The nursing shortage is not going away. This isn’t hyperbole. The numbers are sobering. There are more than 195,000 openings for registered nurses projected through 2031 according to the U.S. Bureau of Labor and Statistics. RN turnover and vacancy rates broke records in 2021. Median bedside RN turnover was 18%, up from 14.8% in 2020. As for those looking to enter the field or begin work at a new hospital, according to the American Hospital Association, nearly 60% of nurses name a hospital’s technology suite as an important factor in their decision making process, and 88% says that technology plays at least a somewhat important role when it comes to where they practice, suggesting that digital engagement technology could be key to attracting and retaining clinical talent.
Digital engagement technology that starts with people
The fact that we will be forced to deliver more complex care with fewer staff is leading hospital executives to recognize that technology needs to be a member of the care team going forward. While many organizations are starting to introduce the use of e-sitters, e-ICU, bed alarms, and even robots, there is a missed opportunity to leverage patient-facing technology as part of their efforts to scale care teams. At Get Well, we understand that the right technology can bring to your patients the experience they want and to your care team the solution they need to relieve some of the burden they are feeling.
At Get Well, we’re committed to delivering on the promise to meet the expectations of patients and the needs of clinical staff — so much so that we’ve expanded our leadership bench with the addition of Katherine Virkstis, Vice President of Clinical Advisory Services.
A trained primary care physician who practiced family medicine before transitioning to the research and consulting side of healthcare, Katherine brings deep healthcare knowledge, strategic insight, and operational expertise to Get Well. In her new role, she will contribute to Get Well’s enterprise-wide nursing and clinical vision and lead key initiatives, including the development and implementation of best-in-class training and cohort services.
We recently sat down with Katherine to learn more about her and to hear her thoughts on the role digital engagement technology can play in improving the healthcare experience for both patients and clinicians.
Tell us a little about your clinical background and what brought you to Get Well.
I started my clinical career as an EMT while I was a pre-med student at the University of Vermont. I later went to medical school at the National University of Naturopathic Medicine in Portland, OR, and practiced family medicine for several years in central Vermont. My practice focused on women’s and children’s health through an individualized and holistic approach. I viewed my role as a primary care physician primarily as a teacher, giving patients and families the information and tools that put them in control of their health.
Eventually I landed in the Washington, D.C., area, at Advisory Board, a subsidiary of Optum, a division of UnitedHealth Group. My teams surfaced best practices to help clinical executives solve operational, clinical, and workforce challenges. I first learned about Get Well during a research study I authored in 2009 on how to prevent avoidable hospital readmissions, in which I profiled Get Well’s inpatient patient education tools as a best practice. Over the years, I’ve kept an eye on Get Well’s growth and evolution, always feeling a personal connection to its philosophy of putting patients at the center and giving them the tools to play a more active role in their own health.
What do you enjoy most about your work?
I’m most excited to be part of a company that’s at the leading edge of the industry. More than giving patients better access to information, we are connecting patients to their care teams in ways that have never been possible before. At the same time we are freeing up time for nurses and doctors to spend more time with their patients. These are meaningful interactions that lead to safer clinical outcomes, build trust, and promote healing.
What are some of the biggest challenges facing today’s clinician workforce?
Unfortunately, the list of challenges is long. We’ve already touched on some of the statistics. In addition to those, bedside RN vacancy rates doubled from 2020 to 2021. Turnover was highest among assistive personnel. Average patient care technician turnover was 38% in 2021. That means more than one in every three patient care techs leave every year. They aren’t just leaving their hospital; often, they’re leaving the healthcare profession altogether. The International Council of Nursing predicts a worldwide shortfall of 13 million nurses by 2030. In other words, this problem is expected to get worse during the next several years, not better.
When teams are stretched thin, nurses are usually the “last line of defense.” That means nurses are doing work that typically falls outside their responsibility. That’s a problem because having overburdened staff leads to poorer clinical outcomes. When nurses take on additional work, it compromises their ability to prioritize the most critical care needs and puts patient safety at risk. In 2021, patient safety metrics worsened nationwide — we saw a 47% increase in central line-associated bloodstream infections; a 44.8% increase in ventilator-associated events; a 33.8% increase in methicillin-resistant Staphylococcus aureus; and an 18.8% increase in catheter-associated urinary tract infections.
It’s frustrating for nurses, who aren’t likely to remain in a job that consistently pulls them away from the care they are educated to provide; that frustration further escalates turnover rates.
It’s costly to pay highly skilled clinicians to do work that could be accomplished by unlicensed assistive personnel. All of this is happening in a tough business environment. Health systems have reported margin erosion caused by soft volumes (5% lower than pre pandemic levels) and increased labor costs (up 37% from 2019). The average total premium labor expense as a percentage of payroll expense doubled from 4.8% in 2020 to 9.7% in 2021.
What is the best way to address those challenges?
We won’t be able to rely on traditional workforce tactics or pre-pandemic staffing models moving forward. We’ll have to think differently about the role that technology can play. The need to scale clinician impact through digital engagement technology is clear — to drive both efficiency and care quality. What might be less obvious is that patients are key to achieving that efficiency. Patients have become accustomed to using mobile apps that enable faster self-service with more visibility.
Get Well can play a really important role by reaching more patients through the same tools with which they are most comfortable and familiar. Get Well’s digital engagement technology automates select care team workflows and responsibilities thereby allowing the care team to focus on core nursing activities. We also leverage SMART app technology and native messaging within the EHR to provide real-time updates and allow staff to prioritize those patients who need immediate attention.
This insight — that patients are a key to provide clinician relief — was the inspiration for Get Well Together. The easier it is for patients to self-serve and self-manage, the more effectively clinical care teams can provide patient care. Ultimately, we can help our clients achieve a better experience for patients and care teams at once.
Katherine will share more of her thoughts on how digital engagement technology can support nurse workflow in a JONA: The Journal of Nursing Administration article in the coming weeks. Stay tuned for more from her there and of course here on the Get Well blog.