With workforce shortages expected to continue plaguing the hospice industry, providers have stepped up staffing support and are focused on developing career growth opportunities. Some providers are engaging volunteers as well as certification programs in their recruitment and retention strategies.
The hospice and palliative care workforce has been shrinking in recent years, with staff burnout, retirement and limited opportunities in specialty training leading the charge on contributing factors. Shortages are expected to worsen during the next 25 years, with research indicating that supply of a hospice and palliative care specialized workforce will be exceeded by demand of a growing aging patient population.
Widespread shortages heightened during the pandemic, with many hospices struggling to fill their ranks and sustain operations while taking heavy blows from COVID-19. Staff burnout has forced many hospices to reevaluate their policies around paid leave and paid time off (PTO) as employees respond to childcare needs with school closures and remote learning. Some have also fallen ill to the virus themselves or are quarantining after possible exposures.
Boosting morale with staff appreciation efforts and providing increased access to mental health and PTO have been among the strategies hospices have used to foster staff resilience.
Many organizations are designing career trajectories to stem the tide of a diminishing workforce. Education will be key for hospices to unlock new doors of staffing support.
“People want to be challenged and know there are opportunities out there. They don’t want to just go through the tasks of their job routine,” said Gina Mancuso, psychosocial educator for Unity Hospice. “When we challenge them to educate themselves further and strive for these kinds of ‘feathers in their cap’ or career perks, they can then find a pride in themselves that keeps things fresh. That’s where people feel engaged and valued.”
Located in Green Bay, Wisc., Unity Hospice offers a program that supports the professional development of their social workers. Through a certification program, Unity Hospice provides certification and recertification in hospice and palliative care through paid continuing education courses, along with study materials and support of other related expenses. One of the eligibility requirements to receive this support is employment at the hospice for a minimum of three years.
Since the programs’ recent launch, two social workers and one grief counselor have completed certification through the program. Four social workers have submitted pending applications. The program is expected to sprout legs in the long term and keep staff engaged in their career development to combat burnout, according to Mancuso, who told Hospice News that there’s already an “uptick of excitement” among employees and the effects are “really showing up in patient care.”
“This program keeps people engaged in honoring their strengths, and we see extremely high job satisfaction within our psychosocial disciplines of chaplains, social workers and grief counselors,” said Mancuso. “It impacts not just the individual, but our patients, their families and our agency in general. People coming right out of college especially like to hear about this kind of support.”
Finding sustainable avenues of staffing support will be key for resurging a shrinking workforce in hospice and palliative care as providers continue to anticipate challenges ahead.
Hospice leaders identified staffing shortages as their top concern in a Hospice News survey in collaboration with Dallas-based tech company Homecare Homebase. More than 26% of 300 respondents anticipated staffing as their greatest non-COVID-related challenge, outweighing concerns about increased competition in the hospice space and new payment models.
Boosting volunteer interest is another strategy rooted to hospice career development. Under the Medicare Conditions of Participation, volunteers must account for 5% of a hospice provider’s patient care hours. Hospice providers often consider volunteers to be a member of their interdisciplinary care teams along with nurses, chaplains, social workers, the medical director, and other professionals. Hospice volunteers provide more than 19 million hours of service annually.
Dallas-based SilverStone Hospice has found success in transitioning volunteers to become full and part-time employees. SilverStone founder and CEO Alfonso Montiel himself first came to the hospice community as a volunteer.
“I touched hospice for the first time as a volunteer, and it was that experience that got me into growing SilverStone Hospice,” Montiel told Hospice News. “We’re very much a culture of mentorship right from the beginning. It’s not our second nature, it’s our first nature. We just happened to apply it to business now.”
As Montiel explained, SilverStone Hospice focuses on volunteerism as an avenue to support growth of its workforce, encouraging volunteers to seek out career opportunities within the organization. The hospice often employs routine check-ins with volunteers with ongoing surveys and evaluations about their goals and interests in different areas of end-of-life care. A vast majority of the hospice’s workforce were volunteers who were hired on as employees.
“Volunteering is creating the career opportunities for our folks to develop and run with,” said Nischelle Reagan, director of operations and sales support for SilverStone Hospice and also a former volunteer. “There have been a lot of opportunities for growth for those who have maybe never been in the hospice capacity or worked in the hospice capacity before. They want to learn more about the end-of-life care field, and that passion has turned into purpose among staff.”
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