Back to The Workforce Optimization Blog

Preserving Hospital Services Through Workforce Stabilization

Kathleen Wessel from the American Health Association joined Adam Rousey, Chief Sales Officer of VISTA Staffing Solutions, and Lou Vadlamani, Interventional Cardiologist, Founder, and CMO of CardioSolution.

The American Hospital Association (AHA) is the national organization that represents and serves all types of hospitals, healthcare networks, and their patients and communities. Nearly 5,000 hospitals, health care systems, networks, other providers of care, and 43,000 individual members come together to form the AHA.

VISTA is a full-service healthcare staffing partner. Whether you’re a healthcare organization looking for a specific provider or a clinician looking for locum tenens or permanent opportunities, VISTA is here to help.

CardioSolution is a physician-led group that brings heart care to underserved communities across the country.

VISTA and CardioSolution are Ingenovis Health companies.

Adam and Lou’s teams are working with AHA Members to drive workforce stabilization and develop proactive recruitment strategies. By improving the condition of the workforce, hospitals can avoid reducing or eliminating services due to staffing concerns.

As hospitals contend with workforce challenges, one top-of-mind motivator is ensuring patient services continue without interruption. By adjusting how hospitals address workforce challenges, they can avoid reducing or eliminating services due to staffing concerns.

VISTA staffing embarked on a journey a number of years ago to evolve its operating model and align closer with hospital leadership to better understand the root cause of the labor-related issues around cost, and quality and really get into the root causes of these issues.

They built a model, simply based on trust, transparency, and accountability, that they aligned with the AHA and their goals and missions around delivering better care and greater value and ensuring financial stability, increasing public trust and confidence in the healthcare system, and addressing workforce imbalances.

Since then, VISTA has taken the AHA mission and incorporated that into their delivery solutions, helping AHA members gain visibility into their labor utilization, and balancing that with contract labor and their full-time workforce, ultimately reducing the dependency on contract labor. And it really is a unique model.

The Tenants of Care in Rural Settings

The tenants of building a program are:

  • Quality of care (having the right physician with the credentials and qualifications to do the job)
  • Continuity of care (supporting them with the appropriate people to help them succeed)
  • Continuous and uninterrupted care (making sure that if there are emergencies for that provider the service line doesn’t get interrupted)

How hospital service lines are impacted by provider staffing shortages

When you’re looking at what are those basic tenets of building a program of a service line, you have to have the quality of care, you have to have the right person with the credentials and the qualifications to do the job, and that in itself is a challenge finding the right person.

Once you find that right person, then you have to surround them with the appropriate people to help them succeed.

And what does that mean?

Well, that person can’t provide care 24/7/365. So how does that person get well-needed relief, so that burnout is prevented, and how do you ensure that that person is still engaged, and provides high-quality care rather than getting burnt out and tired and then leaving?

The way interruption comes in if something happens, and we faced a lot during the COVID era, the hospital would have one provider, they would get COVID, and boom, they’re out. And for several weeks, if not longer, that service was unavailable locally. And they’re scrambling trying to find it.

In the meantime, if there’s a leakage or a hemorrhage of patients, patients don’t come there anymore, because they don’t feel like there’s a continuity there. It’s interrupted care. So they lose that volume, they lose it to some other hospital, whether it’s local or whether it’s far away.

Having quality, continuity and uninterrupted care are essential.

Without a good workforce solution, and I think particularly in rural America, you have to be somewhat creative to get that workforce solution because there’s just not an overabundance of qualified providers.

It goes without saying that divert and closure delays impact healthcare systems, financial stability, and more importantly, the patients and their families, and not just their physical health, but their mental health, and how that even works itself into the patient’s family members and both immediate and extended. It’s a very obvious but a very important topic that we are all looking at.

Impacts on the hospital on a larger scale

The newest, AHA report talks about the current state of healthcare systems as a whole. And referencing that even optimistic models show that there’ll be a 37% reduction in operating margins for these hospitals related to the pre-pandemic level and that more than half of those hospitals are going to operate in a negative margin, it’s going to be the most difficult year since the beginning of the pandemic, with no foreseeable federal relief at all.

What that means is that those of us who are in healthcare all need to play our part, and we need to help and give support. We need to seek to understand.

When you talk about a larger scale, what’s at stake is how our country delivers health care.

From our standpoint, it couldn’t be more serious, it couldn’t be a larger situation that we’re all facing. Working closely together to ensure that we have these kinds of positive outcomes, and proactive, creative solutions. It’s never been more important than it is now.

How are hospitals getting creative to preserve patient services and be more proactive?

Our cardio solution is sort of a unique model, as far as providing full-service, cardiovascular care.

Essentially, what we do is develop programs in rural America.

It’s difficult to recruit a quality physician to move to a rural area where they don’t have any real ties. Now, if we find such a physician, fantastic, otherwise, what happens is, they rotate in.

We rotate in and out with two physicians. It’s always the same two physicians.

We provide absolute uninterrupted continuity with quality of care with two physicians who don’t necessarily live locally, they come in, they provide service for 10 days, and then they’re gone for about four or five days, and then they come back.

While one is out, the other is out.

What happens if the volume is just not there to support two physicians?

Having one physician, particularly in a specialty like cardiology, which covers 365 days 24/7 is just super challenging, and it leads to burnout, frustrations, and then the physician ends up leaving.

Providing some sort of temporary coverage for that physician, maybe one or two weekends a month, maybe a holiday or two holidays a year provides well-needed rest.

Provide that service with a known entity, not a revolving door. It’s not today, it’s me tomorrow, it’s Jack, the next day, it’s Jim. It’s the same sort of one or two people coming in and out to provide that relief.

The other thing that does is eventually the program may need two physicians or three. But now you’ve got a working interview with the providers who have come in to relieve the main physician.

You’re not basing your decision based on a 24-hour or two-day visit. But based it on several months of interactions.

  • How does that provider interact with other clinicians?
  • How do they interact with the staff?
  • What is their work ethic?

You have essentially a working interview, you’ve had an audition.

Improvements we can make in staffing and recruitment to positively impact hospital services

There’s not one magic bullet. It starts with establishing trust, transparency, and accountability.

The obligation of establishing trust starts by being educated on the micro and macro dynamics of not just healthcare systems challenges, but the individual facility in that healthcare system. And then even the individual units and delivery services of those individual facilities and, ensuring that together we work through the larger corporate initiatives, along with service line delivery options at the patient level, really understanding those and earning the trust.

It starts with transparency and really opens up the doors to both sides.

The outcome of that is we get to make proactive decisions based on data and facts and not emotion.

We’ve partnered with facilities to look at who and how they’ve spent their money specific to contingent labor.

We’ve seen discrepancies with consistency in locums billing.

The contract with the company doesn’t match the confirmation letter, and then it doesn’t match the invoice.

This creates an untrustworthy, untransparent environment that sometimes healthcare systems don’t even have the time or understanding of where those dollars are going.

We’ve seen things that have been billed back to hospitals around state taxes, car insurance, daily seasonal fees, and management fees.

This has been millions of dollars on an annualized basis, especially over the last few years, as contingent labor and labor costs have been multiplied by a factor of 10.

Those are basic, fundamental aspects of what a hospital should not be concerned with.

Their core competency is delivering patient care and in our space, it’s ensuring that those hospitals when they need support when they need guidance, or compensated services, we do that in a financially responsible way.

We do that in the position of an industry expert providing data on labor trends and hiring trends. In doing that we can create a more transparent, healthy environment.

It’s as simple as doing what you say you’re going to do and being there to address the challenges in real time and learn and commune.

We can minimize and even eliminate those challenges moving forward. And if we do those things, then we can create a relationship that’s based on that reference ability and results and not drive up labor revenue and costs, further contributing to the challenges that healthcare systems and AHA members are facing.

How does workforce stabilization intersect with other AHA priorities?

The things that the industry is learning about the impact of the pandemic on behavioral and mental health is staggering, and it’s developing in real-time.

Lou with CardioSolution thinks we’ll continue to see the need for increased and diversified delivery of mental health for generations: “That’s something we’re planning for, it’s something that we’re seeing.”

Lou continues, “…early indications show increased demand, and a lack of supply for that particular line of service.”

Adam with VISTA adds, “What defines a great leader is the actions not just when things are easy, and when things are going well, but when they’re under duress. And the current environment is challenging.”

Adam continues, “…unfortunately, we’re in arguably the most challenging time in our country’s history with the future of healthcare, and supporting these leaders that need, and desire, people that they can trust and have experiences that can help them make those decisions in an environment that are based on data versus emotion, will ensure that the decisions that are being made today, they won’t just affect, you know, the current environment, but they’re going to affect the future state of healthcare in our country as a whole. The leadership that’s in place, aligning with those leadership goals and initiatives and ensuring that we’re addressing both the short and long-term prioritizations of delivering health care, those are some of the most important and serious topics right now in our space.”

Back to The Workforce Optimization Blog

Related Posts