Staffing Pressures Push Hospice Providers to Reevaluate Care Delivery Models

Long waiting periods for home visits and mounting pressure on clinical staff are forcing hospice and palliative care providers to rethink how services are delivered. The issue is not simply a matter of growing demand. It is also a question of whether existing care models can support increasingly complex patient needs without placing additional strain on nurses, social workers and caregivers.

Care in hospice and palliative services requires significant collaboration between clinical teams and the patients' families. Such an approach is hard to maintain if there are staffing shortages, which make the provision of services and the process of intake of patients more complicated. Providers have to take care of more patients, at the same time maintaining the necessary level of interaction with the families of the patients in emotionally charged situations.

The issue has wider consequences for the healthcare system. The delay of palliative support may negatively influence the discharge process and place extra pressure on the acute setting. The hospitals have to be able to provide the patients who do not need intensive care anymore, but who still require careful management of their symptoms and family support, with the appropriate community services.

In response to such issues, many healthcare providers re-examine existing care pathways and resource allocation strategies. Some healthcare providers focus more on the processes of triage and prioritization. Other organizations look into the possibility of involving non-clinical personnel and community organizations in providing some aspect of care.

The pressure is also changing discussions around workforce planning. Hospice organizations have traditionally focused on direct care delivery, but staffing constraints are encouraging leaders to think more broadly about recruitment, retention and the long-term sustainability of specialized roles. The challenge is particularly acute because hospice and palliative care rely on skills that cannot be replaced quickly through short-term hiring efforts.

Payers and health systems are now paying more attention to this issue. When there are gaps in service delivery within the community, other parts of the health care system experience expenses that could otherwise have been avoided. For example, the patient who did not receive timely help stays longer in the hospital or experiences unnecessary emergency measures which could have been avoided if he/she had received earlier palliative services.

The present circumstances imply that the effectiveness of the solutions for the problems of hospice and palliative care will become more connected with workforce issues and capacity issues. Buyers may focus more on such models of delivery that can ensure continuity of care even if there are problems with staffing. The discussion has moved from the expansion of the services to their sustainability.