Looking Beyond the “New Normal” Toward a Better Healthcare System for the Future

As of August 27, 2021, there were more than 101,000 patients in the U.S. hospitalized with COVID-19, more than double the number of the previous month.[1] Just as with the initial surge of virus cases in 2020, hospitals are struggling to main adequate staffing to care for these patients. The staffing problem, however, is quickly escalating as so many clinicians have left hospitals for less stressful positions or have taken early retirement.[2] Some have chosen to leave the professional altogether.

According to a poll by the Washington Post – Kaiser Family Foundation, around 30% of healthcare workers have considered leaving the profession due to “burnout, trauma and disillusionment.”[3]

The result of this shortage is longer emergency department wait times and a growing backlog of less critical patients as staff focuses on more acute cases.[4] In this scenario, it doesn’t take long for hospitals to exceed capacity. This, when combined with staffing shortages, can negatively impact quality of care. Multiple studies have found that clinician workload in intensive care environments is correlated with patient outcomes.[5]  

According to an article in the Nursing Times, excessive nurse workloads can increase patient safety incidents by up to 30%.”[6]

There are steps hospitals can take to address staffing shortages and mitigate the risk to patients. Physician’s Regional Health System (PRHS) in Naples, Florida, is a prime example. The region is one in which ER volumes are typically consistent and predictable, averaging around 25,000 visits each year. However, during the height of the COVID-19 pandemic in 2020, the health system experienced an influx of COVID cases. 

Unlike other hospitals, PRHS did not experience an issue with staffing shortages because all of its emergency medicine physicians and APPs were employed by Integrated Care Physicians (ICP). The health system was able to maintain consistent staffing in both its emergency department locations throughout the pandemic. This was critical as many of the COVID patients presenting in the PRHS EDs were elderly with more complex comorbidities, requiring the highest level of care. While other staffing companies were reducing physician staff and lowering physician pay to save money, ICP did not. This gave PRHS greater stability throughout the largest healthcare crisis of our time. The health system was even able to open a new wing in 2020.

With ICP emergency physicians and APPs in place, PRHS has been able to continue its 30-minute ER Service Pledge, available 24 hours a day.

In addition to maintaining optimal staffing levels in the ED, partnering with an emergency medicine, critical and hospitalist management company like ICP can help improve operational efficiencies through the use of technology. For example, throughput technology allows ED providers to see all patients in the ED at a single glance. The technology is available through an app so the data is available on the physician’s mobile device. They can then use the app to request help from hospitalists in assessing patients for admission. If the patient meets the criteria, hospitalists can then work to get the admission process going. This helps reduce overcrowding in the ED and frees up staff to spend more time with the patients that need the most urgent attention.

Triaging patients is another area that suffers when EDs are over capacity or understaffed. Yet, timely triage is critical to quality outcomes. Virtual triage is a great opportunity to fill this need, even before the patient presents in the ED. ED management partners can fill this need through telehealth technology. Patients can be assessed and referred to the appropriate care facility, which helps relieve the burden on already overworked ED staff. 

Recent research suggests that using remote patient monitoring (RPM) after discharge can reduce the length of stay in the ED, which reduces overcrowding and relieves stress among staff. A case report published by Science Direct found that “Earlier discharge has the potential to reduce iatrogenic complications such as hospital acquired infections and deep vein thrombosis” while improving the “capacity, efficiency, and quality of complex home-based care.”[7] Leveraging an ED management partner to fill this need can help reduce readmissions, improve outcomes, and enhance the patient experience.  

Beyond COVID-19

The phrase “the new normal” is one that has been bantered about a lot over the past year and a half. While we can’t know for sure what that will look like, we can project with great certainty that it won’t look like our previous normal. Nor should we want it to. This is the time to look forward, to identify areas that weren’t working before and decide what we can do to make long-term improvements for both our patients and our health systems. Partnering with industry experts like ICP in the ED can help mitigate the impact of the pandemic now while paving a path to a better healthcare system for the future. 

[1] https://www.reuters.com/world/us/us-coronavirus-hospitalizations-hit-eight-month-high-over-100000-2021-08-27/

[2] https://www.washingtonpost.com/health/2021/04/22/health-workers-covid-quit/

[3] https://www.washingtonpost.com/health/2021/04/22/health-workers-covid-quit/

[4] https://www.nytimes.com/2021/08/21/health/covid-nursing-shortage-delta.html

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5413463/

[6] https://www.nursingtimes.net/news/workforce/excessive-nurse-workload-linked-to-higher-patient-safety-risk-04-05-2018/

[7] https://www.sciencedirect.com/science/article/pii/S2213007121000988

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