Skilled nursing facility staffing shortages: Sources, strategies, and impacts on staff who stayed.

Autor: Leland NE; Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., Prusynski RA; Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA., Shore AD; Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., Cary MP Jr; School of Nursing, Duke University, Durham, North Carolina, USA., Falvey J; Department of Physical Therapy and Rehabilitation Science, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA., Mroz T; Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA., Saliba D; Geriatrics Research Education and Clinical Center, Greater Los Angeles Veterans Administration, Los Angeles, California, USA.; Borun Center, Division of Geriatrics, University of California, Los Angeles, California, USA.
Jazyk: angličtina
Zdroj: Health services research [Health Serv Res] 2024 Dec; Vol. 59 (6), pp. e14355. Date of Electronic Publication: 2024 Jun 25.
DOI: 10.1111/1475-6773.14355
Abstrakt: Objective: To examine skilled nursing facility (SNF) staffing shortages across job roles during the COVID-19 pandemic. We aimed to capture the perspectives of leaders on the breadth of staffing shortages and their implications on staff that stayed throughout the pandemic in order to provide recommendations for policies and practices used to strengthen the SNF workforce moving forward.
Study Setting and Design: For this qualitative study, we engaged a purposive national sample of SNF leaders (n = 94) in one-on-one interviews between January 2021 and December 2022.
Data Source and Analytic Sample: Using purposive sampling (i.e., Centers for Medicare & Medicaid quality rating, region, ownership) to capture variation in SNF organizations, we conducted in-depth, semi-structured qualitative interviews, guided a priori by the Institute of Medicine's Model of Healthcare System Framework. Interviews were conducted via phone, audio-recorded, and transcribed. Rigorous rapid qualitative analysis was used to identify emergent themes, patterns, and relationships.
Principal Findings: SNF leaders consistently described staffing shortages spanning all job roles, including direct care (e.g., activities, nursing, social services), support services (e.g., laundry, food, environmental services), administrative staff, and leadership. Ascribed sources of shortages were multidimensional (e.g., competing salaries, family caregiving needs, burnout). The impact of shortages was felt by all staff that stayed. In addition to existing job duties, those remaining staff experienced re-distribution of essential day-to-day operational tasks (e.g., laundry) and allocation of new COVID-19 pandemic-related activities (e.g., screening). Cross-training was used to cover a wide range of job duties, including patient care.
Conclusions: Policies are needed to support SNF staff across roles beyond direct care staff. These policies must address the system-wide drivers perpetuating staffing shortages (i.e., pay differentials, burnout) and leverage strategies (i.e., cross-training, job role flexibility) that emerged from the pandemic to ensure a sustainable SNF workforce that can meet patient needs.
(© 2024 The Author(s). Health Services Research published by Wiley Periodicals LLC on behalf of Health Research and Educational Trust.)
Databáze: MEDLINE
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