Labor shortages in the delivery of health care and related services can have a negative impact on health service business as well as the health of patients in the community. For this reason, is it important for facility administrators to think critically and creatively about how to prevent any disruption in the continuity of care. Facility administrators must develop a strategy which is affordable, ensures minimum disruption, and provides for longer term alleviation of the problem.
Specific opportunities to facilitate continued operations are the use of telehealth, advanced nurse practitioners and overseas recruitment. Provided the financial needs of implementing each initiative can be met, all three strategies can be implemented to reduce the impact of the labor shortage. Each situation will be different, as the nature of the facility and the skill area of the shortage will define which aspects or needs are the most important.
Telehealth The use of technology presents an opportunity, particularly when labor shortages are related to regional issues such as population density. Using video conferencing software to connect to physicians and specialists in city centers is a good option for more rural and remote locations that have difficulty attracting residents. It also ensures that rare diseases or unusual situations can access the expertise that is required. Telehealth is a good option, but it cannot replace positions that have a physical component of care, such as many nursing and support positions.
Advanced nurse practitioners. In many states advanced nurse practitioners can provide primary care, including writing prescriptions, that is like a physician (Yee, Boukus, Cross, & Samuel, 2013). This can be useful if the labor shortage is related to a lack of doctors, but will not be as helpful when there is a shortage of nurses, or when a location fails to attract enough staff at a general level.
Overseas recruitment. Recruiting health care workers from other countries can provide a medium-term solution for many facilities. A contract with such workers would include the costs of relocation and a signing bonus, but in exchange the community would receive assurance that the individual would fill the role for which they are hired for a minimum period. Developed countries have this advantage because of the differences in value of the labor. Often skilled health care workers in low income countries remain unemployed or underemployed due to lack of infrastructure for the services (Liu, Goryakin, Maeda, Bruckner, & Scheffler, 2017). This advantage can be used to attract professionals to less attractive locations, at least for a time.
There are additional financial costs when faced with a labor shortage. This includes the basic costs of recruitment and selection, the cost of training and the cost of incentives which are needed to attract potential candidates. Affordability can be an issue, but looking at a business case for the chosen strategy means ensuring that costs are reduced in the long term, and the high cost of business disruption, to the facility and to the patient, is avoided.
In the long term, dealing with health care labor shortages should look at decreasing demand by increasing the health of the population and decreasing the needs for intervention through prevention, while also ensuring that a position as a skilled professional in the health care industry remains an attractive option for qualified individuals.
While labor shortages in health care can be a challenge for leadership and administrators, there are potential remedies. To offset the higher upfront costs of recruitment, training and incentives a long-term perspective and a business case may be needed to justify the use of additional funds. In the medium and long term, the ideal result is reduced costs and increased patient health.