If it takes 21 days to form a habit, imaging how many Bad habits we can develop in 21 pay periods?

Author: David J. LeClercq

It has been said that it takes 21 days to form a habit. What happens when it’s not 21 days or 21 weeks, it’s 21 pay periods! When I leave my office at lunch to grab a sandwich or salad and I see the same people walking around town in joggers because they have been working out of their house since March, I must wonder how difficult it is going to be for them when they must put their suit and tie back on for the first time. Will it even fit? There have been many changes to our lives since March, some are good, and many are bad. Will the wine and Netflix go from 7 nights to maybe 2? In our hospitals there have been many changes out of necessity with meetings and day to day responsibilities. Have we started the journey back with our at home working staff so to try and break some of the habits that we have developed since early March, if not, start with the Monday 8am meeting and ease into it.

Are there “positives or lessons learned” we can learn from this challenging time?

Author: David J. LeClercq

It does not seem like we are doing much of the same as we used to in 2020 as we have done in the past. This has been incredibly challenging, and every industry is looking for new ways to deliver their product, service, and in your case patient care. As bumpy as a road as this has been there also have been many “work arounds” and new procedures. We all have started to evaluate how we work to be successful during COVID-19. Do we have a plan to maintain those new procedures or work habits as we emerge from the pandemic? All great inventions stemmed from a necessity, COVID-19 was not a necessity, however our new improvements should be carried forward. Are we going to go back to the way we used to do things or are we going to re-evaluate certain changes we have made that makes sense to continue? C2 Healthcare has been nimble for years with remote coaching and training when not on site. During this time, we have identified many new improvements to our coaching and virtual presence to enhance our client deliverables. What are some of yours?

What will your costs look like when your RAC FEMA relief and other resources dry up?

Author: David J. LeClercq

Over the last few months there have been many resources that have been provided to hospitals around the country. These resources are a very welcome relief and well deserved. As you find your way through the “pandemic journey”, there will be a point when these resources are not available and there will be an absence of staff or allocated financial resources. Hopefully, we are coming close to that point from a health perspective. From a financial perspective, have you looked at your current staffing and expense levels and projected out the picture it creates when these resources have dried up?

Is your PTO accrual rising because employees working at home are not using vacation time?

Author: David J. LeClercq

With the new norm under COVID-19 many employees are working from home. Personally, I have been on video calls where attendees are dialing in from their vacation home or VRBO. Although this is not completely new behavior, the trend is growing exponentially. Additionally, as children are learning remotely, families can spend more time together at home or on extended “worcation” while still maintaining their job functions. It does not matter where you are as long as there is a strong wireless connection.

The question is, have you seen a dramatic rise in your pto accrual compared to last year, and what new guidelines must be adjusted or added?

How is your “volume” today compared to last year at the same time? Is it really that different?

Author: Betsie Sassen

Interestingly enough, most of our clients’ volumes are relatively flat today compared to the same time last year. It is the “nature” of that volume that has changed. It’s volume requiring frequent donning and doffing of PPE, extra staff to screen for COVID-19, alterations in caregiver to patient ratios due to increased acuity and maintaining separate care areas for COVID-19 and non-COVID-19 patients. Unfortunately, what we are hearing about other facilities is that while overall hospital volume is remaining flat, FTEs are not remaining flat, and in some cases have greatly increased, at unsustainable rates outpacing volume, in areas such as the Emergency Department, Progressive Care Unit, and in some cases the Intensive Care Unit. While COVID-19 does pose some legitimate extra “care” steps and challenges, what is your organization’s tolerance for these variances? What is acceptable? And if these areas must go over, are there other areas that run more efficiently to get the net impact to zero?

How is Covid-19 reimbursement impacting your financials? Have you calculated the new run rate without the extra payments and extra expense

Author: David J. LeClercq

I know this may be a difficult question to ask depending on where you are in the country, but have you figured out what your revenue would look like with the same patient population without the additional COVID-19 reimbursement or additional funding? You probably have and the picture might not look great. Do you have a plan to get back in order when this subsides? C2 Healthcare can help you with that.

What are the effects of Covid-19 in the benchmarking world?

Author: David J. LeClercq

The world of benchmarking is often “partly cloudy to cloudy”. Questions arise such as where my peer came from, what types of patients do they really have, what is the physical layout of the unit, and so on. During COVID-19, hospitals are making many changes such as allocating resources for COVID-19 in a general department. In this event there may be many inconsistencies occurring that change the traditional makeup of a nursing unit. As an example, if you are costing out your COVID-19 nurses to a separate cost center, they will not be consistently measured as in the past. In addition to that, the typical patient that occupies a bed within the nursing department could now be a COVID-19 population which is requiring an additional layer of staffing. In other words, a patient in 2020 might not be the same as a patient in 2019. We all need to be aware of these issues and the impact of the benchmarking industry. C2 addresses that, how do you?

Should you be setting labor standards based on Covid-19?

Author: David J. LeClercq

The long and short answer to that is yes … and no. The proper way is to identify which departments have been profoundly affected by COVID-19 and what the extent of the impact. With that said, you would not expect a Med Surg Department to operate under a normal staffing plan pre and during COVID-19 when COVID-19 patient rates are falling in the Department. However, instead of ignoring the variance, our clients are adjusting their standards during the time COVID-19 patients are occupying units in order to reflect the new requirements for staffing the needs of the patients. Once the patients have returned to normalcy, the previous standards will be reactivated with normal Med Surg patients. This will allow your leaders to continue to have confidence in their staffing, while also projecting real variances. Is this the case in your hospital, or are you giving everyone a pass during COVID-19?

As the society is finding more ways to be virtual, how does it impact those that cannot?

Author: Betsie Sassen

We have seen the detrimental effects to businesses and employees that were not able to pivot/adapt to virtual delivery of services such as restaurants, health clubs, spas, the travel industry, and more. Many have and will simply go out of business and those that survive will find that their business will return very slowly. As far as healthcare goes, what we saw with our clients is that while volume dipped initially with COVID-19, overall volumes did return with a robust backlog of elective procedures and doctor’s visits that were “put off”. Our clients had to develop safe ways to take care of their patients and maintain services because they simply had no other choice. Our clients also got creative with “virtual visits” and “virtual group therapies” wherever they could. In some cases, the volume was never lost because patients that are on hemodialysis or in active cancer treatment such as radiation and chemotherapy simply cannot put that off or do that virtually. What we also saw, unfortunately, were patients who should have gone into their doctors or the Emergency Room, but simply did not because they were too scared. The non-COVID-19 that our clients are seeing now are much sicker because they missed appointments and care they should not have.

As we are preparing for the holidays (holiday cards, decorations, cookies), do you also have a holiday staffing plan?

Author: David J. LeClercq

This is normally a very celebratory and yet stressful time of the year. The celebration aspect is obvious, yet this stress can be made up of many ingredients. These ingredients could be shopping, meal planning, holiday cookies, pageants, road trips, an eventually the late nights up wrapping. As we prepare for the Holidays at home, are we having the same planning for the Holidays at work? Just as you make up your shopping list, you also need to look at your projected volumes within each department had appropriately staff so not to use unnecessary labor an unnecessary holiday pay. By proactively managing your resources to your patient needs, you will not only be effective with patient care and satisfaction, but you will also meet the needs of your employees and their families. If there was ever a year to allow people a break during the Holidays… 2020 is definitely that year. If there was every year from a financial perspective that you needed to appropriately staff to patient volumes… 2020 is also that year.

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