New Hampshire hospitals adapt to changing workforce needs

Facilities employ retraining, reassignment as some procedures return
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A shift change at Catholic Medical Center during a ‘thank you’ moment staged by area first-responders. (Photo by Jeffrey Hastings)

While the Covid-19 pandemic has brought unprecedented pressure on New Hampshire’s healthcare workforce, hospitals have found a variety of ways to adjust their staffing to try to minimize layoffs and meet increased demand in emergency departments.

With elective surgeries and other revenue-generating procedures shut down, hundreds of healthcare workers have been furloughed, taken pay cuts, but when possible, hospitals are finding ways to reassign and retrain on the fly.

Across SolutionHealth’s two locations, Manchester-based Elliot Health System and Nashua-based Southern NH Health System, staff have also been retrained and redeployed, said Kelly Corbi, chief operating officer.

“This includes physicians, advanced practice providers, nurses, patient care assistants and more who have valuable skills that could be applied to areas where we have need. An example is a pediatrician who was redeployed to the Emergency Department,” Corbi said.

The economic impact of Covid-19 has been severe across the board, but especially for hospitals, said Corbi. That has led to cancelation of non-essential surgeries and other procedures as well as to set up additional beds in case they’re needed for Covid-19 treatment and to stock up on personal protective equipment supplies.

“These revenue losses and added expenses did force us to take measures to stem our losses. In mid-April, we placed roughly 650 employees on furlough status,” said Corbi. “Those employees are eligible to collect unemployment but maintain their benefits. Others saw reduced hours and pay reductions.”

At Catholic Medical Center in Manchester, spokesperson Lauren Collins-Cline said due to a drop in patient volume and, in turn, revenue, the hospital in late April placed 423 employees on a 60-day furlough and either reduced hours or pay for an additional 914 employees, but they too are retooling.

“Over the last two months, we have redeployed or retrained people for different roles, like having nurses who normally work in endoscopy man the phones in our employee health call center and asking others in clinical roles to help with patient screening at our front entrances,” she said. “Healthcare positions are often license-specific so retraining would also mean relicensing — something that would be impractical during these circumstances.”

Bringing employees back

Under Gov. Chris Sununu’s revised stay-at-home orders hospitals, are ready to resume some of the revenue-generating activities curtailed in March, giving hospitals the “green light” to resume certain procedures, said Collins-Cline.

“As our patient volume builds, we are bringing employees back for the roles needed to support that patient care. It will be slow at first, but we expect to gradually increase in the coming weeks,” Collins-Cline said.

Samantha O’Neill, vice president of human resources at Portsmouth Regional Hospital, said the facility has not had to furlough or lay off any staff, but many are working reduced hours.

“We are working very hard to redeploy them to other areas in our facility and that of our sister facilities at Frisbie Memorial Hospital (in Rochester) and Parkland Medical Center (in Derry) to ensure they are receiving their full amount of hours,” she said.

O’Neill said existing staff has been cross-trained to ensure that they can maintain their hours. For instance, many of the nurses who work in the operating room, outpatient clinics and other departments have experience working in the intensive care unit or other inpatient care units and are getting refresher classes to work alongside the nurses on those units.

Sarah Currier, vice president of workforce strategy at Dartmouth-Hitchcock in Lebanon, said that, from the very beginning of the pandemic, the organization has prioritized finding ways to cross-train and upskill employees.

“First, we have created a program called Staff-Match to make sure that employees with skills and availability can be reassigned to different areas of our facility that may need those skills and have openings whenever possible,” said Currier. “Next, we have redeployed employees with specific skill sets, like being trained in how to don and doff personal protective equipment, from their regular jobs to have them teach their colleagues and share that knowledge.”

She added that the Staff-Match program allows D-H to redeploy staff to other areas that are in need, due to additional patient census, or staff absenteeism due to child care.

“At this time, we have had limited numbers called off because of the flexibility this program has provided,” Currier said. “We have also taken this time to train up our staff in critical skills in order to care for potential Covid-19 patients. We are now working on our recovery plan which we know will positively impact staffing needs.”

Hiring continues

In April, SolutionHealth put a hiring freeze in place for all non-essential positions. However, Corbi said, it continues to hire essential and strategic roles, particularly respiratory therapists, licensed nursing assistants and environmental services staff.

O’Neill said Portsmouth Regional is still hiring in some areas, but the main focus is to ensure that current staff have the ability to work the hours they were hired for, and the same is true for CMC, where Collins-Cline said the hospital would first bring an employee back from reduced hours or furlough before having a new hire start for a particular role.

“We are still hiring for certain, specific positions directly related to patient care, although start dates will vary widely. We’re hiring in the operating room, as well as for RNs, LNAs and various tech positions,” Collins-Cline said. “We are mostly holding off on hiring for positions that are not directly related to patient care but we still have about 100 openings.”

Dartmouth-Hitchcock is still hiring, said Currier. with a priority placed on filling roles that will help save money, by reducing reliance on travelers and overtime or will help facilitate time-sensitive, urgent elective surgeries, procedures and ambulatory visits.

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