In light of the nationwide shortage of clinicians and other allied health professionals, hospitals and health systems are struggling to staff operating rooms and are spending more money on the labor needed to deliver high-quality patient care. Healthcare leaders are looking for creative solutions to help solve these problems.
This was a major theme in a discussion at Becker's 14th Annual Meeting led by Peter H. Doerner, executive vice president and chief development officer for North American Partners in Anesthesia (NAPA).
Five key takeaways were:
- The growing volume of outpatient procedures is driving demand for anesthesia staff. Historically, anesthesia clinicians delivered care for procedures performed within a traditional hospital setting. Today, demand for anesthesia coverage has grown due to procedures migrating to ASCs and office-based practices, while still requiring care within the hospital setting. "The shift to outpatient is good for patients; however, it has reduced the clinician supply in hospitals and health systems," Mr. Doerner said.
"One barrier we have is our mission, which is to be a safety net healthcare facility in Massachusetts," one participant said. "That creates a real problem in terms of our payer mix and we have significant competition for anesthesiology providers from two small institutions near us."
- Seasoned anesthesia clinicians are retiring, and the pipeline of new clinicians isn't keeping pace. An inadequate number of new anesthesia clinicians are graduating. The S. Bureau of Labor Statistics projects that 7,600 new CRNA positions will be needed by 2028. Yet only 2,400 CRNAs graduate each year. At the same time, many clinicians—especially anesthesiologists—are retiring, and the unemployment rate for this specialty is less than 0.5%. With a growing patient aging population in need to surgical care, the result is a massive projected shortage of anesthesia providers over the next decade.
"We have a system with nine hospitals, and the culture of surgeons and anesthesiologists is very difficult these days," one attendee said. "As a result, we only have a certain number of hospitals with staffing for cases overnight, which means we're transporting patients from hospital to hospital." - Staffing models must change to align with employee preferences. Healthcare workers want staffing models with flexible work-life balance. Prior to 2020, most of NAPA's clinicians were traditional W2 employees. However, today, only about 60% to 65% are full-time W2 employees. "Flexible work hours have become the norm today," Mr. Doerner said. "For example, CRNAs in Philadelphia desire 24-hour shifts — that's what the market commands. We've had to adjust scheduling in that area to recruit and retain CRNAs."
- To maximize limited anesthesia resources, it's critical to leverage scale. In many markets, NAPA cross-utilizes anesthesia clinicians across various locations. "With concentration in a market, you can move sub-specialists and others around appropriately to maximize labor," Mr. Doerner said. "For example, not everyone needs a full-time pediatric anesthesiologist five days a week."
- NAPA partners with healthcare organizations to create anesthesia clinician stability. NAPA works with partners to identify and implement operational efficiencies. Filling vacant roles and making investments to drive retention creates dependable local teams. "We focus on strong leadership and maintaining a nurturing culture as drivers of clinician engagement," Mr. Doerner said. "NAPA has reduced its rate of clinician resignations to 5.5% — our lowest level in recent years. The national turnover rate is 10-30%."
NAPA's national network of anesthesia experts drives superior clinical outcomes, operational and financial performance and client satisfaction for hospitals and health system. "Our experienced, clinician-led organization is focused on clinical quality and value-add services that create clear differentiation," Mr. Doerner said.