Hospitals Are Barely Keeping Ahead In The Battle Against Shortages in Staffing, Supply-Chain
Hospitals, like every other business across the globe, are truly feeling the pressure of staying open and operational. Hospital Costs have skyrocketed, more, and more patients keep coming in due to COVID, or for every day ailments, and there doe not seem to be an end – or even a brief respite – in sight.
The problem, though, is that the supply chain cannot keep up with the pace of what the hospitals require. They don’t have enough suppliers don’t have enough staff to keep up with demand. Which by the way, is another factor hospitals are facing – rising demand with not enough workers to facilitate the proper among of supply.
Hospitals “are really suffering from a lot of instability – both operational and financially,” said Michelle Hood, executive vice president and chief operating officer of the American Hospital Association, during a recent webinar hosted by U.S. News & World Report. The cost to care for patients increased some 20% overall on a per-patient basis when compared to pre-pandemic levels, she said, and labor costs jumped about just as much from 2019 to 2021.
Many health systems are investing in new technology and digital tools to save costs while at the same time working to improve care outcomes and coordination. Digital transformations and analytics are helping Los Angeles-based Cedars-Sinai Health System address supply-chain challenges, “so our front-line workers or patients don’t suffer,” said Nausheen Ahmed, director of supply chain optimization at Cedars-Sinai. “We’re able to maintain the level of care we did pre-pandemic and not have to cancel any surgeries or push anything out.”
The panel agreed that the COVID-19 pandemic “forced us to get really creative,” said Jeffrey O’Brien, chief operating officer for Dartmouth Hitchcock Medical Center in New Hampshire. “We had typically been running a just-in-time sort of inventory approach. And boy, that was turned upside down when the pandemic hit.”
The ongoing labor shortage in the field is also proving to be a big roadblock to digital transformation. “With more technology-forward kinds of processes, you’ve got to make sure you’ve got the right skill sets in the right places,” said Kristen Miles, senior director of healthcare supply chain product strategy for Oracle, a health technology provider. “Not only are we needing to embrace the technology, but we’re also needing to learn how to educate” clinicians and staff across the care continuum, she said.
The last 2½ years have given hospital leaders many opportunities to explore possible solutions to operational challenges. For example, in an earlier phase of the pandemic, when Dartmouth Hitchcock was facing a lack of COVID-19 test kits, leaders there asked the medical center’s lab to make their own, O’Brien said. “Over a very short period of time, we found ourselves actually in the test-making business by default,” he said. “Not only did that help us serve our own patients, but the state of New Hampshire quickly latched on to that and said, ‘We need your help.’”
Ahmed said that Cedars-Sinai has rebuilt technology to better monitor workflows, product tracking and stock levels. Hood added that health providers using cloud-based technologies and analytics “can help us become more efficient and precise as we think about the future.” Panelists suggested thinking about redesigning supply-chain management like an air traffic control system.
Also essential to address operational disruptions: collaborating and clearly communicating between teams and departments across the organization. “The most important thing is the internal and external communication,” Ahmed said, and “developing those models internally that are customized, that help us focus our attention and that we develop in partnership” with the teams “on the business problems they’re facing.”
Miles added that transparency “underpins” everything in this area, but in health care, transparency “doesn’t seem to be something that’s bubbled up to the top yet,” at least in part because “we have an incredibly complex pricing structure not seen in other industries.” O’Brien agreed that transparency is critically important “to get ahead of the challenges that might happen in the moment.”
To address staff shortages, Hood said that AHA members are experiencing shortages for all jobs, from entry-level positions to the most specialized roles. “The forecasts that are out there are pretty scary as far as the supply expected over the next five to 10 years,” Hood said. “So we have an urgent issue today, but this issue is going to go on for some time.” Turnover rates “continue to be high in just about every category,” she added, so workforce retention is a primary focus. Much of that effort involves addressing burnout and the emotional trauma inflicted by the pandemic, as well as teaching new skills to individuals, such as front-line managers.
Workforce development and retention can be especially challenging in rural areas. “We have a talent gap,” O’Brien said. “We’ve seen a 45% increase in open health care jobs in our region alone in the past year,” he said. “No industry can sustain that.”
Some health systems and hospitals are using digital tools to improve efficiency, Miles said, by pulling data and analytics to plan ahead for procedures and to allow patients to self-monitor their conditions from home. For example, leveraging technology can help nurses not only manage patient care better, she said, it can also allow them to manage more patients at the same time. “I think that’s really exciting,” Miles said.
At a policy level, Hood said the AHA is working with federal agencies and legislators to refrain from reinstating some restrictions that were in place pre-pandemic, such as limitations on the use of telemedicine and interstate licensing laws. “There’s probably a good 50 to 60 waivers that were put in place during the pandemic that we really want to hold on to,” she said. O’Brien agreed: “What was allowed to happen during the pandemic actually closed a care gap for patients that otherwise we would have seen tremendous challenges with, even beyond the challenges that we face today and their complexity.”
Miles said she hopes for something like an international, anonymized patient database “where we can start to see, globally, trends and illnesses” and act strategically to address them in real time – or in advance.
Again, panelists stressed the value of collaboration and working together like a think tank might to solve big sector-wide problems. “You may not have the skill sets within your own health system, but you may have it at another institution,” she said. “If you create these think tanks, where they bring in problems and you solve them together, you may be able to help each other out and leverage the community as a whole. Sharing is caring, right? So share the information and the know-how.”