How will hospitals and healthcare organizations temporarily supplement their staffing to support the surge of suspected and confirmed COVID-19 cases that require hospitalization?
As hospitals prepare for an influx of patients, many are considering ways to increase their staffing, including securing locum tenens, extending traveling nurses’ contracts, paying extra shift bonuses, and canceling associates’ planned time off (in compliance with union rules at represented organizations).
Hospital leaders should consider the following additional tactics:
Implement emergency credentialing processes. Following the president’s declaration of a national emergency, CMS implemented the 1135 waiver program, which waives and suspends certain licensing restrictions aimed at temporarily increasing the pool of possible providers. In light of this, coordinate with freestanding outpatient and ambulatory centers and credential providers to care for acutely ill patients. Utilize off-site locations, along with their providers and staffs (many of whom are former inpatient acute care professionals), to care for patients without fevers or other COVID-19 symptoms.
Centralize resources. Establish COVID-19–specific care areas within the organization. Separating suspected and confirmed COVID-19 patients, and the healthcare teams caring for them, from all other acutely ill patients prevents the spread of the virus to noninfected patients and healthcare providers. Steward Health even designated one of its hospitals, located in Boston, as a dedicated COVID-19 care center as a way to cohort patients and centralize resources.
Implement interim CDC guidance regarding quarantine for exposed healthcare providers. The initial conservative approach was to send care providers who had been exposed to patients with suspected or confirmed COVID-19 home for a 14-day quarantine. Realizing that this strict recommendation would quickly reduce the availability of care providers, the CDC subsequently modified its guidance. Care providers exposed to COVID-19, but who are asymptomatic, are no longer restricted from work.
Hire students. Nursing, pharmacy, and allied health students’ clinical rotations have been canceled. Employ these students (many whom have already completed all HR screening processes) to provide patient care as unlicensed assistive personnel (e.g., patient care technicians) to perform phlebotomy, EKGs, and patient transport, and to assist with patient care.
Reassign employees. Large academic medical centers employ numerous researchers and other employees who could be reassigned to support more urgent needs. Repurpose these employees and deploy them to the hospital’s staffing pool. Residencies and medical student clerkships are also being disrupted and/or canceled. Deploy these talented professionals to areas where their experience can best be utilized.
Add temporary employees. Reach out to employees of retail stores, bars, movie theaters, and dental offices. Employ them to provide non–patient care support, such as food preparation and delivery to inpatient units; supply delivery, stocking, and inventory management; and environmental services. These temporary hires will need to successfully complete the HR screening process, and hiring them now allows time for training.