Abstract
This paper examines some critical challenges that all health care facilities in the nation face. Challenges within the health care sector are nothing new, they have been around for ages, but the severity and type of issues have progressively grown. The increasing size of the health care market and the necessity for treatments creates an open channel for more advancements and changes to be made which poses possible solutions, but also brings upon new issues. Two major issues that are present today are staff shortages and rising medical costs. These two problems seem simple on the surface, but they are more complex than one might think. Staffing shortages and rising costs are problems in of themselves, but they also serve as a catalyst for other challenges. In order for health care to be accessible for all, affordable, effective, and productive, action needs to be taken by health care facilities to help ensure that all patients receive the highest quality of care.
Introduction
The healthcare field is constantly changing with new technologies, treatments, procedures, and payment methods each day which makes it difficult to stay ahead with the latest updates and advances. This makes for a complex system in which administrators and clinical staff must adapt to in a timely manner. This complexity brings about new obstacles and challenges in which administrators are forced to deal with on a regular basis. There is a broad range of challenges that include staff shortages, physician burnout, rising costs, medicinal and technological advancements, training, and ethical decisions. Two of the more pressing issues are staff shortages and the rising medical care costs. As the market grows, it is demanding more, and the search for qualified individuals is becoming harder to accomplish. In order to meet the needs of the patient and the organization, prices have risen astronomically which poses issues for not only consumers but also managers and hospital staff. Prices and costs have become so high that it inhibits people from receiving the proper care they need. In order to stabilize a solid foundation for healthcare to build upon, it is essential that challenges are addressed in order to ensure safety, performance, and productivity.
Labor shortages in both clinical and nonclinical areas are plaguing hospitals and health systems around the country. Since the nature of operations is 24 hours, 7 days a week, there are many positions to fill. A recent survey of over 200 hospitals showed almost 31 percent of hospitals reported that they cannot find enough candidates to fill open positions (LaPointe). Patients who come into health care facilities, are usually facing a stressful situation whether it is an illness, disease, or procedure. In order to provide them with the correct and appropriate care, it is essential that all roles are filled. Many healthcare organizations are experiencing generational transitions as longtime leaders in the baby boomer group retire and millennials join or advance in the workforce (Haefner). Unfortunately, studies have shown that millennials tend to shy away from the healthcare industry, which causes a loss in valuable employee selection. The Department of Health and Human Services suggest that by 2020, the U.S. will face a shortage of 50,000 physicians (Shanafelt). With less people being interested in health care and with a large majority of people retiring, it causes a large gap that causes economic, productivity, and burnout issues.
When there is a shortage of staff, it puts more responsibility on the current employees which can lead to feelings of anger, exhaustion, and frustration. When there isn’t enough staff to disperse into certain positions, we must pile on the workload to the employees that currently fill those roles in order to try to equalize the playing field. When more work is added, there are multiple issues that could stem from that. For one, the employees who take on the extra burden may not be totally qualified for what they are asked to do. This poses a threat of danger because in health care the things that are dealt with are very personal and serious, as well as confidential. It takes adequate training and skills for certain activities and without them, various boundaries could be crossed. What someone might lack in one area, might cause a life to be lost or a lawsuit to be filed. This also applies to managerial staff, not just the clinical staff. It is critical to have all employees well trained because messing up and omitting only one element in the admission of a patient could result in a delay or complete loss of revenue.
The second issue that might arise from shortage of staff would be burnout of the employees, specifically physicians and clinical staff. Physician burnout impairs both the morale of an institution and patient care. Fifty-one percent of physicians reported experiencing frequent or constant feelings of burnout in 2017, up from 40 percent in 2013, according to Medscape’s annual survey (Haefner). Due to the current and projected shortage of nurses and physicians, there are many changes and incentives that are being offered in order to gain the attention of people searching for a career path.
As shortages become more and more prevalent, there are various strategies that can be used to try to improve recruitment and retention. Some of these tactics could include national advertising, paid interview expenses, paid relocation expenses, sign on bonuses, flexible hours, and tuition benefits/reimbursement (Clinical Laboratory Management). Staff shortage issues coupled with ineffective recruitment can have a negative impact on all operations of a health care facility. It could be in terms of morale or proficiency of the staff which will lead to mistakes due to overwork and stress. Due to the diverse workforce in health care, it is also important to note the group of people you wish to target for the jobs because each generation of people have different wants, needs, and interests. For example, younger generations might be interested in salary and benefits for further education opportunities, whereas an older generation might be more concerned with health care and retirement plans (Clinical Laboratory Management). There is a decent amount of competition within this health care sector, so grabbing the attention of qualified candidates is essential when assessing the challenge of staff shortage.
Another challenge that has affected hospitals around the world is rising medical costs. There are various reasons for this significant increase in price which can be attributed to five factors which include more people, an aging population, changes in disease prevalence or incidence, increases in how often people use health care services, and increases in the price and intensity of services (Bienhoff). Over the years, health care has gone from being a small part of the economy, to one of the largest industries in the nation. The growing need for services has taken a toll on not only health care facilities, but also the pockets of the patients. Due to the creation of government programs like Medicare and Medicaid, it has induced the demand for health care services. Those programs helped give thousands of people insurance, but then that gave providers the ability to drive up prices. It almost served as a doubled edged sword because in attempt to reform health care, it raised prices instead of lowering them. Since some prices have increased so much, people cut back on certain services and visits.
As time goes on, there are always new technologies and tools which is costly to maintain and administer. In order for large investments to be beneficial, they must be analyzed and used to the best of their ability. This includes proper training for staff that will be involved and appropriate administration to those who need it. The confidentiality aspect also brings about its own set of issues when regarding price because hospitals want to ensure that new technology doesn’t create an equally costly confidentiality issue. There have been many cases where there have been confidentiality breaches due to the incorrect use of technology and electronic health records, which just adds to the spending issue.
Chronic diseases also play a large role in the increased healthcare spending. The high prevalence of chronic diseases is a key driver of total U.S. healthcare costs. In 2010, 86% of healthcare spending was for patients with at least one chronic condition, and 71% of spending was for patients with multiple conditions (Chapel). There are many preventative steps to be taken that could lessen the risk of obtaining a chronic condition. We as a collective group need to stop dishing out money to treat diseases and learn how to take steps to prevent them. Controlling costs as a whole requires decreasing waste, reforming the payment system to change incentives, changing the delivery system to improve coordination and integration, managing costly patients with chronic diseases differently, and engaging patients and families in shared decision making (Chapel).
Inevitability, health care will always have its challenges due to its unpredictability and rapid change nature. The demand for services, the need for qualified labor force, and the need for financial resources will never go away. In order for facilities to be resourceful in meeting these challenges, they must be proactive and adaptive. The staff that work endlessly to meet the needs of patients need to be taken care of as well. Without well trained staff, the healthcare industry would be in crisis mode. It is important that challenges in the system are recognized and actions are taken immediately to create a foundation where quality care and patient safety is top priority.
Works Cited
- Bienhoff, Kelly. “New Study Explains Why US Health Care Spending Increased $1 Trillion.” Institute for Health Metrics and Evaluation, www.healthdata.org/news-release/new-study-explains-why-us-health-care-spending-increased-1-trillion.
- Chapel, John M., et al. Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, Dec. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5798200/.
- Clinical Laboratory Management, edited by Lynne S. Garcia, ASM Press, 2014. ProQuest Ebook Central, https://ebookcentral.proquest.com/lib/desales-ebooks/detail.action?docID=1600264
- Haefner, Morgan. “4 Of the Most Pressing Challenges Health Systems Face Today.” Becker’s Hospital Review, 9 May 2017, www.beckershospitalreview.com/hospital-management-administration/4-of-the-most-pressing-challenges-health-systems-face-today.html.
- LaPointe, Jacqueline. “Healthcare Staffing, Recruiting a Major Problem for Hospitals.” RevCycleIntelligence, 15 Mar. 2018, revcycleintelligence.com/news/healthcare-staffing-recruiting-a-major-problem-for-hospitals.
- Shanafelt, Tait. “Physician Burnout: Stop Blaming the Individual.” NEJM Catalyst, 2 June 2016, catalyst.nejm.org/videos/physician-burnout-stop-blaming-the-individual/.
