This September, the Flex Monitoring Team released the Workforce Toolkit to Support Critical Access Hospitals and Rural Providers. The toolkit was created to assist Critical Access Hospitals (CAHs) in tackling the unique issues they may face in recruiting and retaining staff. The toolkit consists of five modules, including an introductory module, which are designed to provide the most pertinent information and resources to CAHs and their leaders, as well as State Flex Programs that support CAHs. 

Module Key Points:

Introduction Module: Workforce

• CAHs face unique challenges as small and often rural hospitals.
• Workforce retention poses major issues for CAHs, particularly as burnout is a major concern for CAH staff who often have more roles and responsibilities than their peers at urban and large hospitals.
• There are a variety of resources and strategies to combat workforce shortages among CAHs: education and training, student loan forgiveness, quality of life improvement for CAH workforce, and utilization of advanced practice practitioners and traveling/temporary staff.

Module 1: Organizational Culture and Leadership

• To address their facility’s workforce needs and to prevent their own burnout, CAH leaders should have competency in many skills.
• Key strategies for promoting a positive work culture are outlined in this module, with a focus on prioritizing staff. Case studies from hospitals are provided for reference.
• Recruitment of staff for CAHs requires extra consideration, as level of fit is one predictor for employee satisfaction and retention, as well as hospital success.
• CAHs have unique traits that can be appealing to prospective staff: 
  • A different quality and pace of life that comes with rural living
  • The ability to do a wide variety of tasks and procedures that may not be possible in a large hospital
  • Becoming ingrained in their community and seeing the impact they have on their community firsthand

Module 2: Leveraging Partnerships

• CAHs can use partnerships with other health care providers, educational institutions, and community organizations to support areas of need in their hospital. Some examples of when to leverage partnerships are:
  • To address staffing shortages
  • During emergencies that require extra personnel and resources
  • When negotiating rates with insurance companies 
  • Community health needs assessments and community benefit spending
  • Workforce pathway and provider rural training programs

Module 3: Emergency Medical Services Workforce

• The wide variation in EMS organization, workforce, and service reach can pose challenges for CAHs.
• Rural EMS agencies often struggle with reimbursement and rising operational costs.
• Rural EMS agencies and CAHs (including those that operate EMS services) can utilize resources and opportunities such as education and training programs, scholarships and grants, cross-certification efforts, and strategic engagement of volunteers to bolster their EMS workforce and retention.

Module 4: Administrative & Support Staff Workforce

• Administrative staff are responsible for tasks like patient recordkeeping, scheduling, and billing, and are often the first people patients and their families encounter at a hospital. Support staff include roles like custodial and facilities management staff. This section also includes hospital technicians, such as x-ray technicians and phlebotomists. 
• Enhancing recruitment and retention beyond raising wages includes strategies like prioritizing work-life balance, offering remote or hybrid opportunities, and facilitating professional development.
• Decreasing barriers to entry is vital for administrative and support staff recruitment and retention. 
• Promoting employee safety will aid with retention rates, as well as providing quality care to patients. 

The Flex Monitoring Team hopes that the release of the Workforce Toolkit will provide CAHs and State Flex Programs with new ideas and resources to make their hospitals as successful as possible in providing a safe and satisfactory work environment for employees, as well as providing quality patient care.