Labor shortage, recovery of referral flow top priorities for hospices

More than 67% of 203 hospice care professionals surveyed listed staffing as their biggest non-COVID challenge in 2022, according to the 2022 Hospice News Outlook survey and report. This is an increase from 33% the previous year.

Staffing shortages have long been a thorn in the side of the palliative care industry and are expected to worsen over the next two decades.

A shortage of nurses has been the greatest blight for palliative care providers. The U.S. Bureau of Labor Statistics has projected the nursing shortage to last at least until 2024. The agency predicts that more than half a million nurses will be needed to replace those retiring or leaving the workforce. profession. Nearly half of the total nursing workforce is expected to retire over the next decade.

“Recruitment and retention has always been a priority for us and this will continue in 2022,” Heath Bartness, CEO of St. Croix Hospice, told Hospice News. “This will be a significant issue for the entire industry, now and in the future.”

The pandemic has exacerbated the workforce crisis. More than 20% of healthcare workers have considered leaving the field due to COVID-19-related stress, and 30% have considered cutting their hours, according to research published in JAMA Network Open.

A focus on workplace culture

Hospices have engaged in a range of tactics to bolster their ranks, including increasing pay, expanding benefits, expanding education and training programs, and using contract nurses, to name a few. -ones.

St. Croix, a HIG Capital portfolio company, was among the hospices that made corporate culture a centerpiece of their recruitment and retention efforts. Last year, the company launched its Career Ladders program to provide career growth opportunities for clinical team members. St. Croix provides additional training and financial incentives to staff at each level of the program aimed at developing their expertise as they move up the ranks, according to Bartness.

“When it comes to retention, employees stay because of a great culture, belief in their work, and opportunities for growth,” Bartness said. “Over the past 12 months, we have added over 300 employees to our ranks. This is something that does not happen without intention, commitment and investment in any market, let alone in a healthcare labor market like we have never seen.

These workforce pressures are also a key consideration in hospice technology investments.

Approximately 33% of respondents to the Hospice News survey indicated that improving employee engagement and satisfaction will drive their technology investment decisions for 2022. Nearly half (47%) of respondents identified the solutions designed for the optimization and automation of processes as a key objective, both to improve efficiency. and lighten some of the administrative burden on staff.

Electronic health and medical record systems represented the most potential return on investment for 26% of hospices surveyed.

Hospices are “sharply focused” on processes and technology solutions that maximize clinical efficiency and clinician satisfaction, according to Scott Pattillo, director of strategy at Homecare Homebase, which sponsored the Hospice News survey.

“One of the main ways providers can do this is to optimize decision-making in care planning and scheduling,” Pattillo told Hospice News. “Technology can be used to automate back-office and front-office tasks and optimize clinician satisfaction and efficiency, reduce turnover, and create greater clinical capacity while reducing costs.”

Spread the word, expand the portfolio

Provider priorities also included the need to raise awareness of palliative care provision and to build a broader set of upstream health care services.

About 12% of hospice professionals saw the need to improve public awareness of their services as their top concern – the second highest percentage behind staffing.

A lack of awareness or understanding of their services has been a challenge for hospice providers since before the Medicare benefit was created. Many believe that palliative care only happens in patients who are living the last days of their life or that it hastens death. These misperceptions have historically made many families reluctant to pursue these options.

Meanwhile, more than 52% of hospices surveyed said their organizations would continue palliative care service offerings in 2022 for the first time. The findings reflect a broader trend of hospices seeking to build relationships with patients earlier in their illness.

“Agencies are building longer-term relationships with patients, which means providing a wider variety of home services,” Pattillo said. “By focusing on the whole patient and providing multiple care services, agencies can create better patient outcomes while increasing their census of patients served.”

A growing number of hospices are getting into palliative care. About half of community hospice providers in the United States are hospices, according to the Center to Advance Palliative Care (CAPC).

In addition to reaching payments sooner, hospices are looking to diversified palliative care services as a way to capitalize on the value-based payment models proliferating in the marketplace, such as Medicare Advantage or Accountable Care Organization Realizing Equity. , Access, and Community Health (ACO REACH).

Many players in the palliative care industry view service diversification as a business imperative to ensure that hospices, especially smaller community organizations, remain financially viable to support their mission.

As COVID-19 appears to be receding at the start of the year, providers are also anticipating some normalization of their referral flows.

Access to health facilities has been restricted during the pandemic, resulting in lower referrals, counts and length of stay. In many cases, facility-bound patients did not fully benefit from palliative care due to COVID-related restrictions, especially early in the outbreak. While restrictions have eased in many states across the country, referral volume from these institutions has yet to rebound to pre-pandemic levels.

Besides the home, survey participants identified assisted living facilities and nursing homes as the most promising environments for growth, at 35% and 30%, respectively.

“We have a good mix of referrals from all walks of life: seniors’ residences, hospitals and community physicians,” Bartness said. “While we have continued to maintain a healthy referral flow from senior living facilities throughout the pandemic despite census pressures in these settings, we expect this to increase as census pressure eases. into a new ‘normal’.

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