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COVID-19 Considerations for Hospitals: From Surge Planning to Staffing Management to Planning for the Future


During a normal year, most hospitals see fluctuations in patient volumes based on seasonality, national trends and other factors.  Never before have ALL our nation’s hospitals seen such a drastic, almost instant decrease in volumes like hospitals are facing right now during the COVID-19 pandemic. It’s uncharted territory – and knowing how to handle and prepare for these variances can determine both your short-term and long-term success. The pandemic’s impact on surge planning, staffing management and planning for the future is real. Regardless of where you are in the curve, here are some critical considerations.

Surge Planning for COVID-19 Patients

While some hospitals have hit their surge already, others may still have days or weeks to go – depending on when COVID-19 ramped up in their community. For those who haven’t hit capacity yet – lessons can be learned from other markets that may be weeks ahead. With patient volumes down in most other areas, most organizations are cohorting COVID-19 patients first in ICU and medical/surgical units. From there, as capacity and demand surges, other units are converted as needed – adding negative pressure whenever possible for proper isolation.

Before capacity reaches its peak – many organizations and communities have looked outside their four walls to find new locations to care for patients to both create capacity and prevent the spread of the virus.  Outdoor specialty tents for screening and triaging respiratory patients are often a first step. From there, some hospitals may want to evaluate the organization’s urgent care centers ambulatory surgery centers that are likely sitting vacant as volumes have plummeted. If additional capacity is needed, some communities have expanded care to hospitals that are no longer in business but still have much of the needed infrastructure to care for patients.  New York City even planned for temporary hospitals in non-hospital sites such as university dormitories, hotels and nursing homes. These non-hospital facilities can be used for a number of options to increase capacity – whether it’s for the isolation of persons under investigation (PUI) for COVID-19; confirmed COVID-19 patients who don’t need ICU-level care, or these areas could be used for treating non-COVID related patients with less acute needs or healthcare workers who wish to isolate to protect their families.

Regardless of when your surge occurs, having a task force constantly evaluating and brainstorming options for capacity management and surge planning will help streamline the process of expanding COVID-19 care into other clinical areas and/or facilities.

Best Practices for Staffing Management

Staffing for hospitals during COVID-19 requires significant strategy and a nimble approach. For health systems with a massive surge such as New York City – it takes an all hands-on deck strategy. In other markets where the COVID-19 patient volume is slower to ramp up, it can be a delicate balance.  With many outpatient and/or procedural areas closing or operating at less than 50% capacity – organizations may have nurses and staff with availability to cross-train or step in to support other areas.

Developing a comprehensive task force or committee designed to evaluate staffing needs across the system will help reallocate and/or reassign staff to support other critical operations – whether it’s to help deliver frontline care or support areas such as the Hospital Emergency Operations Center, new respiratory diagnostic screening centers or even administrative areas such as Human Resources that may need additional support during the COVID-19 chaos.  Some organizations have partnered with staffing agencies or reached out to recently retired nursing staff to prepare for the COVID-19 surge.

Sadly, some hospitals are already considering layoffs, furloughs and/or flexing healthcare workers down to part-time to protect their financial viability at a time when every day of staggering declines in patient volume can mean millions in lost revenue.

What’s Next – Preparing for the New ‘Normal’

COVID-19 has already had a staggering impact on hospitals across the country – and one that isn’t like to fade quickly given the many uncertainties around the future, continued spread of the virus once social distancing policies are relaxed.

With so much uncertainty, hospitals are left to simultaneously try and work miracles to recover financially while also planning for whatever the future holds. Here are a few tips to consider once your surge has passed as you look to embrace the new “normal.”

  • Reevaluate Your Budget: While your budget is likely set – it may very well be time to start over – or at least take a scrutinous look at any planned construction, major capital expenditures, new approved FTEs and/or other major cost line items. Most organizations’ financial standings have been turned upside down, so completely reevaluating your budget mid-year makes perfect sense in this scenario.  While it can be an exhausting process – it’s one that needs to start ASAP.
  • Ensure Your Telehealth Strategy is Sound-Proof: If you haven’t figured out telehealth yet, developing and deploying a strategy is more important than ever. With more COVID-19 surges possible over the next several months or until a vaccine is deployed – you’ll need to ensure you have a way to protect patient volumes if social distancing policies are extended and/or reinstated over the next 18 months.
  • Set Your Operational & Marketing Strategies NOW: Don’t wait until social distancing policies are relaxed to set your strategy to regain patient volumes. Plan to ramp up marketing efforts and patient engagement strategies to help reassure patients that it’s safe and important to seek medical care at every level. Develop operational plans to get elective procedures back on the books as soon as possible – and deploy strategic campaigns to bring in new patients, too. Focus on outpatient services including routine screening and physical exams, imaging services, and lucrative service lines.
  • Focus on Revenue Cycle Optimization: With every hospital in the country facing a similar fate – and many hospitals already functioning with operating losses and/or very narrow margins, optimizing the revenue cycle now will be more critical than ever. Look for opportunities to improve collections, reduce A/R days and consider partnering with an outsourcing partner who can help you develop a plan to improve your margins for the remainder of the year – given the change in volumes and many uncertainties ahead.
  • Even in markets where COVID-19 volumes have peaked, this storm is far from over for most health systems. Developing a plan and strategy for increasing volumes and revenue will be critical for long-term success.

GeBBS Healthcare Solutions offers a full spectrum of outsourced medical billing, collections, coding and telehealth expertise. GeBBS also offers a full continuum of revenue cycle management solutions to help vulnerable healthcare organizations protect their bottom line today and after the COVID-19 pandemic is behind you. To learn more about our technology enabled solutions, visit gebbs.com

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