Patient acuity levels have steadily risen in the United States recently, forcing many providers to content with the need for greater healthcare capacity. And experts expect that trend to continue and even escalate in the years to come. What can hospitals, skilled nursing facilities (SNFs), and other healthcare facilities do to meet this surge in high-acuity patients?
Here’s a closer look at the recent increase in high-acuity patients, its strain on facility capacity and cost, its impact on patient and workforce outcomes — and a rundown of what leaders can do to mitigate the risk.
Report: Surge in High-Acuity Patients Just Beginning
According to the Sg2 2023 Impact of Change® Forecast, higher levels of patient acuity — and the shortages in staffing that go along with it — will continue to cause “hospital capacity challenges … into the next decade.” And this trend is happening even as more care moves to an outpatient basis, the authors emphasize.
What’s driving this increase in high-acuity patients? The report points to an aging population and rising rates of chronic disease. It also shows that patient case mix index in the U.S. rose by 5% from 2019 to 2022. In addition to this increase in the “diversity, complexity, and severity” of patient illness — or maybe because of it — the average length of stay in hospitals increased by 10% over the same period.
The result? An ongoing strain on capacity “across sites of care,” increasing “workforce challenges” for employers — and putting more patients at risk. Ultimately, providers must work to “redesign” care so that high-risk patients aren’t excluded amid the surge in utilization, in the words of Sg2 intelligence senior director Tori Richie.
3 Ways to Adapt Healthcare Capacity for High-Acuity Patients
But how can providers tackle the huge task of redesigning care? The good news is that three methods are already not just available but in wide use. These include investing in new technology, ramping up home-based care, and implementing new staffing models. Let’s take a close look at each.
#1: Innovations in Technology
Innovations in technology can enable organizations to provide care for more patients or residents than ever before. And it can do so in ways that were never before possible. Indeed, from more closely monitoring high-risk patients to using data to predict trends, technology has become essential for successful care.
And with modern electronic health records (EHR) systems, most facilities already have a foot in this new system of interconnected technologies — even those that may have otherwise slow to embrace concepts like telemedicine or digital health.
Yet embracing newer technology can do even more. Technology can also be used to automate important workforce tasks like timesheet approvals, contract management, and assignment extensions. This saves valuable time for administrative teams, while helping to ensure the availability of essential workers at critical times. Automation can also boost the labor budget by reducing the workload for managers, letting them take on more advanced tasks.
> Read more about how to leverage automation here
#2: The Shift to Home-Based Care
Of course, technology is also a driving force in the current expansion of at-home care. Thanks to new remote and virtual systems and devices, more and more complex and chronic conditions can be treated at home. And with programs like the Acute Hospital Care at Home (AHCaH) Waiver program, regulators are actively encouraging this shift with financial incentives for healthcare providers.
As a result, many more hospitals, SNFs, and other providers now use technology to offer their own home-based care programs. By shifting care out of the facility — especially for post-acute patients — these programs can dramatically boost bed space. As a result, they can help providers adapt the healthcare capacity needed to treat an influx of higher-acuity. They may also help boost patient and resident satisfaction by better accommodating those who want to age in place.
Today, an entire discipline of nurses and clinicians who specialize in using this technology to expand healthcare capacity has emerged. Clinically skilled and tech-savvy, these telehealth nurses and clinical workers can manage a high volume of home-based chronic care patients. They can even do so from a remote location, furthering the value they provide employers.
And, while Covid-19 may have accelerated this trend, it shows no signs of stopping in the post-pandemic years. The authors of the patient acuity report predict a 20% increase in home care volume over the next decade.
#3: Upgraded Staffing Models
An influx of high-acuity patient acuity demands immediate changes in staffing, whether or not providers are ready for them. More complex patients who occupy beds for longer periods of time require more work. Leaders who fail to adjust their staffing to accommodate that work have few alternatives to the overtime, diminished morale, and risk to safety and outcomes that come with understaffing.
On top of that, more cities and states now require providers to employ a specific ratio of staff to patients (or residents). Long a factor in workforce management for long-term care (LTC) facilities, staffing ratios now increasingly affect hospitals, too. For instance, Oregon recently became the third state to pass a law establishing minimum ratios for hospitals.
If standards for staffing are becoming more challenging, employers also have more options than ever to meet them. For example, some providers have adapted to today’s needs with acuity-based staffing. A way of mapping out assignments based on each population’s specific needs, this model combines proactive, hands-on integration of staffing and assignment creation with an in-depth understanding of each unit’s case history and informed projections of its future (often derived from analytics technology).
Research shows that acuity-based scheduling not only enables better care for patients but can also improve job satisfaction for nurses. And a 2018 pilot study showed that it can also improve “assignment equality” and the way nurses perceive patient safety.
There are plenty of other effective alternatives to traditional staffing. For instance, flexible staffing — or the use of externally sourced workers to ensure continuity of care — is a core strategic component of healthcare workforce strategy today. Providing a model for using contingency staff like travel or per diem nurses, flexible staffing helps employers expand healthcare capacity in times of high patient census. It also keeps workforces more adaptable to changes all throughout the year.
Licensed, credentialed, and fully vetted, contingency workers can quickly fit into any workforce with a minimum of onboarding. They can also reduce skills gaps by providing short-term access to specialty workers, and improve morale among overworked core staff. And, though they may cost more than permanent employees, they can help offset that expense by reducing overtime and turnover.
> Take a deeper dive: Read more about the benefits of contingency staffing here
Expand Your Capacity to Treat High-Acuity Patients with CareerStaff
As one of the nation’s leading providers of healthcare workforce solutions, we at CareerStaff are proud to offer the contingency workers your organization needs to expand capacity and ensure continuity of care. Learn more about how our award-winning, Joint Commission-Certified solutions can help your organization here. Or get started now by requesting contingency staff now.