Lasso

Hannah’s Crisis

Hannah* is the Chief Administrative Officer of a community hospital serving a mixed rural and urban area. Over the last few months, she and the department chairs have been struggling to get a handle on a serious understaffing situation.

In part, this was due to the difficulties of finding qualified people willing to relocate to their region – they weren’t exactly a destination spot. That didn’t trouble Hannah too much, since she considered it the price of doing business in their locale.

What did concern her, though, was how quickly staff were leaving – their turnover rate was astronomical. To find out why, she had recently distributed an anonymous survey to all providers and staff.

The results were in, and the reason for the high turnover was finally clear: the short staffing was too much pressure. Her team was getting burned out.

People wrote in about working week after week without a day off. They spoke of the stress of not having the right mix of specialties on the team, and always having to scramble when that expertise was needed. Most worrisome of all, were reports of compassion fatigue and slower response times.

Hannah knew there was no time to waste – they had to get this situation turned around fast.

Patient Demand Forecasting and Burnout

Turnover in healthcare organizations is strongly tied to burnout. Understaffing, incorrect provider mix, and high patient load can all play a role in the emotional exhaustion leading to employee turnover. (See: How Bad Scheduling Can Ruin Practice Morale.)

As patient demand forecasting directly affects these staffing issues, it is a profoundly useful tool to have in your arsenal.

For healthcare professionals, burnout is a serious problem. In a 2012 study, 45.8% of physicians reported at least one symptom of burnout. Moreover, compared with working U.S. adults, physicians were significantly more likely to have symptoms of burnout (37.9% vs 27.8%) and to be dissatisfied with work-life balance (40.2% vs 23.2%) (P < .001 for both).1

Burnout and Patient Outcomes

Burnout strongly correlates with patient care, so it is not an issue medical practices can afford to take lightly.

A study of nurse staffing and burnout found that after “controlling for patient severity and nurse and hospital characteristics, only nurse burnout remained significantly associated with urinary tract infection (0.82; P = .03) and surgical site infection (1.56; P < .01).”2

Adverse outcomes are a problem in terms of quality of care, but they also are a financial burden. That same study found that “hospitals in which burnout was reduced by 30% had a total of 6,239 fewer infections, for an annual cost saving of up to $68 million.”3

Burnout and Turnover

A 2009 study by Leiter and Maslach demonstrated a pathway from burnout to turnover, concluding that, “the findings supported the mediation model of burnout, in which areas of worklife predicted burnout, which in turn predicted turnover intentions.”4

For healthcare organizations, turnover is no minor issue; it is disruptive and expensive. There are the business costs of recruitment and hiring, as well as orientation and training. Turnover also means a loss of organizational knowledge. More alarmingly, the dissatisfaction communicated by burned out staff can often make a difficult work environment even worse. On top of that, turnover also means practices must contend with decreased productivity, reduced patient satisfaction, and replacement staff.

Hospitals with high nurse turnover spend an average of $3.6 million more than those with high retention.5

Patient Demand Forecasting and Staff Retention

The high burnout levels in healthcare organizations undercut staff retention, which negatively affects patient outcomes and costs practices millions.

Where the burnout stems from concerns about staffing, patient demand forecasting can be a lifesaver.

Patient demand forecasting can relieve pressure on teams by ensuring the right mix of specialties is always available. It can account for real-time changes on both the patient and provider side, reducing short-staffing concerns. It can even reduce provider stress by making sure no one goes too long without a day off.

By addressing several of the underlying issues that can cause or exacerbate provider burnout, patient demand forecasting becomes a tool that practices can use to reduce turnover and increase staff retention.

*Names and situations presented throughout this post are meant to serve as fictional examples only. They have been created as composites representing common situations, but do not reflect specific individuals or organizations.

This post is an excerpt from the OpenTempo report on Patient Demand Forecasting.

Sources

1 D Tait, et al, “Burnout and Satisfaction With Work-Life Balance Among US Physicians Relative to the General US Population,” Arch Intern Med. 2012;172(18):1377-1385. http://archinte.jamanetwork.com/article.aspx?articleid=1351351
2 Jeannie P. Cimiotti, et al, “Nurse Staffing, Burnout, and Health Care–Associated Infection,” American Journal of Infection Control, Volume 40, Issue 6, Pages 486–490, August 2012. http://www.ajicjournal.org/article/S0196-6553(12)00709-2/fulltext
3 Cimiotti, “Nurse Staffing, Burnout, and Health Care–Associated Infection.”
4 MP Leiter and C Maslach, “Nurse Turnover: The Mediating Role of Burnout,” J Nurs Manag. 2009 Apr;17(3):331-9. http://www.ncbi.nlm.nih.gov/pubmed/19426369
5 Pricewaterhouse Coopers’ Health Research Institute, “What Works* Healing the Healthcare Staffing Shortage,” 2007. http://pwchealth.com/cgi-local/hregister.cgi/reg/pubwhatworks.pdf