i need help fp

Health & Health Systems Group 10- Final Paper

OUTLINE DUE MAY 17 FINAL PAPER DUE JUNE 12

Group members: Jadyn Bogart Kelly Garwood Freddy Knutson Mason Packer Ariana Smith

Topic: Hospitals (recco by Freddy/ Kelly, Ariana also works at OHSU, ok with the topic as well) Anything else?

Potential topics:

Hospitals ● Staffing- there is a mass exodus of staff either retiring or are being burnout from

the pandemic/short staffing. At this point, it appears that we cannot train enough nurses fast enough to make up for what has been lost and keep up with the increased demand for healthcare. There will be a lot about this, it will be super relevant and fairly easy to fill up the pages about.

○ I’m a big fan of this! I think there is more than enough to talk about with the issues of staffing, I have a bunch of information as well. Is everyone else good with this? How should we handle the break up of tasks/ sections for the outline?

● Hospital acquired infections ● Covid…many places were underprepared, hospitals also lost money due due

cancellations of elective surgeries, we can also discuss how things have changed The VA Healthcare System

● How it’s run, who gets benefits and who doesn’t, also the glaringly obvious faults but wonderful benefits.

● Compare and contrast to other government healthcare systems like medicare and medicaid?

Paper components: Reform initiative/intervention being made in the area to solve a problem (last few years) Explain how this effort may impact the other aspects of the system How the system may impact the effectiveness of the intervention

Outline: topic/intervention of choice Tentative sections to be included in the final paper At least one reference Team member responsibilities for each section Team members who are responsible for editing and proofreading Who is responsible for submission of outline and final paper (tentative date and time)

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Final Paper Outline

Topic:

Navigating the healthcare workforce decline: addressing staffing shortages and burnout in the wake of the pandemic.

Sections:

Pre-Pandemic:

● Before the pandemic, the healthcare industry already faced staffing issues that were later exacerbated by COVID-19.

● Recently there was a study done on the national nurse shortage that talks about pre-covid issues (Aiken et al., 2023).

● Historically, hospitals have high turnover rates because of heavy workloads and insufficient staffing.

● In-patient demand was on the rise due to various factors, one example being an aging population.

During-Pandemic:

Staff starting to get burnt out quicker, quitting or retiring early

Staff getting sick themselves, ending up in ICUs, not able to return to work

Hiring down as new nurses don’t want to enter the workforce by being in a hospital during a pandemic

Rise in travel nursing and their pay- hospitals having to rely heavily on staffing which costs more than staff nursing

Lower paying jobs in hospitals hard to fill- people not making much aren’t wanting to risk their lives in a hospital

Staff mental health challenges- stress, anxiety, depression

Post-Pandemic:

Current State of employment

3% above expectation

No longer increasing in numbers

Nurse burn-out

Future of Employment

Baby boomers living longer than ever, more healthcare workers will be needed

Lack of nursing education staff means less nurses entering the workforce

Potential Solutions (Telehealth as an example):

Telehealth is being used as an alternative to long wait times at hospitals and for convenience for the individual, it also helps nurses be less burdened by not having to take care of one additional patient.

Another alternative is to bring in other licensed nurses to help with the increasing gap in the nurse-to-patient ratio.

Reshaping the current internal structure to benefit nurses, such as being more flexible with their shifts etc.

Barriers/Limitations of Solutions (telehealth):

Technical difficulties, individuals not having proper electronic devices or internet access

Regulatory issues with laws, location of patient during appointment (in or out of state)

Patient privacy and HIPAA, security risks on hospital end and patient end

Limitations to appointments- can’t do proper physicals, take labs, have imaging done

The amount of staffing is still needed, but does offer flexibility of working in person and at home, could relieve some staffing problems

References (Minimum 1):

Aiken, L. H., Sloane, D. M., McHugh, M. D., Pogue, C. A., & Lasater, K. B. (2023). A repeated cross-sectional study of nurses immediately before and during the COVID-19 pandemic: Implications for action. Nursing outlook. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9729649/

American Academy of Actuaries. (2021, April). Telehealth After COVID-19. Actuary. www.actuary.org/sites/default/files/2023-04/IB.EmployeeBenefits4.23.pdf.

Detrow, S., & Noguchi, Y. (2021, October 22). Just when more nurses are needed, it’s more difficult to get into nursing school. NPR. https://www.npr.org/2021/10/22/1048289060/just-when-more-nurses-are-needed-its- more-difficult-to-get-into-nursing-school

Gajarawala, S. N., & Pelkowski, J. N. (2021). Telehealth Benefits and Barriers. The journal for nurse practitioners : JNP, 17(2), 218–221. https://doi.org/10.1016/j.nurpra.2020.09.013

Galanis, P., Moisoglou, I., Katsiroumpa, A., Vraka, I., Siskou, O., Konstantakopoulou, O., Meimeti, E., & Kaitelidou, D. (2023, August 14). Increased job burnout and reduced job satisfaction for nurses compared to other healthcare workers after the COVID-19 pandemic. MDPI. https://www.mdpi.com/2039-4403/13/3/95

Jones, C. H., & Dolsten, M. (2024, April 6). Healthcare on the brink: Navigating the challenges of an aging society in the United States. Nature News. https://www.nature.com/articles/s41514-024-00148-2

Lagasse, J. (2022, May 12). Hospitals can change their models of care to meet the worsening nursing shortage. Healthcare Finance. https://www.healthcarefinancenews.com/news/hospitals-can-change-their-models-ca re-meet-worsening-nursing-shortage

Shi, L., & Singh, D. A. (2023). Essentials of the U.S. health care system. Jones & Bartlett Learning.

Telesford, I., Telesford, I., Twitter, E. W., Hughes-Cromwick, P., Amin, K., & Twitter, C. C. (2024, March 28). What are the recent trends in health sector employment?. Peterson-KFF Health System Tracker.

https://www.healthsystemtracker.org/chart-collection/what-are-the-recent-trends-heal th-sector-employment/#Percent%20of%20all%20U.S.%20nonfarm%20employees% 20working%20in%20the%20health%20sector,%201990-2023

Team Member Responsibilities:

Jadyn Bogart: Pre-Pandemic Section

Kelly Garwood: Post-pandemic

Freddy Knutson: Potential Solutions

Mason Packer: During-Pandemic

Ariana Smith: Limitations/ Barriers of intervention (telehealth)

(Responsibilities will be each section, editing/proofreading, and who does final submission)

Jadyn Bogart Kelly Garwood Freddy Knutson Mason Packer Ariana Smith PHE 350

Final Paper: Outline

1. Introduction a. As a group we chose the hospital systems and the staffing challenges that developed during the COVID-19 pandemic, the after effects on the hospital systems, and what solutions have come from those challenges.

2. History a. Pre-pandemic staffing

i. Before the pandemic, the healthcare industry already faced staffing issues that were later exacerbated by COVID-19.

ii. Recently there was a study done on the national nurse shortage that talks about pre-covid issues (Aiken et al., 2023).

iii. Historically, hospitals have high turnover rates because of heavy workloads and insufficient staffing.

iv. In-patient demand was on the rise due to various factors,

one example being an aging population.

3. Background and problem a. During the pandemic

i. Staff starting to get burnt out quicker, quitting or retiring early

ii. Staff getting sick themselves, ending up in ICUs, not able to return to work

iii. Hiring down as new nurses don’t want to enter the workforce by being in a hospital during a pandemic

iv. Rise in travel nursing and their pay- hospitals having to rely heavily on staffing which costs more than staff nursing

v. Lower paying jobs in hospitals hard to fill- people not making much aren’t wanting to risk their lives in a hospital

vi. Staff mental health challenges- stress, anxiety, depression

b. Post-pandemic

i. Current State of employment

1. 3% above expectation

2. No longer increasing in numbers

3. Nurse burn-out

ii. Future of Employment

1. Baby boomers living longer than ever, more healthcare workers will be needed

2. Lack of nursing education staff means less nurses entering the workforce

4. Description of the intervention and intended impacts a. Potential solutions- telehealth

i. Telehealth is being used as an alternative to long wait times at hospitals and for convenience for the individual, it also helps nurses be less burdened by not having to take care of one additional patient.

ii. Another alternative is to bring in other licensed nurses to help with the increasing gap in the nurse-to-patient ratio.

iii. Reshaping the current internal structure to benefit nurses, such as being more flexible with their shifts etc.

5. Potential limitations or barriers

a. Technical difficulties, individuals not having proper electronic devices or internet access

b. Regulatory issues with laws, location of patient during appointment (in or out of state)

c. Patient privacy and HIPAA, security risks on hospital end and patient end

d. Limitations to appointments- can’t do proper physicals, take labs, have imaging done

e. The amount of staffing is still needed, but does offer flexibility of working in person and at home, could relieve some staffing problems

6. References

a. Aiken, L. H., Sloane, D. M., McHugh, M. D., Pogue, C. A., & Lasater, K. B. (2023). A repeated cross-sectional study of nurses immediately before and during the COVID-19 pandemic: Implications for action. Nursing outlook. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9729649/

b. American Academy of Actuaries. (2021, April). Telehealth After COVID-19. Actuary. www.actuary.org/sites/default/files/2023-04/IB.EmployeeBenefits4.23.pdf.

c. Detrow, S., & Noguchi, Y. (2021, October 22). Just when more nurses are needed, it’s more difficult to get into nursing school. NPR. https://www.npr.org/2021/10/22/1048289060/just-when-more-nurses-are-needed-i ts-more-difficult-to-get-into-nursing-school

d. Gajarawala, S. N., & Pelkowski, J. N. (2021). Telehealth Benefits and Barriers. The journal for nurse practitioners : JNP, 17(2), 218–221. https://doi.org/10.1016/j.nurpra.2020.09.013

e. Galanis, P., Moisoglou, I., Katsiroumpa, A., Vraka, I., Siskou, O., Konstantakopoulou, O., Meimeti, E., & Kaitelidou, D. (2023, August 14). Increased job burnout and reduced job satisfaction for nurses compared to other healthcare workers after the COVID-19 pandemic. MDPI. https://www.mdpi.com/2039-4403/13/3/95

f. Jones, C. H., & Dolsten, M. (2024, April 6). Healthcare on the brink: Navigating the challenges of an aging society in the United States. Nature News. https://www.nature.com/articles/s41514-024-00148-2

g. Lagasse, J. (2022, May 12). Hospitals can change their models of care to meet the worsening nursing shortage. Healthcare Finance. https://www.healthcarefinancenews.com/news/hospitals-can-change-their-models- care-meet-worsening-nursing-shortage

h. Shi, L., & Singh, D. A. (2023). Essentials of the U.S. health care system. Jones & Bartlett Learning.

i. Telesford, I., Telesford, I., Twitter, E. W., Hughes-Cromwick, P., Amin, K., & Twitter, C. C. (2024, March 28). What are the recent trends in health sector employment?. Peterson-KFF Health System Tracker. https://www.healthsystemtracker.org/chart-collection/what-are-the-recent-trends-h ealth-sector-employment/#Percent%20of%20all%20U.S.%20nonfarm%20employ ees%20working%20in%20the%20health%20sector,%201990-2023

7. Team Member Responsibilities

a. Responsibilities will be each section, editing and proofreading, and who does final submission

i. Jadyn- pre-pandemic

ii. Kelly- post-pandemic

iii. Freddy- potential solutions

iv. Mason- during-pandemic

v. Ariana- limitations and barriers

b. Ariana volunteered to have final look and put together of paper, will submit 1-2 days prior to due date with everyone signing off on the final draft

Post-Pandemic:

The outlook for healthcare staffing in hospitals post-pandemic is struggling with one

major reason being burn-out. Originally, as mentioned above, the need for healthcare workers

was trending just above current employment but now that trend is starting to slow. (Shi & Singh,

2023) The pandemic was a turbulent time for healthcare workers, particularly in the healthcare

setting. Workers were thrown into new policies, dealt with high levels of stress and even low

staffing due to staff getting sick. Panic and fear, particularly in the early days, made the normally

stressful job even worse. “Nurses, as frontline professionals, experienced intense psychological

distress due to fear of being infected with COVID-19, transmission of the virus to their family,

fear of death from COVID-19, lack of knowledge of how to use personal protective equipment or

lack of equipment, and lack of support. All these burdened nurses’ mental health and affected

their level of satisfaction and burnout” (Galanis et al., 2023) Working in such stressful conditions

wears on a person. Hospital staff are humans and as such can only take so much before they

will eventually leave the job, and perhaps the profession altogether. A study from 2023 states

that “91.1% of nurses experienced moderate/high levels of burnout.” (Galanis et al., 2023) It

does not take much to imagine that with all this burn-out there are major holes in employment to

be filled. In fact, last year it was rumored that the Portland Veteran Affairs hospital was down

60% total hospital staff. Although, this was hearsay among staff members. Even if it is remotely

true, it paints quite the picture for hospitals across the country. In general, “if health sector

employment had continued to grow at pre-pandemic rates, overall health sector employment

would be 279,100 higher in February 2024.” (Telesford et al., 2024) Although this is about

healthcare employment as a whole, it highlights the pandemic effects on staffing.

Another major reason for the staffing shortage in hospitals is the fact that the Boomer

generation is living longer than any other generation before them. Combined with the increase

in chronic conditions over communicable disease, there was already a strain on the healthcare

systems to provide for this generation before the pandemic. “There is a growing shortage of

healthcare providers, which means that the supply and availability of qualified and skilled

healthcare professionals, such as physicians, nurses, pharmacists, clinical social workers and

technicians, is insufficient and inadequate to meet the demand and need of the population.”

(Jones & Dolsten, 2024) Essentially, we are in uncharted waters when it comes to providing

healthcare. Not only are people leaving the profession, as discussed above, but there is also an

unprecedented need for more healthcare workers.

As if these two strains on the state of healthcare employment were not enough of a

strain, there is also difficulty with people wanting to enter the workforce. Nursing programs have

become incredibly competitive due to the lack of nurses to teach the incoming students.

“There's often 800 people applying to community college nursing programs offering 50 slots. At

four-year colleges and universities, 80,000 prospective nursing students didn't get accepted last

year.” (Detrow & Noguchi, 2021) The numbers don’t lie, there are plenty of people who are

interested in entering into nursing to cover for the defecates but the lack of teachers and other

staff to accommodate more students is putting yet another strain on the lack of healthcare

workers in hospitals. Combined with burn-out, as mentioned previously, and normal retirement

of staff, we cannot make enough nurses at this point to make up for those that healthcare have

and will lose.