patient safety & quality
J . Hudson Garrett Jr ., Ph . D ., MSN , MPH , MBA , FNP-BC , IP-BC , PLNC , CFER , AS-BC , VA-BC , BC- MSLcert™ , NCEE , NREMT , MSL-BC , DICO-C , TR-C , CPPS , CPHQ , CPXP , FACDONA , FAAPM , FNAP , FSHEA , FIDSA
The Hopeful End of a Pandemic , the Beginning of the Endemic
The recent trends for the COVID-19 pandemic continue to show overall decreases in cases ; the transition to a more endemic virus has commenced in many locations worldwide . The Centers for Disease Control and Prevention ( CDC ) continues to update its healthcare guidance regarding testing , appropriate levels of personal protective equipment , and vaccination . As this guidance evolves , there are impacts on the healthcare team at multiple levels . A recent analysis by multiple independent staffing agencies and the American Hospital Association demonstrates an impending crisis in maintaining safe levels of healthcare provider staffing to deliver the safest level of care . This challenge is being felt in the acute-care environment and equally so in other healthcare environments , most notably skilled nursing facilities . Staffing crisis , combined with increasing regulatory and accreditations standards related to COVID-19 and infection prevention and control , have caused further unintended consequences for healthcare personnel and systems .
As the acuity of patient care across U . S . healthcare facilities has not decreased , the need for specialized healthcare professionals is more significant now than ever . Many technical healthcare professionals are stepping away from direct patient care or even leaving the healthcare sector altogether . The loss of this experience within the workforce has exponential impacts across all healthcare , especially in specialized settings such as skilled nursing facilities and intensive care settings . In addition , during the pandemic , the availability of training and development opportunities for healthcare professionals has decreased , resulting in varying competency levels for healthcare personnel .
Several mechanisms can be utilized to improve the current healthcare staffing crisis , which includes :
• Basic ventilator management training for all bedside personnel that might need to care for a ventilated patient during crisis levels of care . Expert respiratory therapists can facilitate this training to bolster the essential skillset across the continuum of care . Healthcare professionals in step-down units , outpatient settings , and skilled nursing can benefit from this type of justin-time training . The Society for Critical Care Medicine has made ventilator training programs available for healthcare professionals at no charge during the pandemic . To view these free training tools and resources , visit : https :// covid19 . sccm . org .
• Use of retirees for critical public health functions : Thousands of retired healthcare professionals with a wealth of knowledge may serve in paid or volunteer roles . During the height of pandemics or large-scale outbreaks , these retired healthcare professionals can be tremendous assets to mass vaccination or testing clinics and reduce the workload burden on already taxed acute care environments .
• Just-in-time training delivery and competency assessment program for critical skills and utilize furloughed HCPs to supplement other workstreams : When elective procedures were
canceled , many healthcare professionals were furloughed rather than being redeployed to other areas with need . One rationale for not redeploying this personnel was due to lack of specialized training such as Intensive Care or Ventilator care standards of care . This can be alleviated as mentioned above by frequent cross-training opportunities .
• Agency personnel resources and staffing supplementation : While additional healthcare professionals are vital to staffing healthcare facilities , improperly trained healthcare professionals can be problematic . Staffing agencies should cross-train staff to ensure that they are ready for emergency deployment to different patient-care environments .
The CDC has provided detailed guidance on best practices to address healthcare staffing focused on three levels : conventional ( normal staffing operations ), contingency ( staffing challenges are mild to moderate ), and finally crisis ( staffing is severely compromised ). This tiered approach to guidance can provide healthcare facilities with some much-needed flexibility during staffing challenges and potentially put patients and other healthcare clinicians at risk for unnecessary exposure to COVID-19 and other infectious diseases .
While the COVID-19 pandemic has taught the healthcare industry many lessons , one of the most significant impacts of the pandemic is only beginning to be felt by healthcare facilities-the staffing crisis ! Without tremendous investments in reinvigorating our healthcare teams , the ability to staff America ’ s hospitals and healthcare facilities will be in grave peril . The American Hospital Association and other clinical associations have published resources to assist healthcare leaders and administrators with meeting staffing requirements . Still , these efforts alone cannot be sustainable without actual changes in how healthcare personnel staffing is currently addressed across the continuum of care . Without highly competent and engaged frontline healthcare clinicians , the patients could be at risk for healthcare-associated infections , medical errors , and other potential adverse events . The time for action is now , and every healthcare executive must fully engage in resolving the next pandemic of healthcare staffing . Maintaining appropriate staffing in healthcare facilities is essential to providing a safe work environment for healthcare providers and safe patient care .
J . Hudson Garrett Jr ., Ph . D ., MSN , MPH , MBA , FNP-BC , IP- BC , PLNC , CFER , AS-BC , VA-BC , BC-MSLcert™ , NCEE , NREMT , MSL-BC , DICO-C , TR-C , CPPS , CPHQ , CPXP , FACDONA , FAAPM , FNAP , FSHEA , FIDSA , is president and CEO of Community Health Associates , LLC , as well as an adjunct assistant professor of medicine in the Division of Infectious Diseases at the University of Louisville School of Medicine . He may be reached at : Hudson . garrett @ chaassociates . com