While many of the steps healthcare institutions have been taking to address the nursing shortage apply to all sizes and types of providers, consultants and healthcare leaders have specific advice that applies more toward larger, academic medical centers or smaller, often more rural, hospitals.
For larger hospitals, Therese Fitzpatrick, PhD, senior vice president at Kaufman Hall, suggests leaning into their ability to leverage ideas, technology and enterprise-wide float pools across multiple hospitals in a larger geography. “Everything … can be scaled,” she says. “That’s how these large systems can really take advantage of their size.”
As a seven-campus system that runs the gamut from metro to rural hospitals, and from ambulatory to freestanding EDs, CHI Saint Joseph Health in Lexington, Ky., suggests first talking to similar providers that are further down the road in implementing various initiatives aimed to quell the nursing shortage, says Anthony Houston, EdD, FACHE, market CEO. “Yes, we compete, but in this space we want to be collaborative,” he says. “See if your neighbors can help you. Or call us.”
Houston also suggests that larger systems collaborate with educational institutions at all levels. “We spent countless hours with all of our schools, starting with technical schools and nursing schools, but also high schools and junior high schools,” he says. “We hired an academic liaison who thinks full time about what we need, working in the community. If you have the scale, and you’re able to dedicate a resource to someone pointed into your community, you can better understand the needs of schools and help tell your story and what your needs are. If you’re a smaller hospital, ask for help from your bigger friends or statewide associations.”
Providers of all sizes should do what they can to be politically active so their state government can better understand their needs, Houston adds. “We have very rural areas with small hospitals and large academic centers in metro areas,” he says. “We all come together to lift our voices. There’s power in numbers; there’s power in collaboration.”
Melissa Bennett, DHA, RN, FACHE, COO and chief nursing executive at CHI Saint Joseph Health, urges providers of all sizes to become more familiar with technological options to deliver virtually integrated nursing and other care.
“Everyone wants to have technology,” but different providers have different needs, and resources, she says. “How do you think about partnering if you’re a standalone facility? Having the right technology in the right spot to help your workforce takes planning. … [Use] your resources—your treasure, if you will—to get the biggest gains.” Without careful evaluation, she adds, “you might invest a lot of money in technology that goes into a drawer and doesn’t get utilized.”
Mid-sized to smaller institutions should work to build their academic pipelines with local community colleges in the same way larger, urban systems do with university medical centers, Fitzpatrick says. While large multistate systems have developed their own nursing schools, “that can also be achieved through collaboration with local schools,” she says. “Not everybody has the ability to develop their own [on-site], necessarily.”
Michael Hansen, FACHE, CEO of Columbus Community Hospital in Nebraska, advises smaller rural hospitals to start recruiting people at a young age, while they’re still in high school, and encouraging them to come see the hospital. They can learn more about not only clinical positions such as doctors and nurses, but also other types of opportunities, such as in business and accounting.
“I encourage people to do rural rotations through your hospitals,” he says. “That’s your best opportunity to recruit people. Critical access hospitals are 25 beds or less. It’s harder to get them to come to rural areas, but they don’t have as many positions to fill. They usually can eventually fill those positions. It depends on the community and what amenities you have to offer.”
CEOs need to be visible in those facilities and talking about what they have to offer during the recruiting process, while human resources staff should get involved in career fairs in the surrounding region, Hansen says. “We have three high schools here. We do a lot of outreach,” he says. “There’s about six counties around us that we provide services to, not only our physicians and things like that but also athletic trainers.”
The Nursing Shortage
Beyond the Bandage