1 Kansas system’s creative approach to filling staff needs – Becker’s Hospital Review | Healthcare News
Hutchinson (Kan.) Regional Healthcare System is relieving staff shortages and filling open positions with a simple initiative: cross-training.
Cross-training has been around for a while, and became more popular during the COVID-19 pandemic when resources were more limited. At Hutchinson Regional, figuring out the most efficient way to allow clinicians to work at the top of their license and scope of practice while maintaining staff in high-need spaces has remained a focus, Jill White, BSN, RN, chief nursing officer at the system, told Becker’s.
“Too often, clinicians are pulled into tasks that don’t require their level of training,” Ms. White said. “These tasks land on their plate simply by default.”
But system leaders are working to move away from the default position and make cross-training a creative tool to improve work for everyone.
“At the heart of it, it’s about asking: who should be doing what tasks? And if something is getting in the way of people practicing to their full capacity, can someone else take that on?” Ms. White said.
Six use cases
Leaders started with patient observers, a small team that remotely telemonitored patients for safety, and who often had some downtime. They looked for tasks that the observers could help with, such as retrieving dietary supplies, delivering items to floors or checking crash carts. Offloading those tasks from nurses allowed them to focus on patient care while also giving patient observers an opportunity to expand their skillsets.
This cross-training strategy has snowballed into more disciplines and departments.
“In the clinical ancillary areas, staffing challenges and hard-to-fill positions pushed us to look at cross-training as a necessity,” Lori Hartnett, vice president of operations at the system, told Becker’s. “When you don’t have enough people to fill every position, you have to maximize the skill sets of the staff you do have.”
Some departments lend themselves more naturally to cross-training, like laboratory and radiology. Having staff that can float between modalities when needed improves efficiency when personnel are limited, and can be an exciting opportunity for growth. Take Dillon Robben, an imaging technologist for X-ray and CT scans who had wanted to cross-train into MRI for some time. He expressed interest to his leader about cross-training, and in a short time, received the training. Now he can perform X-ray, CT and MRI scans.
“It’s kept my job interesting, which I really appreciate,” Mr. Robben said. “Having dual modality training is really beneficial, and it’s something many employers look for and value.”
Cross-training has recently become more common among nurses. This summer, Hutchinson Regional’s patient census was lower, which allowed about six nurses to cross-training to work in the one-call admission center. This allowed direct care nurses to help cover for call center nurses during PTO and sick calls without needing to call in extra staff or use overtime, Ms. White said. It also gave nurses a break from their day-to-day routine and helped them maintain scheduled hours during census drops.
Pediatric nurses are also getting cross-trained to provide care for newborns in the nursery and postpartum units.
Cross-training also helped the system handle phlebotomist shortages, especially on the night shift which was chronically uncovered.
“We decided it was easiest to set a standard: assume phlebotomy doesn’t have enough staff for a third shift,” Ms. Hartnett said. “From there, we looked at the scope of care and realized we could train patient care technicians through a competency-based process to perform phlebotomy.”
This decision cleared up communication, cut down on coverage delays, improved timeliness of patient draws and lab result deliveries, supported patient safety and quality improvements, and also kept technicians engaged and involved in work. Currently, there are about 55 individuals who have been trained in PCT-to-phlebotomy crossover.
How cross-training changes recruitment
Hutchinson Regional redesigned its position control committee to align with the new options cross-training provides.
“We’re pushing leaders to stretch their thinking,” Ms. White said. “It’s not always as simple as ‘a person leaves, so we hire someone new.’ The need doesn’t automatically equate to a new full-time person. So what creative alternatives can we explore? If adding more people isn’t an option, what solutions are available, and how can we work within those?”
These discussions prompt creative solutions that consider staffing collectively, and allow current employees to grow in the system while also meeting the organizational needs.
The committee has also standardized data for leaders to assess whether a new position is necessary.
“As we look toward the future of healthcare, flexibility is key,” Ms. White said. “We’re all trying to prepare for what’s ahead. We don’t know exactly what the landscape will look like, so we need to be leaner and more efficient. That means making the best use of our resources, creating opportunities for staff growth and keeping people engaged.”
The benefits
Cross-training has improved work satisfaction, staffing efficiency, flexibility and productivity.
These roles are structured to be a core part of each individual’s role, while also ensuring responsibilities are evenly distributed across members depending on volume. For example, nurses may only spend one shift per pay period or month at the call center. Phlebotomy has the heaviest cross-training utilization, with technicians picking up about 10% to 20% of their shifts as phlebotomy coverage.
The system has had to create additional training opportunities because of the high volume of requests coming in, Ms. Hartnett said.
For entry-level roles, and staff who do not want to pursue formal education, cross-training allows them to expand their skillset. It also builds team camaraderie as colleagues are given a chance to help cross-training staff learn and practice.
However, the challenge is having enough staff doing the core work so someone can be pulled away to cross-train with a preceptor, Ms. Hartnett said, “It takes a lot of planning and intentionality — it’s not something you can just roll out overnight. But when it’s done right, it makes a big difference.”
How to build a cross-training program at your hospital
It starts with having genuine interest from employees, and matching that to the organizational needs and training options, Ms. Hartnett said. Training plans vary depending on the role, so understanding the training requirements takes time.
“It’s important to invest time up front,” Ms. White said. “Identify the training requirements, the timeline, and whether you have the resources to pull someone off their regular duties to focus intensively on learning. What you don’t want is a training program that drags on because it lacks structure. You’ll end up constantly in training and never reach full implementation. Set a clear goal for how long training should take and stick to it.”
It’s also important to be open to opportunities as they arise.” The work these two leaders are doing is preventing some really difficult challenges down the line,” Benjamin Anderson, president and CEO of the system, told Becker’s. “We’re all navigating a lot of uncertainty right now, and they’ve embraced the mindset that an ounce of prevention is worth a pound of cure. By staying ahead of potential issues and being innovative in their approach, they’re setting the organization up for success.”