Optimizing Pediatric Surgical Care Amid the Workforce Shortage

UH Clinical Update | November 2022

The current workforce shortage in healthcare has created daunting challenges in delivering the care patients need, particularly for surgical teams. Here at UH Rainbow Babies & Children’s Hospital, for example, a shortage of OR personnel has led to surgical scheduling blocks being cut by one-third.

Tiffany Frazee, MD

Fortunately, however, the clinical leader guiding these necessary adjustments at UH Rainbow is a team player known for listening and working collaboratively. Over the past several months, Tiffany Frazee, MD, Division Chief of Pediatric Anesthesia, has worked with surgeons, nurses and technicians at UH Rainbow to find creative solutions to the ongoing staffing shortage that optimize patient care.

“Dr. Frazee has gone above and beyond to help surgical leadership at UH Rainbow manage through a significant workforce shortage,” says Ethan Leonard, MD, Chief Medical Officer, UH Rainbow Babies & Children's.  “She has worked diligently and collaboratively with the surgical divisions on hard issues including reductions and rearrangements of block times, developing process around management of add-on requests and creating metrics for monitoring impact.  She has owned the complex coordination of care to optimize our ability to maintain timely care for our patients and has been a strong advocate for the entire operative team including nurses, techs and faculty.”   

Dr. Frazee was recently recognized for this work with a “Dinner with the Doc” honor from Cliff A  Megerian, MD, FACS, UH Chief Executive Officer and Jane and Henry Meyer Chief Executive Officer Distinguished Chair.

Dr. Frazee likens the schedule adjustment process to putting together a giant jigsaw puzzle, with all the painstaking attention to detail that implies. And she says it’s taken several different strategies working together to arrive at solutions that are acceptable to everyone involved.

“We got really creative about how people share time,” she says. “A lot of credit belongs to the surgeons who rearranged clinics, office time and research time to operate when we had time for them in the OR. We’re now working longer hours in some of those rooms. Also, credit goes to the nurses who’ve remained, who’ve worked twice as hard to get things done. In addition, a lot of cases moved to our outpatient centers, so a lot of work has been done by UH Westlake and UH Suburban to accommodate many cases that they didn't have before. They've done an excellent job with that.”

Dr. Frazee reserves special praise for the OR nurses at UH Rainbow who’ve gone the extra mile to maintain surgical care for patients.

“All the credit belongs to the nurses who remain, who have been doing about the same number of cases every day, and have been doing them very efficiently,” she says.  “They really stepped up and did the lion's share of the work to make all this happen.”

Anytime you disrupt a person’s existing work schedule, there’s the potential for contentiousness. What’s helped her navigate this process successfully at UH Rainbow, Dr. Frazee says, is always remembering that significant schedule changes can be what she calls a “heavy lift.”

“Keeping in the forefront of my mind that I’m asking other people to do a lot of heavy lifting has made it much easier for me to allow them space to have their very reasonable big feelings about that,” she says.

Now in her fourth year at UH Rainbow, Dr. Frazee says she especially enjoys practicing medicine at a place that fills such a vital niche in the local community.

“There are a lot of really dedicated people here who take excellent care of a pediatric patient population that doesn't have another home in Cleveland,” she says. “There are lots of pediatric hospital beds in Northeast Ohio, but there are not a lot of other places for many of our patients to go. There is a group here at Rainbow that is very dedicated to those under-resourced patients. I’m grateful to be a part of it.”

Congratulations to Dr. Frazee on her “Dinner with the Doc” honor.

To nominate a physician for this honor, please visit the Digital Workplace.