ASCs Must Pursue Both Short- and Long-Term Staffing Solutions
As the rate of COVID-vaccinated people in the US rises, and the healthcare delivery system inches toward a return to normal operations, the ambulatory surgery center industry faces a perfect storm of factors affecting staffing.
Well before the pandemic, payors increasingly looked to ASCs to perform lower-cost, high-quality procedures. Although CMS recently removed hundreds of surgeries from the ASC payable list, they have expanded the list of ASC-approved cardiac and other diagnostic and treatment procedures in the last few years. And many patients are seeking to schedule procedures they delayed during the height of the pandemic.
The anticipated volume increase compounds ASC staffing concerns, such as front-line health worker burnout and the nursing shortage -- may exacerbate the situation even more.
Many ASC administrators are using a variety of frantic tactics like large signing bonuses to recruit employees, which is understandable considering the immediate need. But the rush to locate and onboard qualified candidates is simply swapping staff between facilities. This exhausting “hamster wheel” cycle creates churn, reduces efficiency and productivity, and doesn’t address the larger crisis.
What the ASC industry really should focus on is end-to-end strategies that address the burnout and fatigue affecting existing staff, the lack of qualified candidates to fill open positions, and the deficiencies in the workforce pipeline for the future.
Ironically, as ASCs try to fill empty positions, they may forget to take care of their current employees at the same time. There must be an effort to address the mental and physical strain happening in hospitals and surgery centers across the country. Many academic medical centers and the National Academy of Medicine offer resources to help managers address clinician burnout and provide numerous links for provider fatigue that ASCs of all sizes can access.
A good start is to change the expectation of clinician stoicism. To build a sustainable workforce, the healthcare industry must take a hard look at a culture that doesn’t support work-life balance. ASCs must consider more flexible hours, offer mental health benefits to assist with stress, burnout, and depression, and ensure that they don’t overwork staff. These non-monetary options will go far toward supporting a sustainable workforce, but until the conditions and salaries are adjusted as well, healthcare staffing will continue to flounder.
Additionally, all stakeholders must collaborate on a better pathway for the next generation of healthcare workers. Some researchers looking at the impact of burnout from the pandemic predict a shortfall of 18-20 million healthcare workers by 2030, catapulting us from a short-term shortage of bodies to a full-blown industry crisis.
For young people considering career options, health leaders, policymakers, and the education community must demonstrate the value of healthcare and offer incentives to increase the likelihood of participation. ASCs should partner with colleges and trade and vocational schools that offer a broad spectrum of education and training programs with paid externships, mentoring opportunities, and social and financial educational support to attract students into them. They should also begin creating a diverse pipeline and addressing disparities in the provision of care with a special emphasis on encouraging students from rural and underserved markets and under-represented groups, such as communities of color and the LGBTQ+ community.
Finally, there will be an increased need for workers skilled in health technology, including those with knowledge of artificial intelligence and predictive analytics to improve office efficiency and drive good patient outcomes. But those innovations must be user-friendly, or they will increase, not decrease, burnout -- and by themselves, technological tools won’t remove the foundational need for nurses, physicians, and support staff. Moving forward, the healthcare industry as a whole needs to look at both technological solutions and the ability to seamlessly integrate those solutions into the workplace to reduce administrative burden on staff.
One of the primary goals of the Strategic Plan for the Health Resources & Services Administration, part of the US Department of Health and Human Services, is to “foster a health workforce and health infrastructure able to address current and emerging needs." These goals are an important recognition that the staffing crisis is a concern not just now but for the foreseeable future. With the growing value of ASCs in the healthcare system, they must stabilize their operations by providing better, holistic employment packages for existing workers, removing administrative burdens that distract clinicians from patient care, and helping to craft better pathways for contented, healthy workers to care for individuals in need.
Maura Cash RN, BSN, CASC, is vice president of Clinical Strategies for HST Pathways, the top-ranked software solutions company for the ambulatory surgery center industry.