contingent staffing, there are still challenges in its overall management, including quality candidate sourcing, credentialing, onboarding and ongoing support. Add emergency preparedness to the list of tasks and the complexity increases significantly, putting bedside quality at risk.

Hospital leaders use forecasts, predictive modeling and analyses of historical trends to plan strategically, but the bottom-line is healthcare staffing relies on predicting the unpredictable. This is true especially when it comes to emergency preparedness. However, with a flexible and adaptable workforce partner, healthcare organizations can leverage actionable insights and expertise to weather the unexpected and outpace the competition.

Ultimately, they can reduce the costs associated with contingent labor and gain a clearer picture of their temporary labor spend. Organizations that find themselves sacrificing their bedside capability due to the burdens of managing a contingent workforce should look for an MSP they can trust to work as a true partner.

A successful MSP partner is clinically focused and led by technology

In today’s economy, what is needed from an MSP partner has changed, and the bar for service is being set at increasingly higher levels. Relying on a cookie-cutter, big-box managed services provider (MSP) is not the answer. You deserve a dedicated team that works with you to custom build an MSP program that includes:

• Single point of contact
• Dedicated program manager
• Personalized service
• Market expertise
• Process efficiencies
• Technology expertise
• Intuitive reporting
• Program scalability
• Compliant practices
• Spend visibility and cost savings
• Full vendor transparency
• Flexibility

1. Focus on Quality

Good workforce management begins with establishing goals aligned to the organization’s culture and desired outcomes. High-performing MSPs have an experienced clinical team on staff that understand how staffing decisions affect patient care. They understand your unit leaders’ challenges and they sit down with them regularly to determine the unique requirements for the positions they need to fill. They support the entire process of screening, interviewing and onboarding contingent and long-term staff to prepare them for success.

In order to relieve you of the burden of staffing, so you can focus on quality patient outcomes, they should be highly trained board-certified clinicians who have prior experience in hospital leadership roles.

Your MSPs clinical team should have the experience and compassion to:

• Understand your expectations.
• Identify candidates who share your organization’s personality, values and goals.
• Help new hires fit seamlessly into your healthcare culture.
• Limit the potential for expensive bad hires.

2. Innovative recruitment process

Getting the right, high-quality healthcare professionals is key to both productivity and engagement. That starts with clear descriptions and qualifications for each job to attract the best matches and avoid expensive bad hires. Whether that criteria comes from the hospital’s own clinical team or the MSP’s team, clinicians should lead that part of the process.

It helps to work with staffing vendors who meet with the team personally to understand the organization’s culture and staffing goals. It also requires new and innovative strategies to attract, source and qualify talent matched to the organization’s needs. An innovative MSP can provide technology-driven solutions if the hospital doesn’t have its own digital platform. These solutions may include:

• Social recruiting, matching algorithms and programmatic advertising customized to your target personas.
• Innovative nurturing technology which customizes communication across email, text and social so you are always prepared for your next need.
• Unique location promotion kits featuring hospital, clinical setting and location strengths to position your hospital as a desirable workplace for candidates.
• Technology which encourages applicants to self-qualify and provides access to online interview tools to filter the best applicants to the top.
• Social listening technology as well as candidate, staff and partner feedback programs to stay ahead of the market.

3. Strategic vision and realistic goals

It’s important to develop and align with your management team and MSP partner on a strategic vision for staffing. What does a healthy unit look like in the future? From an aligned vision, realistic objectives and goals can be established and measured for success.

Having a comprehensive understanding of your talent helps to reduce your sole dependency on costly short-term options. With a proactive approach that considers all the available resources — whether travel or locum, temp to perm or permanent — companies can craft strategies that address the root cause of staffing challenges, opposed to simply filling the highest demand job on a specific day.

Hiring international staff provides a pipeline for future permanent labor and an effective strategy for reducing the need for contract labor. Contracts can be written to grant permanent employment after a required number of years of service.

In order to benefit from this solution, you need an MSP that can offer a full range of relocation services for globally trained nurses and allied professionals, including credentialing, visa procurement, introductions to peers, housing, training and ongoing support to help them acclimate to their new country. Only a few MSPs can provide that service.

4. Data collection for better scheduling

Successful workforce management requires a management by measurement philosophy. Every organization needs the right data to assess labor utilization. Innovative technology platforms can provide the insights needed to optimize work schedules and reduce dependency on contract labor while improving care delivery. These platforms are generations ahead of the legacy scheduling programs many facilities continue to use.

A good MSP should be on the cutting edge of digital staffing, providing access to a staff management program that is easy to use and offers the following data and functions:

• A clear overview of the entire staff at any moment in time.
• All open positions across the entire organization, down to the individual unit level, with the fill rate for each unit.
• Census fluctuation predictions and ability to anticipate staff shortages.
• A view of who is overspending, and where.
• Ability to schedule the right providers for the day’s needs and notify them of their schedules.
• To assess and maximize the staff’s full skill sets, so their time is never wasted.

5. Enhancing reputation and retaining talent

Any healthcare organization that proactively takes steps to implement a workforce management program should see a return on their investment in the form of an optimized workforce and lower labor costs. As they develop a more productive and supportive work environment, they enhance the facility’s reputation, improving their opportunities to attract and retain high quality talent.

Organizations that can’t dedicate staff to serve as workforce managers without sacrificing their bedside capacity should look for an MSP they can trust to work as a true partner. The MSP should have the capability to develop and implement all elements of a good workforce management plan.

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(1)Bae, S. H., Mark, B., Fried, B. 2010. “Use of Temporary Nurses and Nurse and Patient Safety Outcomes in Acute Care Hospital Units.”

(2)https://www.hfma.org/topics/hfm/2019/october/hospitals-innovate-to-control-labor-costs.html‍

Managed service providers (MSP) take over the burden of managing multiple healthcare staffing vendors and their contracts. However, the number and quality of services offered by MSPs varies dramatically. In response to the demand for contingent staff, the gap between those that simply deliver candidates and those who truly optimize your recruitment and workforce management processes is widening.

In a 2019 Workforce Solution Buyers Survey from Staffing Industry Analysts (SIA), the net promoter score (NPS) for MSPs was a -3%, indicating there is some serious work needed from MSPs to reduce the number of unhappy clients.

If you are finding that it’s taking longer to fill positions than it used to, that the candidates your MSP sends you don’t match your criteria or the process of working with your MSP has become too complicated, it may be time to evaluate whether you’re getting the service you deserve.

What you need in an MSP partner has changed

Your MSP should serve as your partner, with a strong code of ethics that guides their approach to recruitment and workforce management — putting the needs of your facility and patients first. They should feel like an extension of your department, with the goal of improving patient experience and outcomes while saving your facility time and money. They should also customize their program around your needs, rather than make you adapt to their business model. In other words, they should be in service to you.

In order to ensure you are getting the best return on your investment, consider the following traits of a good MSP when evaluating your own.

1. The quality of candidates is consistently high.

Your MSP always sends you qualified contingent staff because they know what you need. They’ve spent time at your facility to get to know your culture and environment. They meet with you, either online or in person, to evaluate the unique qualifications you require for each position. When you request specific skill sets or personality traits, they know exactly what kind of candidates will fit your needs.

2. Good communication creates a strong working relationship.

Your MSP should be easy to contact and should respond to your requests quickly and efficiently. They should give you the option of communicating in whatever method you prefer — by phone, text, email or video conference.

Some MSPs dedicate an employee to work at your facility as an extension of your own team. They can almost guarantee good communication because that employee is empowered to be your advocate on behalf of the MSP.

3. Your MSP structures their partner relationships,  so they want to serve you.

Your MSP has screened all the vendors working on your vendor panel to ensure they have high quality standards. They promise objectivity and fairness and let vendors hear from you directly, so they understand what is most important to your organization.

The panel may be made up of your chosen vendors, their network of vendor partners and/or their internal recruiters. They consider the vendor panel a strategic asset to ensure quality and the highest fill rate possible. Treating you like a market of one, they focus on prioritizing and filling your jobs first and post each job to all recruiters simultaneously for the fastest results.

4. Your MSP is transparent about pricing and fill rates.

From the start, they determine the billing required to deliver the fill rate that will help you provide appropriate patient care. They don’t promise a fill rate at a much lower bill rate, only to come back three months later with a higher bill rate because they can’t fill your needs at an artificially low rate.

They use cloud-based software that gives you instant visibility of open positions across all your units and the fill rate for each one. They also apply social listening technology, active candidate, staff and partner feedback programs, as well as proprietary job scraping technologies to ensure you know where you stand to win talent.

5. A dedicated clinical team manages contingent staff.

High performing MSPs have an experienced clinical team on staff that works on behalf of your facility. They understand your floor managers’ challenges, and they sit down with them regularly to determine the unique requirements for the positions they need to fill. They support the entire process of screening, interviewing and onboarding contingent and long-term staff to prepare them for success.

In order to relieve you of the burden of staffing, so you can focus on quality patient care, they should be highly trained board-certified clinicians who have worked in hospital leadership roles before.

6. A proactive approach to problem solving.

Your MSP should do more than just manage your workforce or fill job orders. Through a clinically and technology led approach, they should start by understanding the root cause of your challenges to create a better outcome.

When the program is running and the MSP’s clinical team perceives performance or clinical issues with any healthcare professionals, they recommend interventions to help improve performance. This might include additional training or mentorship — which they provide. The clinical team also takes responsibility for ensuring your healthcare staff has appropriate, up-to-date licenses and credentials.

7. Innovation is a priority.

The MSP keeps up with the latest trends in healthcare technology in order to provide insights, improved workflows and transparency. They may utilize your vendor management system technology and improve upon it where needed. Alternatively, they may offer their own platform and provide digital products they’ve developed to improve both recruitment and staff workflow efficiency. They are able to pull relevant data to provide actionable insights to help you schedule and optimize your workforce.

8. They look toward the future.

Contingent staffing may serve an immediate need, but a good MSP will be anticipating future needs with multiple staffing solutions. They offer a mix of visiting nurses, allied professionals and locum tenens providers, on a temporary, temp-to-perm and permanent basis, as well as international applicants to increase your available pool of candidates. Based on your unique needs, they should provide short- and long-term temporary placements that can transition into permanent staff as needed.

If your current MSP is not up to the task of developing and managing a reliable and engaged workforce that improves patient care, it may be time to consider a change. Health Carousel is dedicated to serving you and providing a better experience for healthcare professionals to ensure your organization is always the organization of choice when healthcare jobs are posted.

A checklist to help you define your workforce needs

Before you start a search for a Managed Service Provider (MSP), know who you are as an organization and assess your ability to handle all aspects of workforce management. Can you handle every detail of recruiting, onboarding, training, credentialing, billing, ordering, contracting, training, internal notifications, policy change documentation risk and insurance internally? Or, do you need additional resources to do an effective job?

Do you have the time to deal with multiple contracts from multiple staffing vendors? Are you currently using an MSP, but experiencing low fill rates and slow fill times, despite their massive partner network? Do you have the insights and reports you need to prepare for what’s ahead? The answers to these questions will help you narrow down your options and select the right MSP for your specific needs.

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Don’t settle for an off-the-shelf solution

A good MSP should oversee healthcare staffing agencies in a way that takes the burden off you, gives you access to the highest quality available healthcare talent at the lowest cost and empowers you with actionable insights to prepare for what's ahead.

Many MSPs offer a standard solution to increase your access to talent. In this cookie-cutter approach, you develop a transactional relationship, where you let the MSP know what jobs need to be filled and they post them out to the marketplace and send you candidates. Often, your main contact is through a technology platform.

The MSP may have a menu of additional services that come standard, such as screening, interviewing and credentialing, to help streamline the hiring process. They may allow you to purchase just the services you need or require you to buy the whole package. Such an MSP might be a good fit if you don’t use a lot of supplemental staffing. They might also meet your needs if their standardized services complement your internal capabilities.

1. Are they flexible?

In a 2019 Workforce Solution Buyers Survey from Staffing Industry Analysts (SIA), respondents were asked to rank six reasons for using contingent labor from 1 (most important) to 6 (least important). Flexibility was chosen as the most important reason by the most respondents (32%).

Those organizations that take a holistic approach to talent — one that considers all the available resources from temporary, temp to perm or permanent — have the flexibility to address the root cause of their challenge.

Your MSP program should be custom-built and offer a portfolio of flexible staffing options that includes nurses, allied healthcare professionals, physicians, advance practice providers and nonclinical staff — available on a temporary or permanent basis. As the needs of your organization change, your MSP partner should flex and change with you, providing the personalized service you deserve.

2. How do they communicate?

The quality and responsiveness of an MSP’s initial communications represents the quality of their service. Are their responses thoughtful in addressing specific issues or do they read like they were pulled from a template?

Additionally, how do they communicate? Do they provide an omnichannel experience that lets you correspond the way you prefer? For instance, can you pick up the phone when you need to talk to your account manager directly and use technology for simple transactions?

 3. Do they take a clinically led approach?

Quality is nonnegotiable. If the MSP will handle the screening, interviewing, onboarding and/or managing of your contingent staff, their clinical team should have deep experience and the ability to understand the culture of your organization and your desired outcomes.

You want a clinical team that does a deep dive with your leadership team to understand what is specifically unique about each position you're trying to fill. They should ensure all contingent staff are so well qualified they improve patient care and overall employee satisfaction, not detract from it.

4. Do they offer change management support?

Developing a new relationship with an MSP involves change management. The MSP should have a process to establish the milestones that need to be met before going live.

A dedicated team should work with you to ensure a smooth transition and reassess the program several months after go-live to evaluate whether it’s meeting your expectations. You can expect the best results when the MSP assigns a dedicated employee to work onsite with your team, to help manage contingent talent and determine opportunities to optimize your workforce.

 5. How do they use technology?

Healthcare professionals have different preferences when it comes to seeking work. Some like personal interaction with recruiters, while others want to interact online. Utilizing leading edge technology is critical for identifying the best candidates and streamlining the entire recruitment and interviewing process.

You want to look for a forward-thinking MSP that is developing or investing in technology that is intuitive, fast and provides effective recruitment analytics. If you have your own vendor neutral software, your MSP should provide a consultative approach that empowers you with visibility, control and actionable insights on performance and overall labor costs.

Visibility, control and actionable insights

 6. Do they have solid vendor relationships?

Has the MSP provided transparency and collaboration to their partner network to remove the supply constraints and ensure highest quality? Are they a first choice for vendors to join their network?  If they have their own panel, has it been vetted for quality?

An MSP dedicated to your success will work to create a three-way partnership with you and their vendors. The MSP and panel representatives will meet with you to develop an understanding of your needs and be given access to proprietary tools and training to make your jobs standout. As partners, the vendor panel will be committed to giving your jobs priority. They will provide transparency and visibility around costs and billing as well as insights into competitor and market trends. The partnership will work together to assess bill rate and determine what rate is required to deliver the fill rate necessary to meet the needs of your patients.

7. Is the MSP serving your competitors?

An MSP may say you are a priority client. But if they are serving other healthcare facilities in your region, you will be competing with other facilities for the same healthcare talent. An MSP that has no other clients within a 100-mile radius of your facility is able to recruit strategically for the nurses, advanced practice providers, physicians and allied health workers you need.

8. Can the MSP provide workforce management solutions that help with retention?

Some MSPs can partner with you to provide ongoing training, mentorship, conflict resolution and other support that optimizes the productivity and job satisfaction of your staff.

9. What other solutions does the MSP offer to reduce dependency on contingent labor?  

An effective way to reduce reliance on supplemental labor is to turn temporary staff into permanent employees. Having a mix of travel, part-time and international nurses and providers in the pipeline increases your chances of success. An MSP that can contract with highly qualified international healthcare workers and support them in their new homes can provide you with a new source of longer-term talent.

When you take the time to do thorough research on the MSPs you are considering, you maximize the chance of finding the perfect fit for your healthcare organization.

Innovative & Flexible Workforce Solutions

Health Carousel is a total talent management company offering healthcare organizations world-class workforce solutions across a portfolio of businesses designed to improve lives and make healthcare work better. We partner with ambitious healthcare executives to deliver highly qualified nurses, physicians, allied health and advanced practice providers from a range of in-demand specialties when and where they are needed most.

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What We Offer

Health Carousel Travel Nursing & Allied

• Travel nurses to fill a range of short to mid-length contracts
• Allied healthcare professionals including RT and medical technologists
• Rapid response serving crisis and other urgent needs
• On Demand proprietary self-service platform featuring job matching and recommendations

Health Carousel International

• Sustainable pipeline of experienced global healthcare professionals for stabilization
• Temp-to-Perm staff including registered nurses, therapists (PT) and medical technologists
• Global Healthcare Workforce to meet your workforce needs anywhere in the world
• Intelligent automation enables efficient management of your workforce processes

Health Carousel Locum Tenens

• Experienced physicians and advanced practitioners wherever and whenever needed
• Locum assignment, direct hire and contract-to-hire for physicians and advanced practice professionals
• Project-based services to stabilize workforce during a transition or significant gap
• Self-service staffing through our Lucidity tech platform, featuring job matching and searching
• Marketing and sourcing support services through MedPath

Health Carousel Workforce Solutions

• Innovative solutions to make managing your workforce easier, faster, and less costly.
• Intelligent automation enables efficient management of your workforce processes
• Analytics and reporting to keep you informed and prepared for what’s ahead
• VMS/MSP capabilities to assist you in managing your contingent labor with efficiency
• Partner Network of specialized staffing firms to help fill your jobs faster

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What Makes Us Unique

It’s all about uncovering the root cause of your unique workforce challenges to create better outcomes. That’s where we come in—we are problem solvers, digital innovators and quality and ethical leaders committed to putting your facility, staff and patients first. We help you create better outcomes—and get you there faster than you ever thought possible.

OUTCOMES WE DELIVER

• Patient Experience: Access to high quality talent when and where it’s needed
• Revenue Enablement: Protect revenue by fully staffing units and maximizing reimbursement
• Cost Containment: Increased efficiency from a flexible solution that meets your organization’s needs

DIGITALLY-LED PORTFOLIO OF PROVEN BRANDS

Health Carousel brings the benefits of nine unique recruiting brands working together to deliver the most highly qualified healthcare professionals available. Our experienced and digitally-led recruiting teams are plugged into key networks for faster access to qualified healthcare professionals, even the hardest-to-fill positions.

CUSTOMIZED AND FLEXIBLE SOLUTIONS

We keep you and your patients at the center of what we do. That’s why we design our solutions around you and pivot as your needs evolve. We can stabilize a whole department or find just the right healthcare professional for your immediate need. You can receive a white glove, holistic service from our account management team or within some specialties, log into our state-of-the art technology platform and search for candidates on your time.

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"They are easy to work with, they care about what the clients are looking for, and they aren’t pushy. Based on how I am treated, I feel like we are the only client they are working with because they give us great personalized service." - Allison W. | Primary and Specialty Care Coordinator, Madison Health

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Will your investment in a managed service provider pay off?

Every hospital administrator knows the challenge of having to recruit and manage contingent and permanent labor within their healthcare facility. And with the demand for clinical staff outpacing the number of candidates for those positions, you may be questioning your healthcare staffing system for recruitment and hiring top talent.

The first thing to consider is the effect improper medical staffing levels have on your healthcare facility. If you can’t anticipate staffing shortages and don’t have a reliable pipeline to well-qualified candidates, your facility may be paying more for supplemental staff than it should. Whether you’re considering improving your in-house medical staffing process or hiring a managed service provider (MSP) to handle the work for your healthcare facility, your decision will impact:

Cost considerations

The total cost of recruitment and healthcare staffing is much greater than the money you spend on staff salaries. So, before deciding you’re going to attempt to cut costs by doing all the work yourself, it helps to understand the hidden costs involved in staffing yourself and how they can affect your bottom line.

The cost of your own time

Forecasting staffing needs, recruiting — on your own or with multiple staffing services vendors — screening, hiring, credentialing and onboarding candidates takes time and a great deal of effort. It’s especially demanding if you want to attract top talent that is a good match for your healthcare facilities’ services.

The time recruiting and onboarding healthcare professionals such as nurses and doctors will impact your own productivity, as well as that of your nurse managers. Recruiting healthcare professionals also places stress on the entire healthcare team, even when your facility makes excellent hires.

In a 2019 Workforce Solution Buyers Survey from Staffing Industry Analysts (SIA), when asked what percent of time is spent on contingent workforce-related responsibilities, 76% of respondents noted they spend at least half their time on such responsibilities and 45% of respondents spend 100% of their time, a substantial increase from 2004, when only 16% noted they spend at least half their time on such responsibilities.

The cost of new resources

You may decide to invest in a health technology platform that offers forecasting, scheduling and communications features, hoping it will solve your healthcare staffing problems. New technology offers many benefits but it costs money and requires training, which can take time. You also need an IT expert to maintain it and troubleshoot when the system is down. It is important to consider both the purchase and/or subscriptions costs as well as the long term, ongoing cost of maximizing its functionality.

The cost of contract labor

You want your bill rates to be competitive with the other healthcare facilities in your area in order to attract top talent. So, it helps to stay up to date with current rates and know when someone’s fees are out of line. In addition to travel nurses and locum tenens, it helps to have a mix of international healthcare professionals and temporary-to-permanent candidates to draw from, so you are not as highly dependent on contract labor. If you don’t have an efficient and flexible staffing management process or partner, you may end up paying more than necessary to maximize your fill rates.

The quality of patient care

Improving patient care and experience enables you to meet the quality metrics set in value-based-care contracts. Studies have shown that hospitals that provide a higher level of clinical care receive higher patient satisfaction scores in Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys.

In a 2015 study, high hospital rankings were associated with the level of respect doctors demonstrated to patients, how well doctors and nurses listened to their patients and how well pain was controlled. Making the right hires is critical to patient satisfaction and directly affects the reimbursements and bonuses your facility may receive. You want the best system in place to attract, onboard and retain high-quality nurses, doctors, and all healthcare staffing and employees that puts a priority on patient care.

Your retention levels

It’s important to be able to recognize the cycle of decline in a nursing unit and break it. High impact turnover leads to reduced quality of care, which in turn catches the attention of hospital management. Unit managers who are tasked with improving care quality, may come down hard on frontline staff, creating a slump in morale and more turnover. Without intervention, the cycle of decline repeats and this can become a long term staffing issue.

You want a partner who can forecast your talent needs and help you manage new hires, so you can avoid the cycle of decline. Bad hires cost healthcare facilities an estimated 30% of their salary. They affect the workplace culture and the ability for the rest of your staff to do their work effectively and productively. One of the best ways to control labor costs and improve the work environment in your healthcare facilities is to maximize staff retention rates in your company through better selection, onboarding, training, support and conflict management. Other benefits that improve employees morale include consistent shifts, adequate time off and flexible work environment.

Making your decision

After considering all the costs involved in healthcare staffing, you may determine you have what you need to do the job well yourself. However, when considering the value of an MSP, the chances are that if you choose the right one to be your medical staffing partner, you will pay a similar bill rate for new staff hires and avoid many of the hidden costs of an inefficient healthcare staffing solution.

Not all MSPs are created equal, so save yourself money and undue stress by investigating the differences. A good MSP should serve as both consultant and partner, take a clinically and technology led approach, be transparent in their pricing and work with you to develop a custom solution to match your needs.

When you take the time to do thorough research on the MSPs you are considering, you maximize the chance of finding the perfect fit for your healthcare organization.