Trends in Staffing and Continuing Education in the Field of Invasive and Non-Invasive Cardiology

Many challenges exist in the provision of specialty healthcare today. Recruiting and retaining highly experienced cardiovascular and specialty healthcare professionals (primarily RNs and cardiovascular technologists) has become a high priority during a time when healthcare staffing shortages currently exist and are projected to worsen as time goes on. A recent report to Congress projected a significant gap between the availability of nurses and the need into the 21st century. The report predicts that in 2020, 1.25 million nurses will be needed and that only 625,000 will be available.1 Additionally, employment of cardiovascular technologists is expected to grow much faster than average for all occupations.2 Complicating matters is the fact that the average age of most healthcare professionals is increasing (the average RN is 44). As the demands on these healthcare professionals increase, many are leaving the profession for less stressful and less demanding positions both within and outside healthcare. As these professionals retire or move on, this will leave younger, less experienced staff to work in highly technical and difficult specialty areas.1 Privatized Staffing Job performance and satisfaction are highly impacted by the above factors. This serves to intensify the existing staffing crisis in healthcare. Staffing shortages are prompting department managers to seek alternative ways to keep patient care at an optimum level while at the same time controlling costs. Healthworks Inc., founded in 1997, is a company geared toward the privatization of invasive and non-invasive cardiology staffing. The focus is directed at the formation of regional private practice groups, similar to physician groups, that service several different hospitals within a given region. Ideally, hospitals contract for management and staff, realizing greater net savings by paying for services only when necessary. For instance, hospitals that want to compete in the cardiac catheterization market but may not have the kind of volume to command a full-time staff, can outsource the service to Healthworks. The economies of scale realized by the hospital from contracting in this manner are significant, in that the hospital pays on a per-procedure basis, thereby matching expenses directly to revenue-producing activity. This service is known as Comprehensive Departmental Outsourcing. In addition, Healthworks offers per diem staffing for invasive and non-invasive cardiology and electrophysiology. Healthworks also provides education and consulting in these areas as well as in critical care nursing. The company operates on the concept of establishing regional practice groups of cardiovascular professionals to service healthcare facilities within a geographic region. This allows personnel to service a specific area and greatly reduces the overhead related to hospitals with low case demand. Company Associates Through exposure to a variety of clinical sites, the staff at Healthworks, or associates, as the company refers to them, has become exceedingly adaptable to the different clinical situations and diverse management styles they encounter. Benefits offered to associates include free seminars provided by the education department for continuing education credits, flexible work schedules, and better than competitive wages. In the Field A nationally renowned heart center in New Jersey called upon Healthworks in the summer of 2000 to help provide cardiovascular professionals during their staffing shortage. Tammy Franks, RCIS, was willing to fill the staffing void. Although Tammy lives 246 miles away from the hospital site in New Jersey, this did not hinder her decision to offer assistance to the cath lab. For two months Tammy and her family camped at a campsite in New Jersey to make the commute easier. Her dedication and professionalism earned high praise from the cath lab nurse manager, Andrew Haviland, RN, CCRN: Healthworks staff have been a welcome adjunct to our incumbent staff. They have enabled us to help maintain our high standard of patient care. On other occasions, the company has filled short-term needs. For example, one large university hospital in Philadelphia required staffing for 12 weeks to accommodate a staff technologist on maternity leave. Healthworks has also had the privilege of caring for U.S. war veterans during the past three years. At the Veterans Hospital in Philadelphia, Healthworks provides all non-management staff to the cath lab on a daily basis. All Healthworks™ nurses and technologists have had, at some point, the opportunity to provide cardiac care to the patients at the Veterans Hospital. The experience has been not only educational but emotionally satisfying. The diagnostic cath lab at Pottstown Memorial Medical Center (Pottstown, Penn.) is fully staffed and managed by Healthworks. Efforts are made to accommodate the patients and cardiologists™ schedules. Colleen Buckwalter, CVT, and Jackie Kudoba, RN, have both staffed the lab at Pottstown, and comment: Our experiences at other cath labs have given us confidence in our efforts to provide excellent patient care. Exposure to high risk interventional procedures, in addition to emergent cardiac care at other clinical sites, has enhanced our job performance and is recognized by the cardiologists at PMMC. The Healthworks concept of outsourcing is to provide a competent, professional staff consisting of registered technologists and nurses for low or high-volume cath labs where there is not sufficient full-time staff to fully operate all procedure rooms. The benefits to cath labs with low patient volume are that the hospital is charged on a per procedure basis, rather than hourly. Education Well-trained, highly educated individuals are essential for providing quality care. At a time when many institutions are forced to make difficult economic decisions regarding budget allocation, the education division of Healthworks has devised an approach to delivering comprehensive educational services to hospitals, private practice groups, nurses and cardiovascular professionals. Several customizable programs are available via instructor-directed lecture, self study and internet-based learning. JCAHO and OSHA competencies based on hospital requirements are also offered. Courses are offered in a variety of formats and disciplines, and are intended to meet the diverse needs of the healthcare professional. Providing CEUs via the internet or by lecture format eliminates the need to send staff to costly conferences and allows managers to focus their time and staff in more productive, revenue-directed tasks. Job satisfaction increases when staff are given the education they need to achieve proficiency in their specialty. In a time where healthcare staffing in the U.S. is in crisis, companies like Healthworks are striving to bring a fiscally sound alternative to healthcare facilities, as well as offer professionals the control over their own careers that is lacking in today™s traditional healthcare employment. You can find out more about Healthworks Inc. on their website: www.healthworksonline.cc

1. Dodd C. Hospitals, Nursing Schools Plan for Nursing Shortage. St. Louis Business Journal, April 16th, 1999. http://stlouis.bcentral.com/stlouis/stories/1999/04/19/focus9.html 2. Occupational Outlook Handbook. Bureau of Labor Statistics, 2001 version. http://www.bls.gov/oco/ocos100.htm