Published by Hiro Kawashima on May 29, 2019
This week our guest is Dr. Harneet Bath. Dr. Bath is the Vice President at VEP Healthcare, the former Chief Medical Officer at OSF Saint Anthony Medical Center, and an active advisor and investor, and an advisor to Prescience Health. He is also a Northwestern Kellogg alum and is a board certified internist.
HIRO: As a physician, what unit coverage challenges have you observed/experienced?
DR. BATH: Not only me but if you ask 100 physicians out there, they will always complain that most clinics and hospitals don’t have enough staffing or enough good staffing. Having worked in California, Central California, Illinois and other places, it is pretty universal. From the hospital standpoint they feel that they have enough personnel on the ground but physicians always like to complain that they cannot find enough good nursing staff.
HIRO: What are the benefits of good unit coverage and what are some consequences of poor unit coverage?
DR. BATH: Well you’re dealing with people’s lives directly. When you have inadequate coverage or when you have enough number of bodies but they are not the right personnel, that can mean the difference in someone’s life and death. If we’re not talking just about life and death, you’re still talking about increases in length of stay, hospital acquired infections, complications, other things that can occur. Having the right staffing in the particular unit that adjusts to patient volume and patient needs is very critical to any organization.
HIRO: As a hospital executive, how do you currently plan for optimal clinical and unit coverage?
DR. BATH: Most hospitals will look at their average census off of a particular unit and the budgets are done with the nursing leaders, CNOs, directors, staffing supervisors, etc. You try to project how many nurses, CNAs, etc. that you will need on a given day. These are just averages so you will see some fluctuation day in day out as well as weekdays and weekends, as well as seasonal variation. But it’s very hard to predict if you’re doing it manually on how that will look like.
HIRO: How can patient demand and staffing need forecasting help with optimizing unit coverage?
DR. BATH: We are seeing a lot of improvements through AI, data, and operations, and if we can predict better or more accurately than human beings based on different criteria that you are looking at, it allows nursing leaders in the organization or facility to staff much better. There might be days you need less staff which means you can give breaks to some nurses that need it. And then in the seasons or times that you need more people, you can staff appropriately on the frontend and not try to scramble last moment, on that day, or in the morning trying to call 50 different nurses to see who can come in. It saves a lot of time, effort and headache to the nursing leaders and hospital leaders, as well as to the individual nurses. If I’m a nurse that works in a particular unit, I don’t want to be called every morning at 7 to see if I can come in because you’re short by two nurses. I need predictably in my life as well. If we can forecast more accurately going forward, it makes life easier for all parties and causes less nurse burnout as well as hospital executive burnout.
HIRO: When it comes to overall patient care and potential improvements on outcomes whether it’s things like ALOS or patient satisfaction scores, what role that optimal unit coverage play on that front?
DR. BATH: Well, it has a direct correlation because if you are understaffed then of course you will end up missing things and the patient will stay longer in the facility. Now, can you say that if you’re overstaffed, you’ll really drive down length of stay and other complications? The answer is no. Even when you’re overstaffed, there are still things that end up being missed. On the other hand, when you’re not optimally staffed, it can have a lot bigger bearing on your bottom line for the hospital which in turn forces you to use less staff going forward. We have to be very careful when using our resources and use them only where and when needed.Next post: Ep 4 - Perspectives from a lifelong nurse and CNO with Mary Jim Montgomery