Understaffing is one of the most widespread issues in the healthcare setting in the USA and many other countries. This is also one of the most burning issues in the healthcare facility under consideration. Being a certified nurse assistant, I have acknowledged the negative impact of understaffing on employees’ performance and their overall well-being, as well as patient outcomes. Nurses are exhausted, which tends to lead to medical errors and adverse effects on patients’ health or their satisfaction with the services they receive. Understaffing had been a serious issue before the outbreak of the COVID pandemic, but it became an unpreceded burden for the system during the pandemic (Lasater et al., 2020). To improve the situation, it is possible to apply the five-step process suggested by Cox et al. (2014). This paper includes a brief description of the implementation of the five-step process to address understaffing in the hospital in question.
The first step implies the identification of the constraint (the issue that deteriorates the quality of provided care). As mentioned above, understaffing is the most burning constraint to address as it leads to an increased number of medical errors, overall dissatisfaction and low morale of the staff, and inappropriate performance. As a result, patients do not receive high-quality care as nurses often have insufficient time to discuss the necessary issues with patients and families, conduct clinical procedures properly, and fulfill their tasks.
Step 2 of the process described by Cox et al. (2014) encompasses the identification of the exact ways to address the constraint. Seasonality is one of the characteristics of the problem, as the primary load is apparent in the so-called flu seasons. At this period, it is necessary to increase the number of working hours for nurse assistants who can perform multiple tasks, while nurses can concentrate on procedures that need skills assistants do not have. The assistants are often employed part-time, so it can be sufficient to increase the number of working hours of those who already work at the facility. However, it is critical to developing detailed guidelines and instructions regarding employees’ responsibilities. Each employee should understand what procedures and tasks to perform, and on what occasions when their services are not needed. It can be necessary to amend some job descriptions to implement change effectively.
Step 3, as defined by Cox et al. (2014), requires the subordination of all resources and effort to the decisions made to address the constraint. Thus, all employees should be fully informed about the changes, as well as the need for change and its urgency and potential outcomes. The corresponding discussions regarding the new guidelines and instructions should be conducted to make sure that the medical staff is aware of the new tasks and responsibilities. It is possible to create teams with leaders and mentors to help facilitate the change. Step 4 is associated with the evaluation of the system constraint, which can be implemented by conducting surveys. Patients can complete brief surveys that will include questions regarding the time nurses invest in communication with them, the quality of provided care, and their overall satisfaction with the services. Brief surveys for employees can also shed light on nurses’ workload, burnout, and performance. Step 5 can be easily implemented in this process as contracts will be signed for the most intense period, so no inertia can appear.
In conclusion, it is possible to address understaffing by increasing the number of nurse assistants on a seasonal basis. The utilization of the five-step process can ensure the effective implementation of change in the hospital under consideration. The collaboration and commitment of all staff members are critical. The model suggested by Cox and colleagues can also be used to solve other issues the healthcare facility faces.