As COVID-19 spread to Ohio and cases began to pile up, Marti Bauschka, chief nursing officer at Southwest General, began to see the outreach on social media. Then came the calls and voicemails — all from retired nurses in the region and state asking how they could help during the pandemic.
The hospital's chief medical officer was fielding similar calls and began looking at how to re-credential retired physicians who were calling to say, "I can come in, I can help."
MetroHealth, University Hospitals and Cleveland Clinic all have checked in with recently retired staff to determine their availability and licensing in case they are needed.
This is just one piece of the all-hands-on-deck strategies hospitals are implementing to ensure sufficient staffing ahead of the anticipated surge in COVID-19 patients.
Though Ohio's measures have begun flattening the curve so that some of the latest projected surge numbers are looking less drastic, Northeast Ohio hospitals are taking every precaution to ensure they have the providers needed to care for patients.
Some clinical staff who work in nonessential surgeries and procedures, which have been put on hold for the time being, are being trained and reassigned. Others are furloughed or working fewer hours, standing at the ready and staying healthy as workforce needs evolve, which is especially important given healthcare providers' heightened risk of contracting COVID-19.
Another way to possibly expand the workforce if needed is activating the Medical Reserve Corps, a group of volunteer licensed providers available for support during emergency preparedness initiatives, said Lisa Anderson, senior vice president at the Center for Health Affairs, the nonprofit advocate for Northeast Ohio hospitals.
Ohio worked with its licensing boards to survey current and retired licensees to identify unaffiliated personnel (those not already being counted by hospitals) who have clinical or behavioral health skills and may be able to help respond to the potential surge. As of last Thursday, April 9, about 53,000 individuals had responded, more than 22,000 of whom had said they were available and willing to respond.
University Hospitals sent out its own internal skills survey of employees with various licenses, which helped the system set up training and redeployment regimens, said Tom Snowberger, UH's chief human resources officer. The response of people willing to step into whatever role is necessary during the pandemic has been "overwhelming," he said.
UH has communicated to staff its commitment to not let any staff go to an unpaid status, which Snowberger said he considers another way to protect its workforce and ensure patient continuity. Still, some are seeing decreased hours as patient census dips in the short term. Employees can use PTO and potentially borrow future PTO, but if that's exhausted, Snowberger said the system will still work to avoid an unpaid status.
"We're trying to accommodate for the uniqueness of the situation," he said.
Similarly, Cleveland Clinic is maintaining pay and benefits for caregivers whose roles have been temporarily suspended since they will be reassigned. This includes while they wait for reassignment. The system is supporting its caregivers with training and resources so they can respond to changes in assignments, including moving to another department, work site, shift or remote location.
For staff members who don't have the necessary license or credentials to join direct patient care, UH is finding other ways for them to supplement the work environment. For instance, 15 to 20 employees have been in one of the system's cafeterias making masks to distribute to other employees and creating kits for community volunteers who are sewing and donating masks. Others are stationed at entry points to help screen incoming patients.
Some of MetroHealth's medical practice assistants (who typically check blood pressure, weight and temperature at appointments) have been reassigned to help screen people entering buildings in the system. Others are responsible for contacting patients about telehealth visits or are participating in the system's Compassionate Care Rounders program, in which they help patients connect to family members by video chat or read them emails and letters.
At Southwest General, volunteers, many of whom are older, are opting to stay home to protect themselves. Staff members with available time are taking over some of those duties, such as driving the golf carts that help people get to different locations around the hospital.
"We've done our best to keep our staff as whole as we can and to kind of spread that wealth a little bit, so that we're not assigning one person all the time," Bauschka said. "Our HR department is doing a great job of making sure that people get opportunities to pick up time."
The state has implemented policies that will help hospitals more quickly access a pool of additional healthcare providers if needed. For instance, allowing, for the time being, nurses who are licensed out of state to work in Ohio without obtaining an Ohio license and temporarily extending roughly 1,400 licenses that would expire during the declared emergency.
The Ohio Board of Nursing also temporarily suspended the requirement that nurses applying for their license must have passed the NCLEX examination. This enables recent and upcoming graduates of nursing programs to more quickly join the front lines rather than waiting to be able to take that exam (though they will ultimately have that examination). The board estimates this could add 4,000 to 5,000 nurses into the workforce.
Timothy Gaspar, dean and professor in Cleveland State University's School of Nursing, said about 200 bachelor's and master's students are poised to graduate in early May, and the school's goal is to keep that timeline and support them getting a temporary license as soon as possible.
The University of Akron is taking similar steps to expedite the process of clearing their students' degrees, which can usually take some time. Ahead of finals, officials are looking at the grades of the 130 students poised to graduate in early May so they can forward the necessary documentation to the Ohio Board of Nursing as quickly as possible, said Michele Zelko, assistant director for undergraduate programs in the university's school of nursing.
Ohio University announced its nursing and medical students will receive their degrees in mid-April, earlier than planned. Ohio State University's board of trustees on Friday, April 10, was scheduled to consider a request to graduate dozens of senior medical students early. Case Western Reserve University hasn't adjusted its graduation timeline.
Ultimately, with the help of technology and remote learning, Kent State University is poised to have more than 200 seniors complete all their work by April 28 (ahead of the scheduled May 9 graduation) and send documentation to the Ohio Board of Nursing as much as three weeks earlier than it would typically take, said Tracey Motter, associate dean of Kent State University's College of Nursing.
She noted that Kent State faculty have been among those who are helping local healthcare systems train nurses to shift from, for example, operating room care to other more pressing care needs at this time.
The hope, of course, is that the surge will be tempered by all of the mandates put in place by the state and by individuals' efforts to practice social distancing. But if a wave of patients crashes through the region's hospitals, Northeast Ohio health systems say they're ready.
"It's all hands on deck," Snowberger said. "You learn a lot about your organization's culture and you learn a lot about people when times demand courage. ... You can see one organization with one goal in mind working to focus on the solutions and the preparedness for what may or hopefully may not come."
"Hospitals take an 'all-hands-on-deck' approach to staffing during pandemic" originally appeared in Crain's Cleveland Business.