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U.S. Department of Health and Human Services


Exhaustion in the ED and Beyond: Managing Supply Shortages and Staff Fatigue in Healthcare Facilities

Author: Laura Kwinn Wolf, Ph.D., Director, ASPR Division of Critical Infrastructure Protection and Michael Eltringham, Stakeholder Engagement Analyst, ASPR Critical Infrastructure Protection Program Contract Support
Published Date: 2/19/2019 10:54:00 AM
Category: Hospital Preparedness;

Blog Series: Anticipating and Managing the Challenges Associated with Supply Shortages

The next time you face a supply shortage – from saline to syringes – brace yourself. Another shortage may be on the way:  staffing. As we discussed in the first blog in this series, hospitals and healthcare facilities face supply shortages every day, and these shortages require staff to dedicate more time and resources so they can continue providing patient care.

These extra demands can be hard enough to meet during normal operations, but they are especially common and difficult to handle during a disaster.  Long after Hurricane Maria struck Puerto Rico, saline IV bags, cancer drugs, and other critical pharmaceuticals and medical supplies remained in short supply.  When the added stress of a disaster meets increased demands caused by a prolonged supply shortage, your staff may not be able to cope if you don’t have a plan in place. 

Hospital and healthcare facility administrators can keep their facilities operational, continue caring for patients, and better meet the needs of their staff by watching for signs of staff fatigue, taking steps to mitigate or alleviate stress, and partnering with volunteer organizations.

Monitor Staff Fatigue

It is normal for any shortage or disaster response to increase a staff’s workload. Have a plan in place to account for staff fatigue.  It is no surprise that fatigue often sets in when work hours become longer and more intense. When your staff is fatigued, they are less likely to provide effective patient care, more prone to mistakes, solve problems more slowly, and are more likely to get injured on the job.  Fatigue can be a serious threat to both your staff and your patients.

Foster an open environment where staff members can feel comfortable expressing difficulties in managing a shortage response. If additional training is needed or if your staff is overworked, they should be able to freely communicate these concerns with hospital or healthcare facility administrators.

However, don’t expect that your staff will always knock on your door and tell you what is wrong.  Get to know your staff before a disaster strikes and learn to recognize early signs of stress before they become a major problem.  To find out how you can better recognize signs of stress in your workforce and steps you can take to help your staff cope, check out Building Workforce Resilience through the Practice of Psychological First Aid – A Course for Supervisors and Leaders.

Plan to Mitigate Staff Fatigue

In 2018, FEMA issued 124 disaster declarations and, right now, there are more than 100 FDA-recognized drug shortages.  With so many disasters and drug shortages, one or both are likely to impact your facility.  Make sure you have a system in place to identify health and safety risks, and be ready to help.  Have a plan to implement rotating, flexible schedules during an escalating response to help staff remain at peak performance.  Wherever possible, cross-train staff members on multiple roles to minimize the probability of an improper supply application.

To learn more, check out the ASPR TRACIE topic collection on responder safety and health, which includes materials on managing staff fatigue.

Reach Out to Volunteers

Facilities should also coordinate with their state and local health departments to identify qualified volunteers to assist when they suffer staff shortages due to fatigue.

Before a disaster strikes, consider reaching out to your local Medical Reserve Corps (MRC) unit. The MRC is a community-based program that organizes and utilizes local volunteers to promote community health and enhance emergency preparedness and response. Across the country, nearly 200,000 MRC volunteers among almost 1,000 units dedicate their time and expertise to helping their communities.  MRC volunteers include registered nurses, EMTs, physicians and other medical and non-medical personnel who can help your hospital or healthcare facility during a crisis. 

MRC volunteers can help hospitals keep meeting patient needs by augmenting hospital staff, staffing mobile hospitals, providing telephone and administrative support, and more.  If you plan to incorporate MRC into your hospital operations, it is always a good idea to plan ahead.  Encourage MRC units to participate in exercises and trainings so you are ready to respond together.

To start a conversation on incorporating MRC units into your hospital’s emergency plans and to see if your local MRC unit could help provide surge capacity, contact an MRC unit in your area.

The Anticipating and Managing the Challenges Associated with Supply Shortages blog series is designed to highlight actions that healthcare organizations can take to protect patient health in the event of a supply shortage.  The first post in this series detailed Four Ways to Plan to Protect Patient Health in a Medical Supply Shortage. The next post in this series will look at recommendations and resources for building partnerships.   To stay up to date as new blog posts are published, follow us on TwitterFacebook or LinkedIn.



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