ABSTRACT
Background/Case Studies: Ongoing labor shortages occurring during the SARS-Co-V-2 pandemic caused the blood center to re-evaluate current nurse staffing schedules and clinical offerings in the therapeutic apheresis department in order to maintain high quality apheresis delivery to hospitals and improve work-life balance for the apheresis nursing team. A major area of concern was the amount of on-call coverage the apheresis nursing staff experienced. Study Design/Methods: An internal working group (WG) of medical, nursing, administrative, and financial subject matter experts was assembled to evaluate the current model of 24-h, 7-day-week apheresis coverage with nurses regularly scheduled to cover day shift hours and take on-call for after hours and weekends. The WG reviewed hospital apheresis contracts, nurse on-call schedules, types of apheresis procedures, number of after-hours procedures, and geography of service requests for the prior 12 months. Alternative models for nursing staffing that would reduce on-call for the nurses were considered, including full nursing coverage for 3 out of 3 shifts, flexible 3- and 4-day work weeks, and limiting apheresis services to business hours only. Results/Findings: It was determined that covering 3 out of 3 shifts with full nursing staff in order to eliminate oncall would require hiring 8 additional nurses (representing a 25% increase in staff) at a cost of $650K annually. Flexible shifts of 3- and 4-day work weeks added scheduling complexity without resolving the on-call issue sufficiently. Analysis of the types of procedures performed after hours revealed that over 70% were non-emergencies. Limiting hours of apheresis services to 8A-5P M-F with after-hours available only for emergencies approved by the ordering clinician and blood center medical director offered a costneutral approach that mitigated on-call for the nurses and relieved current nursing staffing shortages. Conclusion(s): Chronic and significant labor shortages emerging from the pandemic necessitated changes to the way blood center apheresis services were offered to our hospitals. In-depth analysis of current offerings and types of procedures performed after business hours resulted in the development of an alternative, cost-neutral model for maintaining apheresis service levels and improving work-life balance for the apheresis nursing staff.