Staff makeup plays key role in hospitals' productivity

Healthcare facilities can employ a diverse array of staffing patterns--including those that employ more non-physician staff members--into their organizations in order to increase their productivity and better meet the needs of their communities, a new study suggests.

The study, published in the January 2015 edition of Health Affairs, tracked staffing patterns and characteristics at 1,191 community health centers operating at 8,900 clinical sites in 2012. These centers, which the study authors describe as "federally funded safety-net organizations," provide primary care to low-income patients and typically experience the physician shortages that plague healthcare organizations in underserved communities. However, the authors note that lessons learned from studying community health centers can be translated to all types of healthcare organizations.

The study divided healthcare workers into four distinct categories: physicians; advanced-practice staff such as nurse practitioners, physician assistants and certified nurse-midwives; registered nurses; and other medical staff including medical assistants, nurse aides and lab or radiology staff.

While physicians often were found to be associated with the highest levels of productivity, in facilities with high numbers of advanced-practice staff or nurses, these types of clinicians displayed higher contributions to overall productivity. Further, in measuring the staffing patterns at community health centers throughout the country, researchers seemed to confirm previous reports that the number of doctors available at healthcare facilities varies widely between different regions. The number of non-physician staff members, particularly advanced-practice staffers, was much higher in rural community health centers than those located in cities, the study found.

Noting this effect, lawmakers and advocacy groups have pushed to expand the practice scope of professionals like advance-practice registered nurses to fill healthcare access gaps in nonmetropolitan areas, FierceHealthcare previously reported. Many of these measures have had effects on staff compositions at community health centers, the study found, noting that facilities in states with expanded scope of practice for non-physicians used slightly fewer doctors and slightly more advanced-practice staff.

Though there has been some pushback from physicians in regard to this trend, the industry is increasingly recognizing that non-doctor clinicians are just as vital to improving patient outcomes as their physician colleagues.

"We found that productivity levels were relatively similar across all staff configurations and that there did not appear to be a single optimal model of staffing," the study concludes, noting that all types of healthcare facilities "can use diverse approaches that fit their needs … and those of their communities."

To learn more:
- check out the study (subscription required)