What factors do you see affecting health system staffing strategies? What shifts do you anticipate based on the financial challenges hospitals and health systems face today?
Despite the known staffing challenges across all of healthcare, and specifically anesthesia, we are seeing signs of progress in some areas. The biggest driver is that health systems are becoming more selective in the service lines they will continue to provide. This has reduced some of the demand of the staffing equation, which is helping systems regain a sense of balance. Many of these decisions to reassess service lines were influenced by low financial performance, and these decisions seem to be paying dividends in terms of staffing. Continued consolidation of services is a necessary reality to help the market fully normalize.
How have clinician employment strategies evolved over the past two years?
In our specialty of anesthesia, we are seeing an increasing percentage of the workforce choose part-time or per diem employment. These models give clinicians the opportunity to work when and how they desire. In today’s current labor market, anesthesia clinicians have diverse opportunities in terms of schedule, geography, and clinical environment. The increase in per diem work specifically allows tremendous flexibility for clinicians; however, it does tend to contribute to the clinician shortage and accelerate compensation increases.
As more anesthesia providers are choosing to become independent contractors, how is NAPA addressing these evolving labor trends to ensure that its healthcare clients have sufficient, stable, and standardized high-quality anesthesia staffing?
There has always been a place for independent contractors in the anesthesia workforce. The change we are seeing today is that a disproportionate percentage of the workforce is choosing to contract in this way, for several reasons. While the highest level of quality often benefits from consistent, full-time teams who have longstanding rapport and trust, I do not see independent contractors creating serious quality issues. These are the same highly qualified anesthesia professionals who may have chosen full-time employment just a few years ago. It does cause some challenges around the strength of the perioperative team. Independent contractor relationships are typically of a limited duration. At NAPA, to bridge any possible gap in this area, we leverage rigorous onboarding and close oversight by our local clinical leaders. We have also standardized our documentation and processes across many of our facilities, which allows independent contractors to adjust more quickly to a new assignment and helps the existing anesthesia team members better engage with these new contracted colleagues.
The current backlog in elective surgeries created by the pandemic further pressures hospitals and health systems as they struggle to meet patients’ surgical needs based on other factors. Some are moving more types of (and more complex) surgeries to outpatient centers. Others are making tough choices about prioritizing case volume and acuity. As providers are forced to contract their scope of services, how is NAPA helping its clients optimize operating room (OR) efficiency so they can continue to serve their communities?
NAPA’s data warehouse of more than 2 million patient cases annually is a powerful tool to support our clients in optimizing their OR and procedural areas. Data makes it possible for our regional and local leaders to share detailed information on utilization, volume, vacancy rates, payor mix, and year-over-year reported revenue across a facility or system. By identifying areas of underutilization by time of day, day of week, or even location, we can work with our facility partners to better leverage available resources. Clients are frequently surprised by the level of downtime that exists on a routine basis, as well as the amount of productive “anesthesia time” lost when anesthesia clinicians move between locations—such as interventional radiology, cardiology, imaging, and other non-operating room areas—just for one case in each venue. Through data collection, analysis, reporting, and consultation, we can help clients take a big-picture view of their facility and make data-driven decisions about their perioperative process.