Wicked problems are challenges that are tricky or impossible to solve due to the intertwined nature of the various factors and root causes that create the problem, most of them being difficult to even identify or correlate.
Wicked Problems, by definition, cannot be solved by a single solution or even a set of solutions. At best, the effects of Wicked Problems can often only be partially alleviated.
Here are just a few of the characteristics of Wicked Problems, taken from the 1973 paper by Rittel and Webber:
- There is no definite formulation of a wicked problem.
- Every wicked problem can be considered a symptom of another problem.
- Solutions to wicked problems are not true-or-false, but better-or-worse.
- There is no immediate solution and no ultimate test of a solution to a wicked problem.
- Every wicked problem is essentially unique.
The shortage of nursing staff is one example of the effect of the underlying wicked problem which spans multiple root causes — the great resignation, effects of the Covid-19 health crisis, systemic overwork, inefficient systems, user-unfriendly technology, overuse of traveling nurses, outdated physician-nursing hierarchy, shortcomings in nursing education, just to name a few.
Telehealth to the Rescue!
While telehealth cannot solve the wicked problem, it can alleviate the effects of the nursing shortage and chip away at some of its causes, such as stress, burnout, lack of coverage, etc.
Here are several ways how Telehealth can serve as a solution — or rather a set of solutions — to alleviate the nursing shortage.
Telehealth Workflow Design: Much of the stress in nursing is caused by poorly defined processes, especially the hand-off points from and to other workflows. By focusing on the design of proper telehealth workflows, many stressors can be removed for nurses (and clinicians, too). While, ultimately, all processes should be optimized, it is much easier to start to train on a new process vs. trying to change the established habits.
Telehealth from Home: Much of the demand on nursing in ambulatory care originates from the need to support multiple providers, oftentimes to cover for the existing shortage of nursing resources. By allowing providers to conduct telehealth visits from home a few times a week, many of the nursing tasks typical for in-person care can safely be omitted. While “TeleRooming” as well as “TeleFollowUp” for some patients is still needed, not all patients may require a nurse to be involved in these steps, thus freeing them up for other tasks.
Telehealth Support from Home: A change of pace and scenery can do wonders to alleviate stress and burnout. To support an ambulatory practice, nurses can support telehealth visits from home, including triage, rooming, and post visit tasks.