After nearly two years of rationing hospital resources and beds, healthcare leaders and staff remain cautiously optimistic about returning to a life that more closely resembles pre-pandemic days. Armed with newly FDA-approved Covid-19 vaccines for individuals ages five and up, the focus has begun to shift from halting the spread of the virus to establishing new processes and norms for 2022. But is it really that simple or are we now contending with the perfectly catastrophic trio of resignations, cancellations and vaccinations? Collectively referred to as “The -ations,” this triple threat is precisely why healthcare leaders are likely to continue to look to their staffing suppliers in 2022 as crucial partners for supplying their workforce.
Buried in the rubble amongst the nursing shortage, unsustainably high pay rates and an unprecedented backlog of surgical procedures lies a glimpse of hope that calmer days are coming. However, underestimating the obstacles that lie immediately ahead could prove to be a short-sighted, costly mistake if staffing suppliers are ill-equipped to continue to meet the existing, or even increasing, demand for some specialties. It is critical that leaders not be too eager to pull back on staffing in an attempt to force pay rates down or to quickly reduce the number of travelers.
Faced with multiple surges of Covid-related admissions, hospitals beds around the country were quickly accounted for. Teetering on the edge of disaster, leaders have been forced to make the difficult decision to cancel elective surgeries. With limited numbers of available ICU beds, canceled and postponed high acuity surgical procedures had more than negligible consequences. For example, prior to the initial Covid outbreak, researchers at Mount Sinai Hospital in New York had begun evaluating 77 cardiac patients with severe aortic stenosis for transcatheter aortic valve replacement surgeries. Following the decision to cancel elective procedures, 10% of those patients experienced a cardiac event within the first month, while 35% experienced the same within the following three months. Two died. These types of tragic outcomes are placing pressure on healthcare systems to reduce delays and to find ways to continue to deliver needed care, all of which requires surgical, ancillary and critical care staff.
Like other industries but perhaps more acute, the healthcare sector is facing a massive amount of staff resignations. According to the Bureau of Labor Statistics’ JOLT Survey, more than 530,000 “healthcare and social assistance” workers resigned from their jobs in August of this year. This is up roughly 130,000 employees from August of last year. Employers are battling staffing shortages due to burn out, retirement, unprecedented disparities in wages, and most recently, vaccination mandates. Crises pay rates, though integral tools in the hospital Covid survival kit, are also key players in the staffing shortage conundrum. In some cases, rising pay rates have caused core staff clinicians to resign and take temporary positions, exacerbating the difficulty in filling core staff positions. This is a cycle that is not expected to go away in 2022, particularly when coupled with the rate at which healthcare staff is exiting the industry over potential vaccine mandates. Staffers can expect that with ICU and emergency room staff that have been among the most highly sought-after during the pandemic, operating room staff will be in high demand for the foreseeable future as hospitals begin to address the procedures that were deferred as a result of the pandemic.
While many health systems are reporting 1% to 5% losses of staff due to vaccine mandates, these numbers are far from innocuous during a national staffing crisis. In September, as vaccine requirements began trickling in, the Erie County Medical Center Corp. placed 7% of its workforce on unpaid leave due to New York’s mandate. In anticipation of the impact, inpatient elective surgeries were cancelled, and most ICU transfers were halted. This situation is not unique across the country.
With the most recent resignation numbers being published prior to the surge of the Delta variant, final decisions around the controversial federal mandate hanging in the balance, and a buffet of deferred surgical procedures that were already plaguing the country prior to the Delta-driven rise in cases, staffing suppliers should expect the staffing shortage not to be resolved for quite some time. The newest player on the field will likely be the operating room as hospitals work to catch up on backlog of cases. For more thoughts on the outlook of US healthcare staffing, see our US Staffing Industry Forecast.
