Hospital operations teams are finding creative, technology-driven approaches to do more with less
Patient demand is outgrowing physician supply in rapid fashion, with the United States expected to face a mass physician shortage in less than a decade.
Last year, the American Association of Medical Colleges projected a shortage of up to 90,400 physicians across all specialties by 2025, yet a 2016 update to the AAMC’s report now estimates the number could be as high as 94,700. AAMC President and CEO, Darrell G. Kirch, M.D., called the updated projections confirmation that the looming shortage is “real” and “significant,” and it’s propelling leaders to take a hard look at the future supply and demand of healthcare.
Government initiatives as well as medical schools expanding class sizes are helping to increase the number of new doctors, but hospitals are also taking steps to make better use of the existing physician workforce. Though at a time when the healthcare industry is also coping with widespread physician burnout, leaders have the added challenge of balancing increased demand without stretching their staff too thin.
Hospital operations teams are taking innovative approaches to doing more with less. Let’s look at three short case studies from real healthcare organizations who have embraced technology.
Stop the Bleeding
The easiest way to hire doctors is to keep the ones you already have on staff, but retaining physicians is easier said than done for rural hospitals.
According to the National Rural Health Association, 10% of physicians serve a quarter of the population living in rural America. Unable to rely on lifestyle appeal, some rural medical schools utilize student loan repayment programs to encourage medical students to practice in rural communities.
Other organizations like iNDIGO Health Partners focus on physicians’ job satisfaction to boost retention. iNDIGO is located in rural northern Michigan where recruitment is a challenge due to some of the coldest winters across the country and access to only one-third of the physicians per capita as the southern half of the state. As a result, retention is imperative to serving the partnering community hospitals iNDIGO helps sustain. However, an inflexible shift scheduling process was creating poor job satisfaction for iNDIGO’s physicians and putting them at risk for burnout.
Balancing physicians’ work-life balance preferences with patient demand across multiple sites proved to be more complexity than their manual scheduling process could handle. Redesigning their entire scheduling model, iNDIGO incorporated sophisticated scheduling technology that added the flexibility necessary to help create shift schedules that promote work-life balance. Since the scheduling model overhaul, iNDIGO has reached and maintained an industry-leading physician retention rate of 97.6%.
Increase capacity incrementally instead of with full-time hires by bringing on-demand, Uber-style flexibility to your staffing and let physicians, locum tenens, and moonlighters pick up extra hours as desired. Doing so would capitalize on the work schedule flexibility many of today’s young doctors find appealing.
“We’re living in an on-demand economy, where startups like Uber are showing younger generations that they can ‘be their own bosses’ and manage their own work schedules,” said Sarah Zweifach, an MD candidate at New York University. “Our current medical education system is extremely rigid and structured, with very little flexibility. Coming from this environment, the ability to control my own schedule — to choose when to work more or less — is incredibly appealing.”
Flexible shift scheduling is also common in emergency medicine where patient demand is constant but acuity is variable. To accommodate, many emergency departments staff separate high and low acuity areas. In a recent study on shift scheduling complexity by specialty, Dr. Brian Lahman, an emergency medicine physician and scheduling administrator at Reading Hospital in West Reading, Penn., explained, “Emergency departments have to schedule multiple providers who may have similar and different skills and abilities to care for all of these patients in different areas.”
Emergency medicine groups rely more on locum tenens and moonlighters than any other discipline, but could other disciplines take a similar approach using flexible scheduling technology to increase capacity?
Look for Hidden Capacity
Time-intensive administrative duties are often cited as a top contributor to physician burnout. Using health IT to help reduce the load can not only address burnout but also uncover hidden capacity. Dr. Romil Chadha, a hospitalist at University of Kentucky HealthCare, and his colleagues took a hard look at their group’s spreadsheet-based scheduling process when time spent creating and managing shift schedules reached a peak of 1,480 hours each year.
By automating the process with scheduling software, that admin time dropped drastically to as few as 260 hours per year. Along with a streamlined scheduling process, the team of hospitalists also gained fair distribution of shifts and equalized workloads.
In specialties with multiple service lines, using scheduling technology to implement fair and balanced policies ensures the workload is shared across the physician team. “We have a lot of services that we need to assign everybody to. We need to make sure, of course, that we’re not overloading our doctors,” says Jennifer Chronaberry, RN, office manager for Pulmonary and Critical Care Consultants, Inc., in Ohio. “Our doctors, being on service in the ICU and pulmonary consults, it’s very difficult — they work a lot of hours during those weeks — and we set rules so they don’t have to do two weeks in a row. We have to make sure everybody’s doing their fair share.”
Embracing technology in scheduling operations can help unlock hidden capacity. With so many complex variables at play in hospitals today that affect scheduling, manpower and spreadsheets alone are no longer cutting it in the demand-heavy healthcare environment.
A balanced and streamlined shift scheduling process is an integral part of hospital operations, and with technology’s help, hospitals are able to let doctors get back to why they originally joined the profession — to help and treat patients — and there’s no better return on investment for hospitals than satisfied doctors who are able to see more patients.