By Bart Valdez, CEO of Fastaff Travel Nursing and U.S. Nursing

With almost 5.7M coronavirus cases globally, and over 1.7M cases in the United States, it is no wonder that hospitals nationwide have reduced or completely stopped non-emergency surgeries in the last three months to help slow the spread of the virus.  While the precaution was a necessary one, it delayed an important flow of revenue that hospitals rely on for successful operations. 

As healthcare systems and facilities contemplate restoring this critical revenue stream and re-introducing this service back into their communities, there will be no shortage of unknowns requiring new protocols and procedures compliant with federal and local regulations.  It is an uncertain time that requires flexibility in order to optimize productivity.  Preparing for the unknown is the key to success.

“The best thing hospitals can do right now is make every accommodation to safely re-open surgical operations to full capacity, and provide the full suite of services that they can to their community"
-Mike Bell, Healthcare Executive

A recent study by McKinsey estimated anywhere from 60-80% reduction in hospital operations due to the coronavirus disruption, meaning that revenue-producing units will have to force significant productivity to catch up.  Required escalation of services may require extending hours of operation from 48 or 60-hour weeks to 80, 100 hours or greater.  This added workload will be needed for the next several quarters to catch up with the demand that has been postponed due COVID-19.

“Hospitals nationwide are struggling right now due to COVID-19, and its concurrent event management have created a significant reduction in higher margin revenue streams that are essential for fiscally prudent hospital management,” said healthcare executive Mike Bell.  “In situations like this they are typically reducing staff and trying to flatten expenses, but the long-term effects to their financial stability, not to mention the risk to quality patient care, make this an unsustainable circumstance.”

Staffing for the Unknown

Staffing appropriately to handle these expanded hours of operation will be a challenge, but not impossible.  With careful consideration for proper healthcare professional-to-patient ratios, the health and well-being of permanent staff who may have endured mental and physical exhaustion on the COVID front lines, and reliance on a freshly-charged contingent workforce of experienced travel nurses, hospitals can meet this new challenge. 

“Every hospital situation is a little bit different,” said Fastaff Senior Vice President of Client Services Kathy Kohnke. “Hospitals constantly face dynamic census due to unplanned disruption, and being strategic planning partners with them throughout the year ensures the best success for their continued quality patient care.  Applying best practices from our continued collaboration helps hospitals design successful strategies together.”

The self-described special forces of nursing, Fastaff nurses are experienced and ready to hit the ground running in ten days or less.  By leveraging Fastaff’s flexible-length assignments as short as two weeks and no cancellation fees after a four-shift notice, unit leaders can ensure they face each day fully resourced but know that reductions or increases can be activated quickly to conquer whatever results during the next wave of re-socialization.

“The best thing hospitals can do right now is make every accommodation to safely re-open surgical operations to full capacity, and provide the full suite of services that they can to their community,” said Bell.  “They will often rely on contingent staff in this situation, particularly to extend hours of operation to accommodate peak load capacity.  The flexibility to staff up or down as census returns provide a fiscally rational insurance policy to help them accommodate higher, unpredictable volumes without making financial commitments they will not be able to afford over the long term.”

Expanding Capacity to Meet Demand

Eric Beyer, President at Privia Health, and former President at Tufts Medical Center, had this to say about new considerations for scaling up operations. 

“As hospitals and ASCs prepare to reopen to elective cases, new tactics will emerge.  For instance, many facilities are using fewer OR rooms, increasing time intervals between cases and are prepared for longer hours as surgeons work to meet a backlog of cases.  Additionally, the increased screening activities for patients and staff will add to the per-case workload throughout the process from pre-op screening to post-surgical follow-up, a crucial step in protecting patients and communities against an unnecessary spread of the virus.

“Proactive hospitals and ASCs will develop platoon-type surgical teams to minimize infection spread and may secure access to experienced and credential staff to use as surge forces.”
-Eric Beyer, President of Privia Health

“Further, driven by local factors such as reinfection rates and patient confidence, it is likely that procedural demand will come in waves rather than as a gradual and unified rebuild, driving a need for flexible and creative staffing plans,” Beyer continued.  “Proactive hospitals and ASCs will develop platoon-type surgical teams to minimize infection spread and may secure access to experienced and credential staff to use as surge forces.”

Administrators and unit managers intend to run operating rooms and surgical centers at substantial hours in order to leverage their full capabilities.   The use of travel nurses is a prudent decision, especially rapid-deployment experienced nurses who can hit the ground running within days to augment operations beyond typical 40-48 hour nurses shifts.  In these critical revenue-producing units, one week or even one day without proper coverage logs sizable opportunity cost.

“Right now,” Kohnke said, “The clients we are talking to are eager to safely bring back elective surgeries while keeping patients and staff safe.  These procedures are paramount to meeting the needs of the community who have had to delay procedures, as well as adding to the financial performance of the organization that has been so drastically affected by COVID-19.

“The hospitals are preparing for everything from reaching capacity to operating at escalated productivity and considering protocols such as ample PPE levels, admission procedures for patients, enhanced sanitization procedures, and others. This is where the flexibility of the Fastaff terms can be very useful as they find the right mix of permanent staff and contingent labor to match the anticipated increase in OR usage to make up for the surgery backlog.  No one knows the window of opportunity hospitals will have to get these patients through the surgical process with the possible threat of a COVID return in the fall. Timing and safe planning will be the key.”

Additionally, while administrators and managers are closely monitoring the well-being of their permanent staffing and making sure they have proper rest following intense COVID duty, the contingent workforce can provide required relief without slowing down operations.   Properly-rested and properly-supported full-time staff can continue to perform at their optimal level.

30 Years of Crisis Management Expertise

The pioneer and industry leader in Rapid Response® travel nurse staffing, Fastaff has been sending urgently-needed nurses to coronavirus outbreaks since the first order came in on Thursday, February 27.  When a California-based client had to quarantine dozens of nurses who were at risk for potential exposures, Fastaff had nurses on planes in less than 24 hours from the time the order arrived, and the entire order was filled with nurses ready to hit the ground running on the following Monday. 

The sequence repeated itself the following Thursday, March 5, but this time it was from a nursing home in one of the hardest hit areas of Seattle.  Fastaff repeated the reliable delivery, but this time for six times as many nurses.  The entire order was matched within a half day of recruiting, and all nurses traveled within 24-48 hours. 

Clients can expect the same reliable and rapid delivery in large and small projects, as proven with the ensuring requests that came from large clients in Northern California and New York City with multiple facilities requiring hundreds of nurses in the first wave with escalating requests each week for over a month.

Finally, a database built on strike activity means that the Fastaff nurses have the fortitude to respond in the most urgent and stressful situations such as natural disasters and pandemics, ensures for the client that these nurses are adaptable and will provide quality patient care in any situation. They have proven their grit in these cases, from logging 60-hour work weeks to practicing in field hospitals.  

After 30 years of delivering experienced nurses to flus, strikes, hurricanes, Ebola, and now in the fight against COVID, Fastaff specializes in the urgent and rapid delivery of experienced healthcare professionals to help hospitals ensure uninterrupted quality patient care. For your planned and unplanned situations today, tomorrow and in the future, we are prepared to help you.

As all of us leaders strive to put people first and run successful businesses in this strange time, uncertainty is our unwelcomed companion. When you don’t know what tomorrow brings, effective crisis management requires preparation, contingency planning and a network of partners who will help you succeed. With Fastaff, you are guaranteed reliable solutions for every phase of your new normal.

Additional emergency preparedness resources for hospitals and healthcare facilities