Planned disruption: How change management principles can improve health system performance & profitability

In light of the nationwide shortage of clinicians and other allied health professionals, hospitals and health systems are struggling to staff operating rooms and are spending more money on the labor needed to deliver high-quality patient care. Healthcare leaders are looking for creative solutions to help solve these problems.

This was a major theme in a discussion at Becker’s 14^th Annual Meeting led by Peter H. Doerner, executive vice president and chief development officer for North American Partners in Anesthesia (NAPA).

Five key takeaways were:

1. The growing volume of outpatient procedures is driving demand for anesthesia staff. Historically, anesthesia clinicians delivered care for procedures performed within a traditional hospital setting. Today, demand for anesthesia coverage has grown due to procedures migrating to ASCs and office-based practices, while still requiring care within the hospital setting. “The shift to outpatient is good for patients; however, it has reduced the clinician supply in hospitals and health systems,” Mr. Doerner said.
   
   “One barrier we have is our mission, which is to be a safety net healthcare facility in Massachusetts,” one participant said. “That creates a real problem in terms of our payer mix and we have significant competition for anesthesiology providers from two small institutions near us.”
   
2. Seasoned anesthesia clinicians are retiring, and the pipeline of new clinicians isn’t keeping pace. An inadequate number of new anesthesia clinicians are graduating. The S. Bureau of Labor Statistics projects that 7,600 new CRNA positions will be needed by 2028. Yet only 2,400 CRNAs graduate each year. At the same time, many clinicians—especially anesthesiologists—are retiring, and the unemployment rate for this specialty is less than 0.5%. With a growing patient aging population in need to surgical care, the result is a massive projected shortage of anesthesia providers over the next decade.
   
   “We have a system with nine hospitals, and the culture of surgeons and anesthesiologists is very difficult these days,” one attendee said. “As a result, we only have a certain number of hospitals with staffing for cases overnight, which means we’re transporting patients from hospital to hospital.”

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