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Workforce Challenges in 2021

Fletcher Lance

Nursing Shortage, Remote Staff Create Unique Challenges

Healthcare providers in 2021 are facing unprecedented workforce challenges. As COVID-19 continues to drive changes on all fronts, employers are struggling to leverage patient care with evolving personnel and budgetary constraints.

"It's a tale of two realities," said Fletcher Lance, CEO of The Hardenbergh Group, which provides staffing, consulting and business services to healthcare providers. "For many hospitals, a large percentage of staff are still coming to work every day, while a large number are also working from home. It's a complex workforce to manage."

Nursing Shortage

Navigating the current surge in nursing need amid an already critical shortage is a struggle for most providers, and Lance said the unpredictable environment often means paying premium prices to remain fully staffed. "I've heard of RNs costing as much as $200 an hour," Lance said, pointing to a nationwide nursing shortage of 20,000.

"Right now you might have to meet that peak, as we sort through what it's going to look like after COVID and how we solve the surge. It's double level contingency planning: What happens if one nurse gets sick and exposes four more who can't work? How do I meet that need financially and resource plan when I don't' know if one impact will actually equal four?" Lance said of the thought process for employers and administrators.

He said today's providers also are relying on medical students and other skilled workers to fill in gaps. "People are looking everywhere to meet the demand."

Back to Work

For many of Hardenbergh's 150-plus providers, getting back to work means transitioning to remote services, which are often favored by patients who appreciate the safety and cost savings of telehealth. Still, he said providers should be commended for their willingness to remain on the front lines. "Our medical professionals have a high commitment to serving the COVID population and others. It's been so impressive," Lance said.

Continuing to support staff also should be imperative to leaders, now on the other side of the PPE and ventilator shortages rampant in 2020. Lance also is encouraged by promising treatment and vaccine development. "The courage providers have shown is amazing," he said.

Hybrid Scheduling

An estimated 70 percent of administrative professionals in a healthcare organization are now working from home, often with no end in sight. That's because the situation hinges on variables like vaccination availability and school schedules. "It's so uneven across the US, which makes it super hard to plan," Lance said. "We want to be thoughtful around coworkers' needs, which is why we're not seeing many mandates dictating when someone has to be back in the office."

For many employers, the need for flexibility has led to hybrid scheduling, allowing employees to choose days they work based on personal needs and individual risk factors and allowing them to return when, and how, they wish.

Finding Hope

As COVID diminishes and remote and onsite staff slowly reunite, Lance said it will be interesting to see how the two worlds come together. "Those are discussions going on at most organizations, as certain groups are impacted differently," he said optimistically, noting a recent comeback at The Hardenbergh Group similar to pre-March 2020 numbers.

"Everyone I've talked to recently has been optimistic about the future," concluded Lance. "There will be challenges we all face, but the economy will come back; the elective procedures will come back; and telehealth is not just here to stay, it's become a great addition to other modalities. The executives and leaders I've spoken with are all becoming more optimistic about the future, so I'm very encouraged by this buzz."

A New Role for Lance

A well-known Middle Tennessee healthcare leader, Fletcher Lance recently was tapped to lead the Hardenbergh Group, a healthcare holding company in Nashville that provides staffing, consulting and business services to various healthcare providers in the areas of credentialing, privileging, third-party peer review, risk management, compliance and quality assurance. The Hardenbergh Group is owned by Lead Capital Partners, a private equity firm headquartered in Nashville.

Lance joined the company as CEO after spending the last four years at Vanderbilt University Medical Center, where he served as executive vice president and oversaw the medical center's Vanderbilt Health Professional Solutions (VHPS). During his tenure, VHPS launched and dramatically grew four for-profit portfolio companies: Vanderbilt Supply Chain Collaborative; VHRxS, a specialty pharmacy business; Nashville Biosciences, a genetics company using data to drive R&D; and is in the midst of build a state-of-the-art lab services company for VUMC.

Previously, Lance was the Global Health Care Practice lead and managing director for North Highland, a national management consulting firm focused on strategy, operations and technology. In his 12 years at North Highland, he helped grow the healthcare practice from under $5 million to more than $50 million in revenue for the company.


Hardenbergh Group


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COVID-19, Fletcher Lance, Healthcare Workforce, Nursing Shortage, Remote Workforce, The Hardenbergh Group
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