While many industries have just started to feel the workforce shortage in the wake of the COVID-19 pandemic, this issue is nothing new to healthcare providers. The shortage was a significant challenge pre-pandemic, but COVID-19 has escalated the situation into a full blown crisis.
Data from the Wisconsin Department of Administration, Demographic Services Center, and Population Projections depicts that, in Wisconsin, “it is projected between 2015 and 2040, the population ages 65 and older will grow by 640,000 people — an increase of 72%. That rate is six times higher than the overall Wisconsin population growth projection of 12% for the same period.” Bottom line, the demand for health care services will increase, but the supply of workforce is decreasing.
Strategies to Reduce Labor for a Decreasing Healthcare Workforce
There are not enough people to fill open positions, so providers need to think differently to chip away at the crisis. While there are plenty of conversations surrounding recruitment and retention (See M3’s compilation of content about the issue of the War for Talent), we recommend providers start conversations on how to work with the full-time equivalents (FTEs) you do have, while looking for ways to reduce your need in the future. We argue this can best be solved in a three tier approach, (1) leverage technology (2) outsource, and (3) examine work flow efficiencies (Lean Process).
Investing in technology can be a fruitful way to reduce your labor in healthcare settings. Technology can automate low-level and administrative tasks so providers can focus on those areas that matter: strategic initiatives, quality care to clients, and positive workplace culture for staff. We have outlined below numerous example solutions in three categories; clinical, administrative and service.
Clinical Example Solutions
- Infection Control Entrance Screening
- Wound Care Software
- Vaccine Management
- Mechanical Lifts – Requiring 1 Caregiver
- Advanced Call Light Systems
- Wearable Tech for Patient Monitoring
- Predictive Artificial Intelligence Models In Clinical Decision Making
- Documentation Scrubbing Software
- Smart Toilets
Service Example Solutions
- Meals, Medication, Linens, Garbage Removal, Admission Intake, 1:1 Social Interaction
- Ultra-Violet Cleaning Robots
- Robotic Central Supply Inventory Management
- Application Based Electronic Menus
- Entrance Screening
Administrative Example Solutions
- Cloud-Based Email and Collaboration Platforms;
- Workforce Management Enterprise Systems
- Recruiting Solutions
- Billing Solutions
- OnDemand Staffing Solutions
- Time and Attendance Platforms
- Staff Training Solutions
Outsourcing can certainly have a negative connotation. We know many providers pride themselves on having entirely internal staff and processes. However, more often than not, outsourcing offers cost savings and alleviates provider burden between administrative tasks and personnel concerns. Food for thought: If your organization has not considered outsourcing, why not and what are your barriers?
Entire Department Sample Options:
- Rehabilitation Therapy Services
- Dietary Services
- Information Technology
If entire departments may not be feasible or if your organization has already incorporated, there are numerous other options to outsource burdensome administration process that typically rely extensively on human resource teams. By incorporating third parties, time can be better spent on recruitment, retention, and other company-wide strategic initiatives.
Ideas for Outsourcing
FMLA is complicated, time consuming, and oftentimes challenging to stay in compliance. FMLA administration typically falls under HR. HR professionals are tasked with being experts in payroll, talent acquisition, and retention, but also handling conflict within the workplace. Because of this, HR develops strong personal connection with staff, which can create a difficult environment when making decisions on whether or not an employee’s situation qualifies for FMLA. Oftentimes, exceptions are made and there are discrepancies in employee records. Sometimes, employees even learn to abuse the FMLA policy and this can impact a provider’s culture.
For these reasons, many providers have considered outsourcing this function. When an organization outsources FMLA administration, an outsourced vendor takes the responsibility of determining qualification and managing paperwork and recordkeeping associated with FMLA decisions. In addition, these vendors assist with and track intermittent leave. In this process, when an employee is eligible for FMLA, they contact the outsourced vendor, instead of the internal HR department.
Third party companies can offer the expertise and knowledge of state regulations to better support your organization through the bureaucratic unemployment system while optimizing cost control. Service offerings may include: administration of unemployment claims management, including proprietary systems to manage and track unemployment claims and appeals in real-time, appeal hearings representation, actuarial forecasting of unemployment benefit claims, among others.
Open enrollment is a busy time of year for organizations and their human resource teams. Rather than having internal teams spend time with small groups or individual employees, there are options to have one-on-one open enrollment counselors work with your employees for little to no cost. These counselors can also be deployed throughout the year for new hires. The counselors are non-commissioned benefit consultants that educate employees on all employee benefit offerings. After education, the counselor will take care of signing the employee up within the employer’s benefit administration system on behalf of the employee, taking the work off of the employee and the human resource team.
Work Flow Efficiencies, the Labor Pool, and Culture
The definition of insanity is doing the same thing over and over again, but expecting different results.— Albert Einstein
Work Flow Efficiencies – Utilize Lean to Cut the Fat
When was the last time your organization reviewed your processes? Have you asked, “Are we doing this because it has value or are we doing this because we’ve always done it this way?”
Arguably, there are certain tasks and entire meetings that may be able to be eliminated, shortened, or delegated. Consider putting together a work group of direct care staff and leaders to identify potentially wasteful or duplicative tasks.
Many healthcare providers claim they are flexible in their open role advertising, but are they really? There are countless providers who still use typical 8-12 hour schedules. Consider discussing with your staff the busiest times where it would be beneficial to have shorter 2-4-6 hour coverage. Other options may include weekend warrior positions or offering a 3-4 day workweek.
The labor pool is shrinking. We encourage providers to evaluate if they have expanded their labor pool to the extent possible. Example options:
- Utilize Uncertified Positions (Hospitality Aides)
- Cross Train: Emergency Nurse Aide Training Program
- Family Caregiver Program (Assisted Living)
- Hire Individuals with Disabilities
- International Workers
- Students and Other Youth Apprenticeship Programs
- Utilize Volunteers Beyond Activity Programming; Reception Duties, Dining, or Administrative Functions
It will be very difficult for an organization to make positive changes through any of the aforementioned strategies without taking a hard look at their culture. For example, with opportunities to expand the labor pool to “non-traditional” staffing comes the realization that an organization must be culturally prepared to address the needs of these individuals both within and outside the workplace – see Social Determinants of Health: Addressing Employee Needs to Attract and Retain Talent
- Understand the labor shortage is not going away
- View technology not as an expense but as an investment in long-term labor solutions
- Identify outsourcing opportunities to reduce staff burden and scheduling challenges
- Implement changes to “normal” practices to accommodate expectations of today’s workforce