Could Virtual Nurse Led Models Of Care Be A Solution For A Workforce Shortage? If Funded and Supported, the Answer is Absolutely Yes!

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It feels like there isn’t an industry in Australia right now that isn’t reporting that they are struggling to attract workforce to meet their current demand.  The Australian Bureau of Statistics (ABS) reports that currently Australia has an unemployment rate of 3.8% , which is the lowest on record since 1974.

In essence, everyone is fishing in an incredibly big pond with very few fish and talent is hard to find. Organisations that can not only attract but also retain are at a huge competitive advantage and workforce that don’t feel valued and supported will walk if they haven’t already. Organisational culture is a key factor in getting and keeping a workforce in today’s market.

The other factor to consider post COVID, when it comes to attraction of workforce, is the advent of virtual and flexible methods of work. We all experienced the power and growth of Zoom and Microsoft Teams during the pandemic and many of us appreciated the flexibility that it created in the ability to work remotely and from home.

Working from home no longer seems like a “nice to have”, but practically an essential option, as industries scramble to offer employees not only a pay cheque but also a lifestyle that only Silicon Valley and Big IT seemed to view as a reality pre-COVID. Flexible working arrangements seem like they are here to stay, and employees and talent now more than ever want to find work that fits around their life, rather than trying to create a life that fits around their work.

In the Australian healthcare setting this workforce shortage is felt acutely. It is estimated we will have a shortfall of around 11,000 General Practitioners by the end of the decade and it has been predicted that by 2025[1]  we will have a national nursing shortfall of around 85,000 Nurses.

Unfortunately, there is no single magic solution to this shortfall. It will take a multitude of strategies including large policy changes at both a State and Federal level.

But an obvious solution seems to be supporting nurse led models of care that enable working from home. Surely flexible work arrangements offer a rational and obvious solution to some of the current challenges we are facing across the healthcare setting in Australia?

Only about 51% work more than 35 hours per week. The other 49% work less than 35 hours, which is considered part-time.

There are probably a few factors to account for the significant part-time nature of the nursing workforce, with the most likely being the number of women in the workforce shouldering the responsibilities of motherhood as well as their career.

However, this part-time nature of employment could also present a significant opportunity. But such an opportunity would require us to shift our focus from hospital-based, reactive, activity-based funded models of care to digitally-enabled, proactive, chronic disease management models of care.

Nurse-led chronic disease virtual models of care could create an immediate solution at our fingertips to potentially engage around 165,000 nurses to deliver care virtually across Australia from the comforts of their own home.

Just imagine. If we could find as little as 5 hours on average per week across this cohort delivering chronic disease management virtually into the community, that would entail around 825,000 of additional workforce hours being delivered weekly into our healthcare system.

If you were to equate this to an average working week of 37.5 hour per week, we’ve just added an additional 22,000 full time equivalent nurses into our workforce.  And we have achieved this without any of the costs associated with recruiting from overseas, training new graduates, or paying for expensive and potentially dangerous overtime.

In addition, there is the opportunity to engage highly experienced and talented, recently retired nurses back into employment with the lure of working from their homes or remotely. With the current increased inflation rates and interest rates it could potentially be quite an attractive option to work 10 hours a week from the setting of their own choice. Such an option could also be attractive to someone who can no longer manage the physical requirements of nursing in the hospital-based system. These are the very nurses who could provide high quality, experienced, nurse led chronic disease solutions into the community.

Now while we are exploring what seem like obvious solutions, let’s add the opportunity to include Nurse Practitioners in these models of care. Such an addition would address some of the unmet needs in the struggling Primary Care system (remember the 6,000 GPs we needed?). with such an addition of staff able to prescribe, diagnose and refer, we could really start to address some of the bottle necks we see in Emergencies Departments and the ramped ambulances across the Country.

I am not for one minute pretending this is the only solution required. Obviously, my suggestions don’t solve the shortage in the hospital system, and I am not arguing with the fact that we need more GPs and nurses. As I observed earlier the solution needs to be multi-faceted.

But just imagine if we started to fund and really engage with models of care that have proven to reduce potentially preventable admissions by upwards of 50%, reduce the burden of chronic disease in our population, reduce hospital bed days when patients are admitted, and reduce the reliance on Emergency Department to address basic unmet primary care and thus place additional strain on an already under pressure acute care system.

These models of care aren’t imaginary, they currently exist both locally and increasingly at scale internationally. However, while we continue to focus on the same solution (i.e. how do we staff another hospital, build another hospital, and find workforce to deliver care to the current tertiary system) we actually contribute to the problem.

So, this is the time, right now as we are witnessing industries across the globe embrace the learnings of COVID and the current trends in flexible employment opportunities. We need not only to engage available workforce, but also to build models of care that can drastically improve the face of healthcare delivery, improve outcomes for both the patient and system cost savings and redefine how we manage chronic diseases nationally?

As always, interested in your thoughts and comments and happy to chat about these models of care.

Ben Chiarella

Director of Clinical Innovation

Ramsay Connect