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Staffing
Takeaways
* An internal staffing model is cost-effective and enables nurses to set their own hours.
* Having the right leadership structure and technology to support this model is an important factor to consider.
* Some facilities are signing on with external workforce partners to help them fill staffing gaps.
Internal staffing, Lubell
Continued from page 1
43 employees in its internal " travel
team, " which comprises individuals who
are very comfortable with OR protocols.
Twenty surgical technologists, including
heart catheterization and electrophysiologist
technologists, and 23 nurses
with OR, catheter lab, and postanesthesia
care unit (PACU) skills participate on
the team.
An example Waltenbaugh gave was,
when a nurse in this program noticed
that a surgeon was using the wrong
X-ray during a procedure, she spoke up.
" I'm going to call a hard stop, let's just
make sure this X-ray is correct, " the
nurse said at the time.
This is a case of an OR nurse being
empowered to do her best to carry out
that procedure with competence, ensuring
that the patient received the best
care. When Waltenbaugh hears of these
incidents, she knows that the internal
travel team is doing its job. A nurse
hired from an external agency would
never be that comfortable in the OR
space, she adds.
The move toward internal
staffing
Allegheny Health's travel team is reflective
of a growing trend. Reliance on
external agencies has become a costly
proposition. Contract labor expenses
are about 500% higher than they were
before the COVID-19 pandemic, according
to a report commissioned by the
American Hospital Association.
Some health systems are responding
by looking inward and developing
their own internal staffing agencies.
Nurses and other personnel in these
positions rotate as floaters around the
20
OR Manager | Nov/Dec 2023
health system, deployed to wherever
they are needed. This poses several
advantages because internal hires are
a known quantity. Surgeon buy-in of
internal staff is easier, and it is also
less expensive to use existing staff. The
nurses themselves are paid competitively
and often set their own, flexible
hours.
As Waltenbaugh points out, it is a
win-win for everyone. The program does
not just deliver improved quality, safety,
and consistency of care. The team itself
benefits in many ways.
Some external hires may be wonderful,
but they might be gone after a
6-week contract, she says. Even if a
health system wants to keep them, they
may have already decided to move onto
their next contract. An internal travel
team, hired for its strong skill sets, is
not going anywhere.
And because they are already part of
the Allegheny Health family, travel members
can always find a full-time position
if their situation changes. " And we've
seen that already, " Waltenbaugh notes.
" It's been a really beautiful friendship, if
you will. "
Pandemic fuels more
sustainable approaches
The internal staffing
trend existed well before
2020. However,
the COVID-19 pandemic
certainly expedited this
change, says Craig
Ahrens, MHA, MBA, cofounder
of the Center
for Health Workforce Innovation
and Technology in St. Louis,
Missouri.
Craig Ahrens,
MHA, MBA
Ahrens has worked with large health
systems and academic institutions to
" facilitate physician/hospital relations,
develop strategy, and transform operations
that resulted in tangible benefits
to both providers and patients, " according
to a July 2022 Thrive Global interview.
COVID-19
exposed and created many
workforce vulnerabilities, adds Ahrens.
" We experienced firsthand that healthcare
workers are especially susceptible
to burnout, inevitably leading to providers
leaving their roles or reducing their
hours, causing severe labor shortages, "
he says.
Many healthcare facilities have since
embraced more sustainable labor ecosystems
that empower healthcare professionals
to choose how, when, and
where they work, says Ahrens. A flexible
staffing pool of on-demand workers
often leads to more robust staffing
numbers and retention rates, which will
ultimately have a positive impact on the
health system's bottom line, he adds.
On-demand staffing also brings significant
advantages to the OR suite. It
allows facilities " to surge with surgery
demand and deploy credentialed nurses
to fill staffing gaps in generalized positions
like surgical techs, general OR
nurses, med-surg, and recovery, " explains
Ahrens. " By doing so, highly specialized
nurses can be fully allocated to
the OR, where their expertise is most
needed, optimizing resource allocation
and enhancing patient care and operational
efficiency. "
Reducing dependence on
agencies
Jefferson Health, which provides healthcare
services in the Greater Philadelphia
area and southern New Jersey,
developed such a staffing approach in
2022.
The Nursing SEAL Team-SEAL
stands for Service, Excellence, Advocacy,
and Leadership-provides specialty
nursing care support in nearly all
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