By Kelly Feist, Managing Director, Ascom Americas
The COVID-19 pandemic is what we in healthcare call a compelling event and it highlighted the shortcomings of the entire system with the nursing staffing crisis at the center. The pandemic forced the system to undertake change, often driven by technology. Now on the other side of the pandemic, we’re still faced with many of the challenges that stressed the system before, mainly the nursing shortage. And projections call for this resourcing constraint not to get better anytime soon. From 2021 to 2031, there are 203,
200 projected average annual openings forecasted by U.S. Bureau of Labor Statistics. This constraint comes from a combination of demand outpacing supply of nursing school graduates, not enough nursing school faculty members, the growing rate of retirement of the nursing workforce (50% of RNs are 50+ years old and 1/5 planning to retire in next 5 years) and an aging population driving demand for nursing services.
Despite these statics, nurses are optimistic about the future quality of the healthcare we deliver. In a recent survey we conducted, 80 percent of nurses believe the standard of care in the U.S. will increase in next five years and a majority said it will increase significantly. Why are they so optimistic?
They point to the promise of technology making a real impact in their jobs and in patient care. In the short term, as hospitals recover from the global pandemic, they’re doing so with reduced financial reserves while managing the nursing shortage – this combination further drives a lot of the change we’re seeing in hospitals.
We’ve learned a lot about what drives satisfaction and what detracts from satisfaction for nursing staff. A lot of the nurses who have left the profession are veteran, highly experienced nurses, and we’re seeing new nurses having to come and care for much sicker patients at a much higher patient to nurse ratio. Solutions that fit into managing and supporting the current workflows of nursing staff instead of changing workflows are going to be key in using technology as a force multiplier to make nurses more efficient, give them more opportunity to practice at the top of their license and to make sure that hospitals can ensure favorable patient outcomes. We’ve seen a focus on automation. For example, patient-intake platforms are streamlining the traditional waiting room, and there’s a shift to giving patients more control over managing their appointment scheduling, billing and communications with their healthcare practice.
From a longer term perspective, there’s a conversation about hospital at home with questions like how do we take care of patients with a lower acuity level in the space where they’re most comfortable? And what technology is required to do that? What kind of reimbursement models are required, and how do you drive that practice? Social determinants of health will factor into this as well, as medicine becomes more personalized and institutions, such as schools and governments, play a role in promoting wellness.
While there’s no one consensus on what the hospital of the future will look like, there tends to be more agreement around the concept of a “single pane of glass” access to patient data along their journey. The greatest advancements in healthcare are likely to occur at the intersection of technology and personalized medicine, both inside the hospital and at home. Hospitals will specialize in acute care and treating sickness, while most healthcare, or perhaps it is better referred to as “wellness care” happens at home or virtually.
From a technology standpoint, this requires hospitals to move from digital tools - using technology to improve care - to true transformation, which involves more systemic changes, including process, services, and change management. It’s a harder lift, but with more impactful payoffs.
For hospitals, this opportunity requires you to keep several things in mind:
· Understand your current technology’s capabilities. Often, we see hospitals buy one product for solving one task and another product for a different task. In many cases there may be a better, more holistic or “platform-based” approach to problem solving that identifies one solution that can solve more than one problem. These opportunities to drive a platform based approach require the hospital have a technology plan that looks cross functionally in budgeting and purchasing decisions. This streamlining of technology investments and utilization ultimately simplifies the requirements to maintain the system and supporting infrastructure, as well as staff training.
· Architect a system wide technology strategy. By creating technology review boards, hospitals can implement more holistic solutions that span across workflows, units, acuity levels, etc.
· Quantify outcomes – When hospitals commit to pre-and post-implementation data gathering, they can better quantify and demonstrate success. This helps build the case for more investment.
· Practice continuous improvement – A commitment to implementing continuous improvement models is necessary and includes monitoring, analyzing and reconfiguring tools, settings, processes, etc. It requires reevaluating what they’re doing all the time and adjusting so they can improve patient outcomes and remain financially healthy, ensuring they can be here for the long term.
Contrary to what you might see in terms of smartphone utilization, apps, video consultations, etc., digital transformation in healthcare has barely begun. It’s not a moment in time and many devices attached to patients are still not fully connected to any applications. Caregivers still enter vital signs manually. And patients still schedule appointments by phone, just to name a few examples.
Until legal and regulatory frameworks catch up with new models driven by technology, change will move more slowly than what many of us hope to see. While value-based care has been widely discussed, reimbursement is the lynchpin that needs to transform before we can get there. Until then, the more hospitals can link data, technologies and solutions to the goals of the Quadruple Aim, the faster change can happen.