The COVID-19 pandemic laid bare the problems that have affected healthcare for years, including capacity issues and staffing shortages.
“Staff burnout is a real challenge,” notes Kristin Calheno-Hill, RN, BSN, MA, director of strategic clients at Change Healthcare of Nashville, TN. She gave a presentation at the American Case Management Association’s National Conference in May. “Staffing shortages and capacity issues certainly play a major role. There is an aging population, and that means the workforce is aging as well. Staff burnout is real, and that’s impacting [the workforce].”
Organizations and staff are asked to do more work with fewer resources. The challenge is forcing some to create more efficient processes.
When efficiency is the goal, case management and healthcare systems need to consider using technology and innovation solutions to improve the process of admitting patients to the right bed at the right time and transitioned to the right place.
Another solution is to allow case managers and utilization nurses to operate at the top of their license. They should be able to spend less time on tasks and administrative work so they can focus their attention on managing care for complex patients.
“When I think about the patients in the hospital today, patients are more sick and complex than ever,” Calheno-Hill says. “I think healthcare systems have a real opportunity to drive efficiencies with the use of technologies to automate processes.”
Organizations should move away from paper and fax and learn how to automate processes to allow nurses to focus their time, Calheno-Hill says. For example, health systems could use technology to predict a patient’s length of stay and level of care. They can leverage data to help automation.
“We still want clinical decisions to be rooted in the evidence and evidence-based criteria on who should be admitted and who is appropriate for [long-term care] or home care,” Calheno-Hill says. “Use analytic data to drive those decisions and to prioritize who we need to be managing.”
For instance, Change Healthcare uses technology that automates a medical necessity review, using data from patients’ electronic health records. The tool predicts patients’ level of care and their length of stay. This can help a case manager prioritize patients according to available data.
“If a patient looks like an observation patient with a shorter length of stay, then maybe they don’t need to focus as much time on transition of care because it’s not as complex,” Calheno-Hill explains.
With more complex patients, case managers could these tools to help patients transition to the next level of care safely.
A healthcare organization’s goal could be to improve workflow efficiency and leverage technology so nurses, case managers, and others can manage patient care without the burden of tasks that can be handled through technology.
“Nurses become nurses to take care of people and manage their care,” Calheno-Hill says. “When they’re burdened with paperwork tasks, this can contribute to burnout in the sense that nurses can’t focus on why they went into nursing.”
No one attends nursing school with the dream of checking boxes on forms. “Anything we can do to alleviate that burden and allow nurses to think about that patient coming in for three times in the past month and [ask] ‘What can I do to make sure they have a safe transition and not end up back in the ER?’” she explains. “Let’s allow them to focus on that rather than the more administrative pieces.”
The future of healthcare will include technological solutions to help with care transitions. Automated processes and data-driven answers will change the workload, Calheno-Hill predicts.
“No one should be operating the same way today as they were pre-pandemic, or even last year at this time,” Calheno-Hill says. “You need to use data to identify where challenges and opportunities are. Investing in tools that leverage those technologies is key.”