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May 27, 2021

Why Is It Important to Staff Top-of-License?

There’s a better way to maximize productivity and improve outcomes: enable clinicians to practice to the highest extent of their education, training, and experience.

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Value-based reimbursement is all about improving quality of care while controlling or lowering costs. Because labor accounts for the highest portion of those costs, it makes sense (on paper) to cut that portion of the pie. For hospitals already understaffed, that’s not a wise approach. In fact, multiple studies show nurse understaffing has a negative impact on patient outcomes. And when outcomes worsen, healthcare costs also increase. 

There’s a better way to maximize productivity and improve outcomes: Make best use of the clinicians and physicians you have by staffing at ‘top-of-license.’ Staffing top-of-license helps ensure staff with the right qualifications perform the tasks at hand.


What Is Top-of-License?

Staffing at top-of-license means physicians and clinicians practice to the highest extent of their education, training, and experience. For example, an RN would focus on complex patient care while a clinician with less training and education (who would also be less expensive) would take a basic patient-facing role.


Benefits of Staffing Top-of-License

Staffing top-of-license benefits both healthcare organizations and its people. Specialization lowers labor costs because you’re not filling shifts with overqualified clinicians who command higher salaries. When hospitals utilizing a top-of-license staffing model negotiate salaries or per-diem rates, they know they’re getting the most value for their money.

Practicing at top-of-license also simplifies delegation of tasks. When clinicians perform duties that no one less qualified can perform, it’s easy to delineate certain tasks and know who cares for certain patients. There is less missed care, which leads to improved quality and outcomes. Studies also link top-of-license staffing to improved patient safety and population health.

Furthermore, when working top-of-license, staff satisfaction increases because they’re doing what they do best. The nature of their work becomes more challenging and rewarding, which improves engagement and retention. Over time, individuals improve their expertise and certain nurses may become valuable experts in a specific niche. 


How CareRev Makes Staffing Top-of-License Easier

Staffing top-of-license is a challenge for stretched-thin hospitals, but it’s possible when you have professionals available ‘on demand,’ like the professionals from CareRev.

Busy hospitals have to staff top-of-license as patient demand fluctuates. As demand rises, CareRev provides access to a range of professionals who can fill in top-of-license gaps. When an RN or CRNA takes a vacation, an experienced CareRev professional with matching skills and experience is there to fill the shift, thereby maintaining the top-of-license staffing model.

Some hospitals may simply lack the budget to hire the staff they need to operate top-of-license. In that case, they may want to lean on per-diem talent more heavily. They can access qualified RNs, CNAs, MAs, and Surgical and Radiologic Technicians in their immediate area within minutes — without pricey agency commissions. CareRev’s per-diem talent are available for shifts as short as one day and for as long as six weeks. 

Redesigning a system to implement top-of-license practice takes time. As you plan, get input from all your clinicians to find out the support they want. And know it may not be possible to redelegate all tasks. Especially as we continue to battle COVID-19, everyone has to do their part around sanitation and infection prevention.

Getting the right person to perform the right job at the right time is one way to control costs while improving clinician satisfaction and outcomes. Remember, when you can’t do it alone, CareRev can help.


Start staffing top-of-license with CareRev

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