Staffing Resources

Patient Access Staffing Problems: Why They Exist & How To Solve Them To Scale Your Organization




The Staffing Trap & the American Access Disparity

Your healthcare organization likely has two goals: operate at peak efficiency and give patients excellent care. Care that sees patients, when they call or visit your website, quickly and accurately served and scheduled. When patients do interact with your staff, those staffers should confidently and consistently direct patients to the appropriate care and to the right appointment.

But for many smaller, economy-class healthcare organizations, achieving optimal efficiency and care requires hiring and training more staff, which the economy-class can’t afford. They’re stuck in the ‘Staffing Trap.’

These are the six most urgent staffing challenges facing healthcare organizations:

Top 6 Healthcare Staffing Issues—Get FREE Checklists & Training for Your Staffing

Top 6 Healthcare Call Center Staffing Issues


High Employee Turnover  High employee turnover. 

Difficulty Attracting Quality Candidates  Attracting quality candidates. 

Skill Gap In Workforce  Skill gap in workforce. 

Unsustainable Workloads Unsustainable workloads. 

Quality & Compliance  Quality and compliance issues. 

Difficulty Managing Remote Workforce  Managing a remote workforce. 

All of these issues unleash devastating consequences:

  • Extreme AHT and hold times.

  • High abandonment rates.

  • Relentless errors.

  • Excessive no-shows and cancellations.

And these afflictions leave many victims:

  • Your patients: When your staff is under-equipped and overworked, they can’t deliver optimal service, which means your patients suffer long hold times and inferior care. According to a study by the Commonwealth Fund, many patients abandon seeking care altogether because of the obstacles they encounter during their scheduling process.

  • Your staff: Their workloads are overwhelming. The suffocating pressure to perform many different tasks simultaneously—while using outdated equipment and 100+ page manuals—leads to duplicate work, errors, and bottlenecks. And because their jobs are exhausting and aggravating, many staff members burnout and quit. This constant turnover only further exacerbates staffing problems.

  • Your organization: An organization stuck in the Staffing Trap leaks revenue and patients, which stymies any hope of growth. It’s impossible to scale if you’re stuck in the Staffing Trap.

Good news: You can break free of the Staffing Trap and harmonize your patient access. To liberate your organization, follow these steps:

  1. Identify the root causes of your staffing problems: Figure out whether the problems stem from Tribal Knowledge, Clinical Combinatorics, the Documentation Nightmare, or false expectations. Analyze your organization’s specific challenges.

  2. Implement Simple Standards: Standardize processes and create a single system that every employee can rely on. This ensures consistency, reduces errors, and makes training new employees easier.

  3. Adopt Modular Coordination: Consolidate all essential patient, provider, and practice data into one platform. Utilize templates for providers, practices, communication, and services to streamline workflows.

  4. Integrate AutomatedFlow (AI-guided call support): Implement an AI-guided call support system that reacts in real-time to specific variables, guiding staff to the correct decisions and streamlining encounters.

  5. Invest in proper training: Reduce agent training time by implementing standardized systems and tools like AutomatedFlow. Ensure that new agents are trained and ready to work within a short time frame.

  6. Eliminate duplicate work: Utilize Modular Coordination to remove redundant processes and paperwork, which will enhance efficiency and eliminate the possibility of duplicate data entry.

  7. Improve communication and collaboration: Facilitate collaboration between multiple departments through standardized systems and modular coordination to strengthen communication across all levels of your organization.

  8. Monitor and analyze performance: Regularly review staff performance and patient satisfaction rates. Utilize the data gathered through tools like AutomatedFlow to continuously enhance processes.

  9. Ensure compliance with regulations: Integrate your tools with HIPAA guidelines and other safety and privacy laws. This includes proper documentation and adherence to provider-specific protocols.

After you’ve completed these steps, you can expect amazing results:

  • Warp speed training that sees your agents work independently within 2 days of being hired.

  • Remarkably strong first contact resolution (FCR).

  • Happy patients and providers.

  • 30% reduction in call volume.

  • Silky-smooth management and seamless staff cross-training.

Causes Of The Staffing Trap

Knowing the consequences of the Staffing Trap is less important than understanding the causes of the Staffing Trap. When you understand the causes, you can attack the problem at its source.

Cause: Tribal Knowledge

Tribal Knowledge

Tribal knowledge refers to the collective knowledge, tactics, and practices shared informally among employees at healthcare organizations. Tribal knowledge is not documented or standardized; it is acquired, over time, by staff members during their day-to-day experiences. These organizational norms are often passed down from one generation of healthcare professionals to the next.

Examples of tribal knowledge include:

  • The expertise of veteran nurses in identifying and responding to emergency situations.

  • The use of proprietary medical protocols developed by experienced physicians.

  • A deep understanding of the organization's unique electronic health record (EHR) system, which can only be gained through long-term exposure to that specific EHR.

Why Tribal Knowledge Causes Staffing Problems

Tribal knowledge is undependable, unpredictable, and inconsistent because there are no standardized guidelines for your staff to rely on to perform their tasks. Tribal knowledge creates staffing problems because tribal knowledge is difficult for new staffers to learn; it is difficult for current staffers to perform; and it is difficult for experienced staffers to teach. Tribal knowledge hinges on each individual employee’s ability to learn and consistently apply it, which many employees can’t and don’t.

Patient access operations built on tribal knowledge inevitably get entangled in the Staffing Trap. Because tribal knowledge isn’t organized into a standardized system, new and existing staff must learn and perform intricate and laborious processes. These staffers are sluggish, mistake-plagued, and incapable of giving patients timely and satisfying care.

At organizations that rely on tribal knowledge, many staffers burnout and quit. And when seasoned team members leave their positions, vital information leaves with them, meaning new hires don't have the support they need to learn the ropes. This creates a nefarious Staffing Trap: You must hire more people to compensate for a lack of institutional knowledge, but you don’t want to increase your headcount without certainty of improvement—especially if those fresh recruits will soon jump ship.

Cause: Clinical Combinatorics

Clinical Combinatorics is the obscured information along multiple decision trees that creates complex permutations.


Sources Of Complex Permutations
Name  Description
Fragmented Systems Multiple disconnected systems that require manual coordination, which leads to inefficiencies and errors.
Practice Workflows Varied and complex workflows that require extensive knowledge and skill to navigate.
Provider Requirements Specific requirements and preferences of individual providers that must be adhered to, which adds another dimension of complexity to decision-making.
Patient History & Present Symptoms Comprehensive understanding of a patient's medical history and current symptoms, requiring careful analysis and judgment.
Clinical Safety Ensuring patient safety through adherence to clinical guidelines, protocols, and best practices—which adds another layer of complexity.
HIPAA Barriers Compliance with privacy laws and regulations, which may limit information sharing and hinder patient care coordination.
Fairness & Efficiency Balancing the need for equitable treatment of patients with the need for efficient operations, which requires complicated decision-making processes.

Combinatorics is the study of combinations of multiple permutations, usually with the goal of optimal selection—learn more about combinatorics here (

Clinical Combinatorics is like playing an entire chess game in a few minutes. Each piece has a unique set of capabilities, and each requires knowledge and careful thought to decide how they should move to create the best outcome. But your staff must do this with every piece during every patient interaction.

Clinical Combinatorics is complex and constantly evolving. It requires your staff members to have extensive medical knowledge and the ability to think critically and quickly. Clinical Combinatorics presents unexpected challenges that must be addressed in real-time. The ever-changing nature of medical information makes it difficult for your staff to stay up-to-date, which is a huge source of frustration.

For example, a patient calls with complex symptoms that require your staff to ask highly-specific questions to ensure proper diagnosis. Clinical Combinatorics means your staff must do all of the following in real-time:

  • Speedily and accurately assess the patient.

  • Consider all available information from multiple sources.

  • Weigh potential risks.

  • Develop a course of treatment. 

  • Document these decisions.

  • Update the EHR. 

  • Coordinate with multiple resources and other staffers.

And all of this needs to be done in a timely manner while adhering to HIPAA guidelines and other safety and privacy protocols.

Why Clinical Combinatorics Causes Staffing Problems

Clinical Combinatorics severely limits your staffing pool because only highly capable, deeply knowledgeable, and extensively trained staff can successfully navigate Clinical Combinatorics, and even experienced staffers struggle to perform their tasks given the dizzying complexity they face on a daily basis.

Which ultimately leads to the Staffing Trap: The deep operational inefficiencies caused by Clinical Combinatorics mean organizations can’t handle increasing patient demand without investing significant time and money into hiring and training highly capable new staff. For organizations consumed by Clinical Combinatorics, scaling is thus impossible.

Cause: The Documentation Nightmare

Documentation Nightmare

The Documentation Nightmare refers to the plethora of patient, provider, and practice data that is scattered across many different, disconnected, and disparate systems: EHRs, apps, and other tools.

 If your organization is trapped in the Documentation Nightmare, it’s impossible to streamline your staff’s workflows. The Documentation Nightmare slows down every task because staff must constantly jump between different tools. Worse still, the Documentation Nightmare creates an atmosphere of chaos and disorder.

Why The Documentation Nightmare Causes Staffing Problems

The Documentation Nightmare creates staffing problems because, when faced with so many different information systems, staffers must manually enter patient information into each database separately, wasting time and resources. This handicaps productivity and leads to burnout. Furthermore, poor communication between departments leads to duplicate data entry, which requires even more time and resources to correct.

The Documentation Nightmare lowers morale among staff members. When faced with an overwhelming amount of data entry and communication hurdles between departments, employees get depleted and aggravated.

Hence we’re right back in the Staffing Trap. Healthcare executives can either hire new staff to handle the excess work brought about by the Documentation Nightmare, or they can continue operating at a torpid level.

Cause: False Expectations

False expectations also contribute to staffing problems and mistaken beliefs. Here are some examples:

  • The "Turn and Burn" Fallacy: The false belief that call center roles are unskilled jobs with high turnover by nature, rather than knowledge worker positions requiring specialized abilities. This results in minimal investment in recruitment, training, and retention.

  • The Micromanagement Myth: The mistaken notion that close oversight and strict policies are the keys to efficiency. In reality, micromanagement creates stress, stifles initiative, and damages morale.

  • The Quick Fix Mentality: The expectation that staffing problems can be easily solved by tactical band-aid solutions like minimal training or arbitrary metrics. A strategic, root cause-focused approach is required for sustainable results.

  • The Helplessness Mindset: The tendency to see staffing challenges as inevitable rather than solvable. This stymies innovation and progress.

Why False Expectations Cause Staffing Problems

These problematic perspectives lead to staffing struggles in a few key ways:

  • The "Turn and Burn" Fallacy results in minimal investment in employees, leading to lack of engagement and high turnover. Constant churn impedes service quality and consistency.

  • The Micromanagement Myth creates a high-stress, low-morale environment. Employees feel distrusted and constrained, which harms productivity.

  • The Quick Fix Mentality ignores the root causes of inefficiencies, like lack of standards and fragmented systems. Band-aid solutions temporarily mask symptoms rather than drive lasting change.

  • The Helplessness Mindset becomes a self-fulfilling prophecy. Believing staffing problems can't be fixed leads to resignation rather than proactive improvements. It's a pessimistic attitude that maintains the status quo.

In summary, false expectations cause staffing problems because they prevent organizations from accurately diagnosing and addressing the real issues. Flawed assumptions lead to counterproductive practices that exacerbate staffing struggles rather than resolving them.

Solutions To Staffing Problems

Keona Health exists for one reason: to solve the biggest problems facing patient access. We’ve spent more than a decade learning about these complex challenges and developing clinically-crafted solutions that have been proven to work. So let's dive in.

Solution: ONEcare—Simplified Work & Role Enrichment

ONEcare is an innovative method for solving healthcare staffing issues through two core principles:

1. Simplified work

ONEcare streamlines complex workflows using Simple Standards, Modular Coordination, and AutomatedFlow (more on these solutions below). This simplifies work for your staff by:

  • Reduces convoluted manual processes.

  • Consolidates data into a single system.

  • Implements AI guidance to handle routine tasks.

Simplified work allows staff to focus on high-value activities rather than getting bogged down in complexity. This makes them more productive and engaged.

2. Role enrichment

ONEcare enriches roles by cross-training staff, implementing self-service options, and expanding duties. This enables staff to:

  • Gain a wider variety of skills to reduce boredom and increase development.

  • Feel empowered to have a greater impact on the patient experience.

  • Take on more responsibilities to maximize their capabilities.

Role enrichment boosts staff satisfaction and retention by making your staff's jobs more challenging and impactful.

Together, simplified work and role enrichment give your staff the tools, knowledge, and opportunities to excel. This helps solve staffing issues by enhancing productivity and engagement within your existing workforce rather than just expanding headcount.

Solution: Simple Standards 

Committed Standards

Simple Standards are a single, standardized system that every employee can rely on to perform their tasks with confidence, precision, and speed.

Simple Standards ensure consistency and efficiency by clearly defining a format and pattern to every element of your staff’s processes. Simple Standards create documentable, reliable, and scalable workflows—unlike tribal knowledge—which is undocumented, unreliable, and unscalable. 

Simple Standards play a crucial role in improving agent onboarding and productivity. Here's how:

Simple Standards and Agent Onboarding

1. Streamlined training process: Simple Standards provide a clear and consistent framework for all tasks and processes. This means that new agents can be trained quickly and efficiently, without the need to learn complex, individualized procedures. The standardized system ensures that every agent is trained in the same way, which reduces confusion and ensures all agents are on the same page.

2. Reduced training time: As explained in our blog post, How Healthcare Call Centers Can Slash Agents' Training Time To 2 Days (, Simple Standards dramatically cut down the training time required for new agents. By providing a standardized approach, new hires can become fully operational within just 2 days, a significant reduction from traditional training periods that might last weeks or even months.

3. Enhanced confidence and competence: Simple Standards empower new agents by giving them clear guidelines and procedures to follow. This boosts their confidence as they know exactly what is expected of them and how to achieve it. The standardized approach ensures that they are competent in their roles from day one, reducing the likelihood of errors and increasing overall efficiency.

4. Facilitates continuous learning and improvement: Simple Standards are not static; they can be updated and refined as new best practices emerge. This means that agents are always working with the most current and effective methods, ensuring continuous improvement and adaptation to the ever-changing healthcare landscape.

5. Cost-effective: By reducing your training times and streamlining your onboarding process, Simple Standards slash expenses. Your organization can quickly onboard new staff without a significant investment in lengthy training programs, which allows for more flexibility in staffing and the ability to respond to changing demands.

6. Scalability: For healthcare organizations that want to grow, Simple Standards are an essential tool. Simple Standards mean new agents can be onboarded quickly and efficiently, which will allow your organization to expand without being hindered by staffing constraints.

The biggest beneficiaries of Simple Standards are your patients. Simple Standards create a culture of safety by ensuring proper protocols are followed during every encounter. By creating an environment where safety is prioritized and protocols are strictly followed, healthcare organizations can ensure their patients receive the best quality of care during every interaction. And this means better outcomes and higher patient satisfaction scores.

Healthcare organizations are often faced with the challenge of growing without hiring new staff. Simple Standards optimize existing resources by providing employees with standardized systems for scheduling, symptom screening, care coordination, and more. Simple Standards allow employees to work independently while reducing burdensome workloads. Combined with their easy learnability, Simple Standards are therefore essential to escaping the Staffing Trap.

Solution: Modular Coordination

Modular Coordination

The solution to the Documentation Nightmare is Modular Coordination: A single system of record which has consolidated all essential patient, provider, and practice data into one platform that can be easily accessed by your staff in the moments that matter. This documentation system includes data about:

  • Visit reasons/appointment types

  • Insurance

  • Day and time requirements

  • Demographics

  • Patient prerequisites

  • Data to collect

  • Location

  • Resources

Modular Coordination means all of this information is organized into templates that your staff can refer to as they work:

  • Provider templates

  • Practice templates

  • Communication templates

  • Service templates

Your staff and nurses can rely on these templates rather than jumping around from system to system. Modular Coordination removes a tremendous amount of manual labor and data entry from your staff’s shoulders, freeing them to be more productive and to offer more patient-centered care. For instance:

  • Service templates contain a list of all of the services offered at a particular clinic, making it easier for staff to identify and book the right type of appointment for each patient. 

  • Communication templates enable staff to easily capture notes on each appointment for quick reference later on, as well as document any special instructions or requests from patients.

The benefits for staffing are obvious. Modular Coordination increases efficiency by eliminating redundant processes and paperwork, ensuring that no duplicates occur in the scheduling process. Modular Coordination also allows your staff to make better use of their time through more efficient methods of communication and organization. 

As a result, patients will experience less wait times and higher satisfaction rates. Modular Coordination facilitates collaboration between multiple departments, strengthening communication across all levels of your organization. The result: less staffing pressure and optimal patient care.

Solution: AutomatedFlow


The solution to Clinical Combinatorics is AutomatedFlow: An AI-guided call support system that conquers Clinical Combinatorics by directing your staff to the optimal action during each and every patient interaction. AutomatedFlow is an intuitive platform that reacts in real-time to specific variables and guides your staff to the correct decisions, ensuring that each encounter is streamlined for your staff and optimized for your patients.

Think of this AI tool as a "Healthcare GPS." It guides your staff and your patients to the right choices. It gathers immense amounts of data, which can then be used to enhance your processes. It enables follow-up communication. And it does all of this while satisfying HIPAA regulations and meeting provider-specific protocols.

AutomatedFlow solves staffing problems because it dramatically improves your staff's efficiency and effectiveness. For example, if a patient calls with high blood pressure symptoms, AutomatedFlow will give your staff recommendations for next steps and automatically alert the patient’s primary care physician. AutomatedFlow ensures your staff follows best practices 100% of the time, which means better outcomes for patients and fewer mistakes due to human error.

Organizations that utilize AutomatedFlow reap big benefits:

  • 25%+ more calls handled per hour, which means diminished wait times for patients.

  • Dramatically improved first call resolution.

  • 70% reduction in training time.

Solution: Shift Your Perspectives

The first step in solving staffing struggles exacerbated by false expectations is recognizing and rejecting the flawed mindsets that hold operations back. For example:

  • Dispel the "Turn and Burn" Fallacy by treating call center roles as specialized knowledge worker positions worthy of investment in hiring, training, and retention.

  • Avoid the Micromanagement Myth by fostering trust, initiative, and employee empowerment. Replace harsh oversight with supportive leadership and constructive feedback.

  • Break the Quick Fix Mentality by taking a strategic approach focused on underlying root causes like lack of standards. Resist band-aid tactics that temporarily mask symptoms.

  • Counter the Helplessness Mindset with a proactive, problem-solving attitude. Approach challenges as opportunities to learn rather than as inevitable realities. 

  • Develop an evidence-based outlook by analyzing data objectively. Make decisions based on facts, not on assumptions or intuition. Skepticism of "conventional wisdom" is healthy.

Keona Health has witnessed firsthand the power of shifting your perspectives. These client organizations did so and triumphed—learn how they did it here: "How These Healthcare Call Centers Solved Their Staffing Nightmare."

  • EmergeOrtho boosted their number of providers and patients by 100%—and they hired 0 new support staff to do it.

  • Virginia Women’s Center slashed training time by 70%. They also increased self-scheduled appointments by 25%.

  • Central Maine Health achieved 60% faster training time for telephone nurses and improved their call documentation from 0% to 100%.

Let’s Transform Patient Access

The Staffing Trap hurts patients, providers, and profits. But with the right tools, liberation is possible.

At Keona Health, we've spent over a decade researching the root causes of staffing problems and developing proven solutions. Our Simple Standards, Modular Coordination, and AutomatedFlow tools optimize your existing resources so you can operate at peak efficiency without expanding headcount.

Want to learn more about how Keona Health can help your organization solve staffing problems? Contact us today for a free consultation:

Our team of experts will analyze your current patient access processes and staffing situation. We'll then design a customized solution to turbocharge productivity, ensure safety, reduce errors, and strengthen care. 

Don't let staffing problems stifle your organization's growth. Let's talk about how we can work together to solve your toughest healthcare staffing challenges. Click the calendar link below to schedule a call with our team!