Rich Birhanzel, Accenture’s global health industry pipe.
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As our population ages rapidly and people continue to face health crises, the shortage of doctors, nurses and other healthcare professionals has quickly become a crisis.
I recently witnessed the seriousness of this with my own eyes when a relative was a patient at a major US metropolitan tertiary care hospital. Looking out of her room one morning, we noticed that the adjoining hallway was dark and empty. When we asked her nurse why, we were told that the entire wing was closed due to the limited number of clinicians on staff.
Although I am very aware of the problem of clinical capacity, this visual confirmation was surprising. My thoughts immediately went out to the people who need care but can’t get it.
Many parts of the US already have a shortage of primary care physicians and other clinicians. And the outlook is bleak. To consider:
• A doctor shortage of to 124,000 is projected by 2034.
• According to the same sources above, within the next 10 years, more than two in five practicing physicians will be 65 or older.
• More than 203,000 new registered nurses on average every year during the decade will be needed to fill the gap created by retirees and nurses moving into other fields.
• 29% of nurses consider leaving the profession.
Work shortage
When we look at the big picture, not only are we short of clinicians; there is earlier a general labor shortage in different sectors as the number of working adults declines. Healthcare organizations have tried quick fixes to compete for the shrinking talent pool by offering hiring bonuses, flexible work schedules, and hiring temporary staff. Educational institutions also paved the way for flexible distance learning programs that allow students to easily acquire graduate certificates in nursing online to encourage upskilling and continuous learning for multi-industry benefits.
Technologies such as telemedicine have expanded enormously since the start of the pandemic. But none of these are long-term solutions. Hiring traveling nurses and using telehealth services will not reduce clinicians’ workloads, automate tasks, or delegate administrative work to others. Essentially, this isn’t just a personnel issue; it is about the clinical work itself.
There is an urgent need for new ways of working and a large-scale rethinking of how healthcare organizations deploy their people and use technology. Those who get it right can see significant benefits, including lower labor costs and improved operating margins.
And for some healthcare organizations, it can mean nothing less than survival. For example, financial tensions and staff shortages have forced many rural hospitals to close in recent years.
How time is spent
Unfortunately, I see how many clinicians’ workdays are spent on non-patient activities. In fact,
Less than half the time that primary care physicians’ work is devoted to communicating with patients. Further, floor nurses spend only 35% of their time interacting directly with patients, with between 26% and 41% of their time spent creating or reviewing clinical documentation.
Other care interruptions, such as finding resources, doctors and colleagues, take up another 16% of nurses’ time. And more use of external temporary workers usually commits experienced nurses to the further training of these colleagues.
Leaders in the healthcare system should ask themselves some important questions.
• Who does the work?
• What tasks do they do that could be done by others with less training?
• How can we automate tasks that are currently done manually?
• What tasks can patients reasonably perform in a self-service model?
• How can we use technology to ease clinicians’ time?
The goal is for clinicians to operate at a level consistent with their experience. Activities that do not utilize their expertise and skills, such as faxing forms, confirming prescriptions, retrieving medical records, and bringing food to patients, must be moved to machines or support staff. Removing these tasks from the clinician’s workflow can create capacity and give clinicians more quality time with patients, improving patient experiences.
Using virtual staff to increase clinicians’ workload is get a grip between health systems. For example, nurses can assist with admissions, monitor patient conditions, record changes, follow up on patients by phone, and communicate with other members of the healthcare team while working in remote areas.
Increase self-service
Self-service has long been the norm in many industries, such as ATMs in banking and automated toll booths in the transportation industry. I think healthcare organizations should follow suit. Research by my company almost shows that three-quarters of healthcare consumers are very likely or somewhat inclined to use digital chat/messaging such as web chat, SMS or direct messages as the first step towards a virtual or in-person visit. And “83% are very or somewhat likely to provide check-in information” prior to receiving services at a hospital or clinical facility.
When a health system in our study implemented self-service technology to allow patients to access account balances and bill payment services online, it resulted in increased staff productivity, reduced administrative costs, and reduced patient registration time per visit.
Overall, I believe that focusing on the tasks that healthcare workers perform, and not the staff themselves, is the key to solving the physician shortage. In the US alone, there simply aren’t enough adults to work as caregivers to meet the growing demand for health services. But through a combination of automation, technology, reinvented workflows and creative sourcing, we can create capacity that can be redirected to improving care and patient access.
