Health

Hospital systems create in-house staff to tackle fuel shortages


Like many nurses today, Alex Scala received a substantial raise when she recently switched jobs.

Scala also received many welcome assignments when she joined the Pittsburgh-based Allegheny Health Network. She contracted with a newly formed team to work shifts in various units in 14 of the system’s hospitals.

After working as a registered nurse on staff at a facility elsewhere, Scala, 31, now commutes from her home in Butler, Pennsylvania, to system hospitals across western Pennsylvania. “I get to meet new people, learn new procedures, how hospitals do different things,” Scala said.

More and more hospital systems like Allegheny Health Network are setting up internal staffing teams to deal with nursing shortages caused by the pandemic — and trying to beat private temporary staffing agencies. multiply in their own game. Depending on the system, nurses may work on a week-long or multi-week assignment at one hospital and then follow a similar schedule at another. Some even work self-scheduled shifts in multiple locations, unlike the typical nurse staff, who often work in a single medical unit within a hospital. These workers are different from traditional “floating” nurses, who move from unit to unit on an as-needed basis in a hospital.

The goal of the internal teams is to provide enough pay and flexibility to attract nurses to work — and thus reduce the system’s heavy reliance on more expensive RNs from outside agencies.

Nationwide, the cost of such contract labor is nearly 500% higher than it was before the pandemic, according to a report by the consulting firm commissioned by the American Hospital Association. That spending is putting many hospitals in a pinch for 2022, the same company, Kaufman Hall, estimated recently, even though some systems have turned a profit during the pandemic.

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Members of new staffing units are often only a small part of the hospital system’s workforce. And such groups would probably not be feasible for many small or rural establishments. But hospital officials say internal staffing agencies will evolve as nurses and other workers, such as respiratory therapists and surgical technicians, seek work arrangements. flexible work.

“There is a big shift in the evolution of the healthcare industry in creating more employees,” said Daniel Hudson, vice president of nursing management and operations at Philadelphia-based Jefferson Health. can move everywhere. time workers.

Although nursing shortages have existed for many years, the staffing crisis has been exacerbated as the need for COVID care has pushed many hospital nurses to the point of exhaustion. Some quit, retire, or find work in home care agencies, ambulatory surgery centers, and medical offices.

Beth Ann Swan, vice dean of Emory University’s Nell Hodgson Woodruff School of Nursing in Atlanta, said a lot of nurses have left the workforce, including those who are newly trained.

RN’s revenue for hospital staff grew to 27.1% last year, up from 18.7% in 2020, as reported by NSI Nursing Solutions.

So nurses from temporary agencies do more shifts. Their wages – and subsequent costs for hospitals – skyrocketed as COVID-19 intensifies. Traveling nurses were making up to $10,000 a week by the end of 2020, although the average price has dropped to about $3,000 this year.

Before the pandemic, Atlanta-based Piedmont Healthcare was spending $20 million annually on nurses from such agencies. “In the last financial year, we spent $400 million,” said Piedmont CEO Kevin Brown. About a third of that goes directly to agencies, not nurses, he added.

To eliminate the middleman, Piedmont established a hospital staffing unit to provide what officials call the best of both worlds — the flexibility of a staffing agency as well as the stability and support of the local health system.

Such work flexibility is a major draw for nurses, said Akin Demehin, senior director of quality and patient safety policy at the American Hospital Association. Relevant factors include work location, frequency, and structure of shifts.

Internal hospital staffing agencies are not a new concept. year hospital Henry Ford Health System. rescue. Team members are paid a higher hourly rate than regular employees and can choose their shifts.

Kim Sauro, director of the system Henry Ford calls the BestChoice program, says the total cost is significantly lower than using staffing from an outside agency.

But for many nurses, the hospital’s in-house programs won’t overcome the allure of temporary agency pay and the opportunity to travel, at least for some periods of their lives.

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Ryan Bannan and his wife, Bharvi Desai Bannan, both nurses in Atlanta, have been on the road for nearly two years, working in Florida, Arizona and Utah, among other locations. “The first and foremost advantage is the salary,” he said. Now that the couple is expecting a baby, they return to Atlanta. Ryan worked as a staff nurse in the intensive care unit, while Bharvi worked as an “in-house mobile nurse”, with a 13-week tenure, for the second local hospital system.

Scala of Allegheny Health Network says she has also considered becoming a travel nurse. “But I have a toddler,” she said.

The medical temporary agency industry remains a profitable business even though revenues have declined since the peak of the pandemic. The president of one such company – Chris Eales of Premier Healthcare Professionals, based in Cumming, Georgia – said the new hospital staffing units do not pose a direct threat to the temporary agency sector. . “Their success depends heavily on their ability to attract, recruit, and retain nurses,” says Eales. “They have to build some credibility.”

His company is still placing temporary nurses in hospitals that have set up mobile staffing units, he said.

The Allegheny Health Network is actually continuing to use some temporary agency help. An exodus of nurses during the pandemic – many moving into higher-paying jobs – has helped spur the creation of the team, said Claire Zangerle, chief executive officer of the nurse system. their internal staff.

The system has increased salaries and benefits for nursing staff to stay. Meanwhile, the new mobile unit offers hourly rates that are even higher than what RNs give regular employees to bring back the agency’s nurses. These mobile workers, Zangerle said, move between hospitals, but still enjoy full benefits and “can sleep in their own beds.”

“I don’t think we’re going to have a temporary agent,” said Zangerle. But hospital flexible work groups, she added, “will change the labor market.”

Kaiser Health News is a national health policy news service. This is an editorially independent program of the Henry J. Kaiser Family Foundation not affiliated with Kaiser Permanente.

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