winston churchill the gathering storm 1948

This new problem exacerbates their pre-existing financial troubles, due to an April 2020 recommendation by CMS, in collaboration with medical societies and associations, to postpone nonessential surgeries and other procedures.

The lack of nurses has forced these hospitals to temporarily close some of their operating rooms (a key driver of revenue) due to staffing issues. 3 Per hour pay is often double that of an in-house staff nurse.Ī recent article in The Boston Globe, “Staffing shortages temporarily close operating rooms, leaving hospitals short on cash,” 4 identifies the criticality of the nursing component in our region with six academic medical centers and their continuing impact on finances. Nationwide American Hospital Association data show that the hours worked by contract or travel nurses as a percentage of total hours has grown from 3.9% in January 2019 to 23.4% in January 2022, whereas the total nurse labor expenses for contract travel nurses have jumped from a median of 4.7% to a median of 38.6% during the same time period. The composition of this vital group has changed with the demands of COVID-19. Labor comprises the largest share of operating expenses for hospitals averaging 51%, where before COVID-19, all nursing labor costs accounted for 30.1% of all hospital expenditures annually. This construct demonstrates, however, the prodigious increase in nursing costs that directly impact the vascular unit’s bottom line, particularly when viewed through the metric of relative value units-the main determinant of professional revenue. “The colinear, most powerful relationship we observed during the pandemic was that of increasing nursing expenses per case, relative value unit and per encounter.” Ochsner’s physician-hospital financial model differs from that of most vascular surgeons’ economic relationship with a hospital because certain direct costs (nursing) are allocated to the professional vascular service line. This deficit in providers results in the hiring of more expensive contract agency nurses (travelers) to provide patient care.

The focus of the Ochsner financial analysis is on how nursing costs specific to a vascular unit have risen astronomically with COVID due to the spiraling decline in staff nurses. We are facing a similar gathering storm in health care, and Brinster et al from Ochsner 2 provide the objective data on these unpleasant facts.

In his book The Gathering Storm, 1 Sir Winston Churchill emphasized the failure to recognize and heed the warning signs leading up to the World War II with the above-pointed quote. “Delight in smooth sounding platitudes, refusal to face unpleasant facts.” 1

Winston churchill the gathering storm 1948