Can Strike Teams Relieve Hospital Staffing Shortages During COVID-19 Pandemic?

The Pennsylvania Department of Health deployed a state-directed health care strike team to help relieve strain on health care workers and hospitals during the COVID-19 pandemic, according to a statement from Acting Secretary of Health Keara Klinepeter.

This initiative is separate from federal strike teams that were deployed earlier in January 2022 to hospitals in Scranton and York. The administration of Governor Tom Wolf was recently granted an extension for the federal strike teams. Both teams are expected to be in place until the beginning of March. 

However, not all clinicians are happy with this solutions. Karen Lasater, PhD, RN, FAAN, assistant professor at the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing, called the state-level strike team initiative “a short-sighted small-scope idea with limited potential to relieve hospital nurse staffing emergencies and meet the healthcare needs of Pennsylvanians.”

“Even before the pandemic, Pennsylvania hospitals were chronically understaffing nurses, resulting in avoidable patient death and nurse burnout,” Dr Lasater said. “Over the last 2 decades, nurse staffing has only marginally improved and has not kept pace with the increasingly complex needs of patients.” Staffing ratios in most Pennsylvania hospitals vary from 4 patients per nurse to more than 7 patients per nurse, she noted. For most nursing positions, the optimal ratio is 2 patients per nurse to 3 patients per nurse.

“The strike team initiative is a distraction from more serious evidence-based policy actions that are needed to remedy hospitals’ long-standing failure to safely staff enough nurses,” Dr Lasater explained.

Pennsylvania Hospital Strike Team Structure

The first strike team was deployed at Grand View Health in Bucks County and includes 10 registered nurses provided through a private health care staffing agency under a contract with the Pennsylvania Department of Health. Depending on hospital needs, the strike team also may include physicians, advanced practice providers, and respiratory therapists and is designed to provide short-term staffing assistance for 7 to 14 days. The staffing agency is focusing its staffing recruitment from outside of Pennsylvania to avoid heightening current staffing limitations within the state. 

Requests for staffing assistance at Pennsylvania hospitals are accepted on a rolling basis. Evaluations to match requests with available resources will be conducted twice per week.

“The intent is that these staff will fill in for a limited time while hospitals develop their own longer-term sustainable staffing solutions,” Klinepeter said, noting that staffing resources are scarce and will be prioritized to address the most acute needs and maximize system-wide impact.  

This initiative is separate from federal strike teams that were deployed earlier in January 2022 to hospitals in Scranton and York. The administration was recently granted an extension for the federal strike teams. Both teams are expected to be in place until the beginning of March. 

Is the Patient Safety Act (HB 106) a Better Solution?

Dr Lasater believes that Pennsylvania’s Patient Safety Act (HB 106) is an evidence-based policy proposal that would address PA’s nurse staffing emergencies, reduce nurse burnout, and save patient lives. Dr Lasater and colleagues at the Center for Health Outcomes and Policy Research at the University of Pennsylvania studied the impact of similar safe staffing policy proposals in New York and Illinois.

“Safe nurse staffing laws requiring hospitals to employ enough nurses to safely care for patients would significantly improve nurse staffing in hospitals and likely save thousands of lives,” Dr Lasater said. “The cost of improving nurse staffing could be offset by cost savings achieved by the impact of better nurse staffing on shorter length of hospital stays. If enacted, the Patient Safety Act would establish a minimum guardrail against unsafe staffing ratios while retaining the flexibility of hospitals to staff above those levels if patient acuity requires.”

Dr Lasater refuted Klinepeter’s comment that staffing resources are scarce. “There are enough actively licensed registered nurses, with more new nurse entrants into the profession than ever before,” she said. “There are too few that are willing to continue to work in unsafe working conditions, at current wages, and for employers who do not value their professional contributions.”

Source

Directed healthcare strike team to help relieve strain on healthcare workers, hospitals. News Release Pennsylvania Pressroom; January 24, 2021. Accessed January 24, 2021. https://www.media.pa.gov/pages/health-details.aspx?newsid=1717