27 July 2016

The Challenges of Staffing a Rural Hospital Successfully

Population health management is a challenging proposition in any location, but especially so in rural areas, which comprise nearly 20 percent of the U.S. population and more than 95 percent of the country’s land. Health care resources are more limited and the population is more spread out than in urban settings. The patient base at rural and nonurban hospitals also tends to be smaller, older, poorer, and less healthy than that of urban hospitals, which means there is little opportunity to mitigate financial risk. The inability to take advantage of the economies of scale enjoyed by urban healthcare systems affords little opportunity for cost reduction. Add in shrinking Medicare reimbursements, and it becomes hard for a rural hospital to keep its head above water.

Financial constraints often require rural clinicians to provide specialty care outside their primary areas of expertise. Obstetrics, for example, is an expensive and usually money-losing proposition for rural hospitals. According to a study in the Journal of Rural Health, hospitals with fewer than 240 births per year were more likely to have family physicians and general surgeons (rather than obstetricians or midwives) attending deliveries. Having physicians flex like this can result in trade-offs in quality and safety.

Insufficient staffing scenarios that broaden and increase rural physician’s responsibilities make their jobs even more demanding and stressful. Hospitals that don’t give their physicians ongoing appreciation and recognition risk losing these crucial resources.

If these challenges sound familiar, here are some strategies to consider:

  • Provide education on chronic disease prevention and self-management. This can help improve population health and smooth out demand for its limited resources. Consider participating in the National Council on Aging’s Better Choices, Better Health® programs, which are available to participating organizations both as workshops and online.
  • Join forces with other hospitals. Jane Bolin, BSN, JD, PhD, senior editor of Rural Healthy People 2020 and director of the Southwest Rural Health Research Center at Texas A&M University, said in an article in HealthLeaders magazine that “Dire financial straits have prompted many rural and nonurban hospitals to surrender some of their cherished independence in exchange for affiliations that provide economies of scale and access to capital and services.” Many rural hospitals find it more efficient to collaborate with external organizations to provide a broader range of services via referral. The partner hospitals can then distribute Medicare reimbursements to everyone who participates.
  • Use LEAN principles to improve physician alignment and engagement and streamline business processes. The Kaizen business process improvement methodology is a core aspect of Sheridan’s management philosophy. Our partner hospitals have seen dramatic improvements in physician engagement, quality of care, speed and productivity after holding Kaizen events to collaboratively identify and implement successful solutions to challenges such as high cancellation rates for anesthesiology, excessive admittance delays and long IV-tPA cycle times.
  • Engage a performance-driven physician services provider to achieve economies of scale and deliver more effective and cost-efficient care. A professional physician services provider can help you reduce waste and overutilization, improve the quality of care and efficiency of its delivery, and help bring physicians into alignment with your value-based health care strategy. Sheridan provides staffing, performance-driven management and best-practice processes for our partner hospitals' key departments and practices, including Emergency Medicine and Critical Care, Anesthesiology, Radiology, OBGYN, Neonatology, Perinatology and Pain Management.

If you’re interested in finding out how Sheridan can help you overcome the staffing challenges at your hospital, learn more about our cost-effective, industry-leading health care solutions that include physician staffing, LEAN-based process improvement and infrastructure support.