Outlining the Challenges That Workforce Shortages Bring to Healthcare Today

Outlining the Challenges That Workforce Shortages Bring to Healthcare Today

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Middlefield Hospital is currently facing the threat of workforce shortage. The hospital’s employee turnover rate exceeds 20%, with over 100 nursing vacancies. After analysis of the situation, the shortage was linked to; a competing hospital opened within our service area, a significant drop in employee morale in the last 12 months, and Essex University’s consideration of eliminating its nursing program due to faculty inadequacies. The increased turnovers threaten Middlefield Hospital’s reputation for quality care in its inpatient and outpatient services. Research links low staffing levels in a hospital to negative health outcomes and patients’ perception of quality of care. For instance, Engl et al. (2019) noted that the quality of care was more likely to be lowest in hospitals with lower nurse staffing and support levels than in hospitals with sufficient staffing and support. This report provides strategies and recommendations to resolve the workforce shortages in Middlefield Hospital and improve employee morale.

Strategies and Recommendations

The first strategy and recommendation will focus on combating the effect of the new competing hospital in our market area. The Middlefield Hospital management will need to do a comparative analysis of our hospital with the competing hospital. The comparative analysis will focus on the care facilities offered in the competing hospital in terms of technology integration and patient care, support for technology use, the pricing of services, and the hospital’s recruitment strategies. Another focus of the comparative analysis will be the staff packages and remuneration details offered by the competitor. This comparative analysis will help Middlefield Hospital identify the specific patient care facilities that need to be improved to increase its competitiveness against the new hospital. It will assist Middlefield Hospital in restructuring its recruitment strategies and improving its employee pay and benefits packages to help reduce turnover intentions and attract new or additional qualified nurses to fill the current vacancies.

The second and third strategies and recommendations seek to transform the work environment and improve employee morale. An analysis of the hospital’s current work environment found that the available nurses were operating in a stressful work environment due to the shortage of nursing human resources. The nurses were also assigned roles that they perceived as unclear and confusing, which reduced their morale for work and self-efficacy and led to avoidance of roles. To solve these issues, the hospital management must provide clear work roles to the available nurses and provide risk allowances to improve morale. It is also recommended that the hospital invests in providing in-hospital refresher role education programs in the next three months.

The hospital will also improve its use of collaboration technologies, including upgrading its current electronic health records systems (EHRs) with a focus on the users and adopting improved patient monitoring systems and telehealth and conferencing systems. The nurses and other employees will also be trained on how best to use the technologies to improve their role and work efficiency. This will focus on optimizing the current workforce and reducing the role overload contributing to reducing morale and turnover intentions. The patient monitoring and telehealth systems will improve work scheduling and work-life balance. The nurses will be able to remotely monitor and attend to several patients simultaneously without physically getting overwhelmed with their roles. The use of EHRs and conferencing systems provides nurses with a way of obtaining easy and timely support from the nurse and physician teams in need.

The fourth strategy and recommendation is for the Middlefield Hospital to lobby and advocate for improved funding and faculty support for the Essex University nursing program. Lobbying the local and state government to support the faculty will help the hospital to recruit well-qualified instructors to revive the nursing program. This will help improve the number of nursing students with a surety of a future supply of qualified nurse graduates to meet the current and future demands of the hospital’s nursing department.

Middlefield Hospital already has a majority of the resources to meet the implementation of these strategies and recommendations. The only major financing resources will be needed to acquire and implement the telehealth and conferencing systems. The hospital’s current EHR and monitoring systems are sufficient to support the implementation of the strategies. However, some systems upgrading will be required.

If the lobbying and advocacy strategy succeeds and a new federal law is passed to provide free nursing education to all students who work in an underserved area, the recommendations will not change. This is due to the reason that the focus of the hospital is to become more competitive and improve the quality-of-care services provided and the efficiency of its service delivery. On the improvement of the employee’s level of pay satisfaction, research shows that the level of pay satisfaction is a predicting factor for nurses’ intention to leave in most hospital settings (Park et al., 2019). Improving the work environment through improving role clarity and using technologies such as EHRs to improve work efficiency are factors of employee satisfaction, quality care, and patient experiences. Research has linked role ambiguity and role conflict in high job demand environments and work overload to nurses’ psychological distress and increased turnover intention (Boudrias et al., 2020). Further, the use of EHRs with user-centered systems designs have shown to improve the efficiency of care delivery while reducing physician fatigue (Khairat et al., 2020).

References

Boudrias, V., Trépanier, S. G., Foucreault, A., Peterson, C., & Fernet, C. (2020). Investigating the role of psychological need satisfaction as a moderator in the relationship between job demands and turnover intention among nurses. Employee Relations, 42(1), 213–231. https://doi.org/10.1108/ER-10-2018-0277/FULL/XML

Engl, E., Kretschmer, S., Jain, M., Sharma, S., Prasad, R., Ramesh, B. M., Shetye, M., Tandon, S., Kumar, S., Wilson, T. B., & Sgaier, S. K. (2019). Categorizing and assessing comprehensive drivers of provider behavior for optimizing quality of health care. PLOS ONE, 14(4), e0214922. https://doi.org/10.1371/JOURNAL.PONE.0214922

Khairat, S., Coleman, C., Ottmar, P., Jayachander, D. I., Bice, T., & Carson, S. S. (2020). Association of Electronic Health Record Use With Physician Fatigue and Efficiency. JAMA Network Open, 3(6), e207385–e207385. https://doi.org/10.1001/JAMANETWORKOPEN.2020.7385

Park, J. H., Park, M. J., & Hwang, H. Y. (2019). Intention to leave among staff nurses in small- and medium-sized hospitals. Journal of Clinical Nursing, 28(9–10), 1856–1867. https://doi.org/10.1111/JOCN.14802

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Provide a 750-word report detailing your strategies and recommendations to overcome the workforce shortages and to improve employee morale. The strategies and recommendations should be as specific as possible and include the resources needed for implementation.

*Include a follow-up paragraph on how your recommendations would, or would not, change if a new federal law was passed that provided free nursing education to all students who work in an underserved area (which you would qualify) with rationale and justification.

Your primary text and journal and website research must be used as a reference to support your analysis.

Scenario Summary
You are the new Chief Executive Officer (CEO) of Middlefield Hospital. Middlefield Hospital is a 450-bed tertiary care facility in a major urban area in the Northeast. The hospital is an integrated health system that provides the full array of inpatient and outpatient services. The hospital enjoys a reputation for quality care in the area.

As the new CEO, you have learned that the hospital’s employee turnover rate exceeds 20%, and there are over 100 nursing vacancies. You have also learned the following facts that may be impacting these workforce shortages.

A new hospital has recently opened in your market area that has produced competition for Middlefield Hospital.
Employee morale has deteriorated over the last 12 months.
Essex University (a local college) is considering eliminating its nursing degree program because there is continual difficulty in recruiting well-qualified instructors.