Cath Lab in Crisis: Interim Staffing Solutions Foster Long-Term Relief

Illustration: Lee Sauer

RoundTable Strategic Solutions powers MedAxiom Talent Solutions, which connects healthcare organizations with seasoned cardiovascular experts backed by the entire MedAxiom team.  

As a leader in delivering innovative staffing solutions to the healthcare industry, RoundTable Strategic Solutions shares unique perspective on workforce challenges, opportunities and trends to help MedAxiom member organizations thrive in the new normal. To learn more, visit the MedAxiom Talent Solutions team in the Care Transformation Showcase at CV Transforum Fall’23.

Introduction

Hospital systems are still dealing with the financial aftermath of the pandemic. Financial and staffing issues that were dormant for years exploded during the pandemic. Hospital floors and offices are feeling the impact of the rise in hospital operating margins from 0.4% to 0.7% after being in the negative for 15 months, according to Syntellis and Kaufman Hall reports.¹

What are the easiest expenses to cut? Positions, salaries, benefits, overtime pay, and educational resources. But the best way to keep your current staff and avoid a staffing crisis is to treat them well. So it isn’t surprising that healthcare providers across the country are resigning, leaving the remaining staff left behind to carry the burden of extra hours and an increasing volume of patients needing care.

Current State of the Cath Lab

Nowhere is this crisis more evident than in the cardiac cath lab, an already high-stress environment given the emergent nature of interventional procedures. Cath lab teams are dangerously understaffed. Nurses, techs and medical assistants are expected to take on additional shifts and adjust their schedules, childcare, eldercare and other aspect of their personal lives. Increasing time on call and shifting schedules can be tough pills to swallow when care team members are then asked to go home before overtime hours begin. When employees aren’t being treated well, they find new employers who will treat them well. High performing providers have options – particularly with ambulatory surgical centers (ASCs) emerging around the U.S. that are only open for standard business hours and closed during weekends. It’s no wonder that cath lab teams, which used to be comprised of the top performers in cardiology, are dwindling in numbers.

Interim Staffing to Solve the Cath Lab Problem

How can cardiovascular leaders help solve some of these problems in the cath lab, especially when replacing staff members results in a financial loss for hospital systems? Enter interim staffing solutions. Interim staff – cath lab managers, service line leaders, nurses and frontline techs – can help fill the gaps until you can find a permanent solution. If you don’t find an immediate solution for several months after a resignation, it can create a domino effect that strains your remaining staff and causes burnout.

If the detriment to the physical and mental wellbeing of individual staff members and the threat to patient health isn’t enough to communicate the crisis at hand, the bottom dollar will. Hospitals and businesses in general incur some of their largest costs when staff have to be replaced. Hospitals often turn to travel nurses, particularly in more rural areas where specialized cath lab staff are limited and end up spending much more. Hospitals have increased spending on contract labor by more than 50% between 2011 and 2020, leading to cost cuts in other areas.²

Cath labs require highly specialized nurses and medical assistants who can handle the stress of treating high-acuity patients while keeping up with the technical nature of the procedures and new devices entering the market. But how can they keep up without continuous education – a resource that’s considered a luxury when budgets are tight? Adequately trained employees experience higher levels of job satisfaction because they know what they’re doing. And your top talent will want opportunities to learn and grow.³ For this reason, current cath lab teams lack sufficient training and experience while tenured employees are finding better job opportunities.

Interim staff leaders are tenured with 15-20 years of experience with direct patient care, expertise in interventional cardiology, and the management knowledge to be able to pick their battles. These leaders are systematic what they can bring to the cath lab team. Stabilizing staff, working on scheduling, occasionally taking call to support the team and be able to walk in the care team’s shoes care provide a huge benefit to nurses and assistants. Seeing a change in the number of missed procedures, patient volumes, issues with morale, and conflict amongst team members doesn’t change overnight without additional HR counseling, union support and other hoops. But the return on investment can be tracked and extrapolated over time in different key areas.

Training Leads to Job Satisfaction and Higher Production

Such experienced leaders not only apply their practice management skills but also educate current team members on best practices, leading to better staff retention of high performers seeking opportunities for growth. Staff retention has a lot to do with proper training and education to shape knowledgeable and confident clinicians.

At one highly respected academic institution in the southeast, MedAxiom Talent Solutions suggested that the facility designate an educator dedicated to the cath lab. Seven new graduates were hired with less than a year’s nursing experience. The staffing solutions team created a three-month training program and manual to the care team to start cross-training new team members them from the beginning. When people know how to do their jobs well, they feel more confident, secure and satisfied with their work, especially in life-and-death situations. Proper education also leads to better patient care, increased production and reduced legal liability due to fewer mistakes.

Interim cath lab managers can provide unbiased guidance and another set of hands to take call duties, providing the staff team some much needed support and stability while organizational leaders consider longer-term staffing solutions. When there’s an issue with patient throughput or training, interim staff have the experience and time to troubleshoot and provide direction.

Building Relationships Amongst Leaders and the Care Team Solves Problem, Retains Staff

There is value in a fresh set of eyes to see what could be done better and a fresh set of ears to listen to staff members’ concerns. One MedAxioim Talent Solution cath lab client found that staff were having some process issues affecting their accreditation survey. “Instead of coming in and dictating a solution, interim leadership came in with their knowledge and expertise and observed communication barriers between the care team and the physicians and executive leaders at the organization,” said Rachael Battin, director of RoundTable Strategic Solutions. “They found out that one of the physicians liked ice cream and planned an ice cream social. By brainstorming about on challenges during the social, one of the nurses got buy in from physician staff and executive leadership team during the social to improve processes.”

Building relationships amongst the team took months but they got through their next accreditation with no deficiencies and were able to retain staff. Once they had the right policies in place, they were able to follow them.

Conclusions

Interim staffing solutions may provide a short-term foundation on which to build your cath lab’s future. Expert interventional leaders, administrators and clinicians not only help you fill the gaps but can also help train and onboard future hires. Short-term investment leads to long-term cost savings and protects your most important assets: the members of your care team.

References:

1. Thomas N. Hospital operating margins rise for 1^st time after negative 15 months: BeckersHospitalReview.com. Published on June 27, 2023. Accessed on August 13, 2023. Available at: https://www.beckershospitalreview.com/finance/hospital-operating-margins-rise-for-1st-time-after-negative-15-months-report.html.
2. Gamble M, Cass A. 20 health systems with highest contract labor expenses.BeckersHospitalReview.com. Published on March 13, 2023. Accessed on September 14, 2023. Available at: https://www.beckershospitalreview.com/finance/20-health-systems-with-highest-contract-labor-expenses.html.
3. Hall J. Why businesses should invest in employee learning opportunities. Forbes.com. Published on Feb. 26, 2023. Accessed on Aug. 13, 2023. Available at: https://www.forbes.com/sites/johnhall/2023/02/26/why-businesses-should-invest-in-employee-learning-opportunities/?sh=1b55e44b6154.