Challenges and advantages of engaging a clinical staffing and management service for your ICU

Trusting a third-party partner to staff and manage your ICU isn’t a decision to be made lightly. Your hospital’s reputation is at stake. Even more important, so are your patients’ health and safety.

Finding the right partner to help you deliver effective and cost-effective critical care is challenging. But if you succeed, you can achieve unique advantages – for your patients, your providers, your hospital, and the community you serve.

First, the challenges

To be clear, partnering with a clinical staffing and management service doesn’t mean picking a partner, leaving everything to them, and focusing your attention elsewhere. And you don’t want it to. Instead, you want a close relationship where your third-party partner is doing the “heavy lifting” when it comes to all staffing and management issues, but nevertheless involves you closely in the process, in the results, and in continuous quality improvement initiatives.

As in any relationship, this poses challenges. And as in any relationship, most revolve around communication. 

A good partner communicates clearly to help you form realistic expectations of what your partnership can and should achieve. A good partner communicates clearly not only with you, but with all your constituents, ensuring that your providers and other stakeholders are involved and informed. A good partner excels at recruiting, staffing, training, and retaining exceptional people who fit your needs and your culture, and then motivating those people to do the best, most rewarding work of their careers. A good partner ideally has experience with hospitals large and small, urban and rural, and can draw upon best practices from around the nation to meet and exceed your high standards.

So how do you find a good partner?

Finding the right partner requires an intensive search

There may be numerous candidates for the partner you seek. However, only a few companies have decades of experience in this field. In contrast, many more have come to market fairly recently. Experience isn’t everything, but it is a testament to consistent performance and a clear sign of an organization’s stability.

Besides the number of years in the industry, there are other important topics you should explore with each candidate. 

Your questions should focus on their methodologies (and level of evidence) for: 

• Transitioning into a new partner hospital
• Establishing close relationships with intensivists, nurses, ancillary departments, medical staff, and administration 
• Recruiting and retaining providers, even in challenging locations
• Fostering collaboration and cooperation within and between departments
• Improving quality, efficiency, and value while decreasing costs
• Responding to increasing patient volume
• Tracking and reporting performance

The advantages for your hospital add up

Staffing and management for critical care provision are complex, and can be time-consuming and costly for hospitals. A good partner not only assumes responsibility for these tasks but also, in the process, improves your quality of care, outcomes, and patient and provider satisfaction. This is the fundamental advantage of a good partnership: they do what they excel at while you apply your skillsets and energy where they’re more productive.

Recruiting providers in this era of a worsening physician shortage is challenging. Your ideal partner has a dedicated recruitment team with proven methods for attracting, vetting, hiring, and retaining excellent providers. To ensure a deeper dedication to your hospital and patients, your ideal partner uses local providers, whenever appropriate, and recruits full-time physicians who will live in and become part of your community. 

Your ideal partner also has an extensive track record achieving key quality metrics and can help you:

• Meet and exceed your targets for length of stay overall as well as for specific major disease categories (for example, pneumonia, COPD, sepsis, etc.) 
• Support quality initiatives and core measures 
• Track rates for CAUTI/CLABSI/VAP 
• Track days on ventilator support
• Monitor the mortality index 
• Improve patient, nursing, and physician satisfaction 
• Collaborate with interdisciplinary teams to develop and implement clinical pathways and evidence-based medicine protocols 
• Optimize utilization of resources and ancillary services 
• Reduce readmission rates 
• Enable more effective management of bed capacity 
• Improve throughput 
• Implement billing services that increase revenue and decrease costs
• Manage electronic medical records and comply with documentation guidelines

If you don’t measure it, you can’t manage it. So, your ideal partner creates a detailed customized performance dashboard to track performance on all key metrics, updates it each month with data you collect to ensure validity, and distributes it to your administration and staff. 

Advantages accrue for intensivists too

Working with a company that delivers critical care staffing and management services can be highly advantageous for intensivists. The relationship can empower each individual provider to take a more active role in improving bed management and throughput, reducing lengths of stay, and increasing patient satisfaction. 

Often, satisfaction scores among providers also increase when a critical care staffing and management partner becomes involved. This may be a result of new initiatives in quality improvement, multidisciplinary staff meetings, evaluations and peer reviews, and education and training programs.

In addition, there may be one more important way that intensivists can benefit and that inevitably increases their satisfaction: Each staffing and management company has a different ownership structure. When you consider candidates, ask about this important feature. Is the company publicly traded? Privately owned? Provider-owned? When it’s provider-owned, intensivists have the rare opportunity to truly take ownership of the care they deliver. 

When the owners are physicians and advance practice clinicians, they may offer a distinct advantage by answering first to the communities they serve – your community – not investors.

Inevitably, satisfaction among intensivists in this situation increase for two reasons: 1) They enjoy new compensation opportunities, and 2) They realize that their partner shares their priorities and stresses that the right choice is always to do what is in your patients’ best interests. 


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