Hospitals and health care leaders face a multitude of challenges these days, including staffing and retention of nurses and other clinicians.
These challenges are often exacerbated by archaic systems, some of which have been in place for decades, as innovation in health care often lags behind technology created for other industries.
Staffing shortages existed before the pandemic, but two recent national surveys revealed organizations need new strategies to retain clinical staff and put the priority and focus back on providing high quality patient care.
Surveys reveal concerning trends
More than half (56%) of the nurses who responded to an IntelyCare survey cited increased work hours — sometimes up to 15% more — as their primary reason for leaving a job. Additionally, 61% of full-time nurses surveyed said they prioritize their job above their own physical and mental well-being.
Retention remains a challenge, with nearly half of health leaders (48%) citing retention and hiring as top concerns, according to a survey of health care executives conducted by Notable, an intelligent automation company for health care.
Nurses and health care professionals also indicated too much time is spent on documentation and not enough on patients. Respondents to the Notable survey said staff at their organization spend, on average, 57.5% of their time on repetitive tasks such as data entry and documentation.
The increase in hours apparently led to another significant problem, according to Notable. More than 28% of respondents revealed they have quit a health care job because of burnout.
With 1 in 3 nurses planning to leave the bedside within a year, staffing ratios could potentially become unsafe for patients and nurses unless the trend is slowed or reversed with viable solutions.
Challenges to health tech innovation
“The health care industry is extremely fragmented and complex, and multiple stakeholders are involved in a highly latticed decision-making process,” said Pranay Kapadia, CEO and founder at Notable. “I’ve heard stories from health system leaders about conversations with technology vendors dragging on for years. By the time they get to sign a contract, the technology that the company has to offer is already outdated; or worse, it’s a point solution that ends up creating more back-end work for the staff.”
“Innovation has lagged because the solutions typically have not been built with actual nurses as co-creators and stakeholders,” said David Coppins, co-founder and CEO of IntelyCare. “If a specific technology is being built to achieve an advancement in the nursing profession, nurses have to be involved in the designing of that solution.”
Both executives say they foresee positive change and growth for health tech innovation, especially as it directly relates to the health care workforce.
“It’s already happening, for two reasons,” Kapadia said.
“First, patients will not continue to accept a subpar digital experience. More than ever, patients are choosing their health care providers based on convenience. If it’s too difficult to schedule an appointment, or if they keep having to do duplicative paperwork, they will seek care somewhere else,” he explained. “To retain patients, health systems are going to have to look to models outside of the industry—like Amazon, like Uber—to create a simple, intuitive digital experience. Many health systems have already prioritized innovation in order to remain competitive.”
The second factor prompting increased health tech innovation, Kapadia added, is that “health systems are short on staff, and many providers are burning out. Our research shows that 57% of health care professionals are worried they will burn out due to the number of repetitive tasks they have to complete,” he said. “For health systems to keep up with their patient loads during the staffing shortage, and to prevent additional workers from burning out, they need to use automation.”
Health systems that have partnered with Notable have found they can save their nursing staff several hours of time each day, according to Kapadia.
Saving nurses time not only helps to prevent burnout, but it also benefits patients. Coppins noted that three-fourths of nurses initially joined the profession “to simply help others. None of them could have expected the last two years and now that so many nurses are finding themselves at a career crossroads, we want to make it known that nurses have options.” Nurses need another choice other than living with burnout or quitting their profession, said Coppins. “There are tech-enabled working models to beat the traditional, antiquated scheduling model for nurses. If nursing is your calling, you can still have a sustainable career.”
Nurse executive weighs in
Karlene Kerfoot, PhD, RN, FAAN, said she agrees there is a need to streamline workflows and increase efficiency for health systems and providers. As CNO of symplr, Kerfoot is responsible for integrating the science of patient care, staffing and clinical informatics into simpler solutions for operational efficiency.
“Patients don’t go to the hospital to talk to a nurse behind a computer. This creates a mutually frustrating health care encounter for the provider and the patient,” Kerfoot explained. “These negative encounters hurt patients and their satisfaction, in addition to decreasing job satisfaction and morale, increasing burnout and accelerating workforce attrition.”
In general, she said, the health care industry is not as highly innovative as other industries, particularly regarding operational and administrative efficiencies. “We wait for other industries to develop innovative solutions, then beg, borrow and steal those concepts for our own purposes. We do this in part because health care has slim margins, making investment in research and development tricky,” she continued.
Like other executives, she said she is hopeful for the future of health technology. “The pandemic helped the industry shake off some of that lackluster energy, get scrappy, and really embrace an innovative spirit. We shed some of the bureaucratic red tape blocking innovative thinking and processes, and now the question is whether we can keep up the pace. If we can, we’ll see some incredible changes in the next few years,” said Kerfoot.
She cited nurse staffing as one example. “We abandoned old ways of staffing nurses based on good evidence the models weren’t working. We certainly can’t go back now. Health care has fundamentally changed. Patients are much sicker and require a higher level of care, and nurses want increased flexibility, so hybrid models that embrace the gig economy mindset as well as parts of more traditional models will do far better,” Kerfoot added.
The more time — real face-to-face time, not computer time — a nurse can spend with patients, the better the patient outcomes, satisfaction and safety. “So, in addition to improving the job experience of providers everywhere, smart technology has the potential to improve patient lives and safety and hospital reimbursements,” she continued.
Can technology really help nurses that much? Kerfoot strongly believes it can.
“Good technology can absolutely have a positive impact on the nursing profession. Inefficient technology, on the other hand, does have adverse impacts,” she explained. “Nurses don’t go into health care to nurse the computer. They go into health care to take care of patients and make a difference in the lives of patients. When computer and admin work get in the way of this patient-centered work, nurses say ‘I’m out of here.’”
“There is a huge opportunity for technology to simplify and make it easier to focus on patients rather than focus on techy administrative process. We just need to use technology to remove dissatisfiers in the job,” Kerfoot concluded.
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