There are few challenges more significant for health system CEOs than evolving their current workforce strategies.
Many are experiencing clinical and administrative staff shortages and seeing a larger portion of the budget devoted to salary, benefits and professional development. Inflation is pushing salaries up, and new potential regulations focused on minimum nurse staffing requirements could limit access to care. But, there's hope.
Technology, including artificial intelligence and automation, are already proving a valuable asset to hospital care teams and will become a force multiplier in the future. Virtual connection capabilities make it possible for hospitals to hire the best talent from anywhere across the nation, which makes a big difference for rural healthcare organizations with a very limited pool of qualified candidates.
Executives are also thinking differently about partnerships to elevate access to care and the patient experience without stressing the current workforce. Leaders are zeroing in on employee experience and retention as a key aspect of future-proofing their workforces.
Tommy Ibrahim, president and CEO of Cooperstown, N.Y.-based Bassett Health Network, said during a panel at the Summit on the Future of Rural Health Care, hosted by Sioux Falls, S.D.-based Sanford Health, that the employee experience is more important now than ever. His team studies turnover data and retention metrics to identify new opportunities to increase retention. Employees aren't just leaving for traditional reasons like compensation, he said; they're making employment decisions based on the leadership development experience, career development progression and harmonization of their work and personal lives.
"Last year, we recruited over a thousand people into our workforce; that's about 20% of our workforce. But that means almost nothing if we also lose a thousand and one people," he said. "The retention work we are focused on and vernacular we are trying to adopt, putting retention before recruitment, it's what our employees want to hear and see our executives really model."
Bill Gassen, president and CEO of Sanford, echoed this sentiment. The workforce can become a competitive advantage, if done right.
"That which differentiates us most from one organization to the next is our most valuable resource: our people," he said. "With that in mind, the most important thing we can do, before talking about recruiting and training the new workforce, is valuing the workforce we have today."
Sanford has made progress on its journey to becoming a "high reliability" organization. Mr. Gassen has set the expectation that all caregivers know they have the expectation to speak up for quality and safety for colleagues and patients. The C-suite is then tasked with creating an environment to thrive. Sanford's employee engagement and net promoter scores have growth over the last few years, Mr. Gassen said.
Mr. Ibrahim also said employees want to feel connected to the social and environmental dynamics of the organization, and diversity, equity and inclusion are part of that. It can be challenging in rural America to hire a diverse workforce because the community is more homogenous than in urban areas, but that isn't an excuse. Mr. Ibrahim advised creating a diverse talent pipeline intentionally from the C-suite down.
"Our board and governance structure is mandating this become a priority for our organization, putting together thoughtful metrics to solve that challenge," said Mr. Ibrahim.
Leveraging technology was also a focal point of the conversation, with each CEO integrating sophisticated digital technology into their organizations to boost the workforce without compromising quality.
"How do we learn how to best optimize and capitalize on the technological opportunities that are in front of us?" Mr. Gassen asked. "How do we augment the work they do? We will never replace them, we don't want to replace them, but allow the work they do to be more satisfying and [achieve] higher quality."
Bryan Health is in the middle of a six-year journey to integrate artificial intelligence and machine learning into the system, according to Russ Gronewold, the health system's president and CEO. The health system has partnered with Microsoft on technology to predict when patients are likely to get out of bed and send staff to the room to prevent falls.
"When the staff understood the technology wasn't the solution, it was an element of a broader fall reduction program," said Mr. Gronewold. "Once we figured that out and people realized what it was supposed to do or not supposed to do, and that it was a nice tool to help them, they really embraced it."
Bryan Health also pioneered the use of a robot to help with surgical instrument sterilization. He said the team embraced the robot and although it wasn't completing a sophisticated task, it did eliminate the frustration of staff members who were constantly disrupted by short, easy tasks throughout the day. Even though Bryan has been on the forefront of artificial intelligence, automation and machine learning, Mr. Gronewald cautioned against chasing "shiny objects."
Bassett developed an innovation institute and governance structure to sift through technology opportunities and identify potential partners. Mr. Ibrahim said he receives pitches from technology startups and companies daily, but the partnerships most valuable are companies strategically aligned with Bassett and the mission of rural healthcare. Technologies that can make the staff safer and reduce burnout are prioritized.
Healthcare disruptors such as retail and big tech companies have emerged as competitors, offering patients a low flat fee for visits. But they can also potentially be a partner as well.
"I want to rush and try to foster partners [with them] when possible so I can keep them out of my territory or at least align with them," said Mr. Ibrahim. While big tech companies have disrupted the retail industry, the healthcare industry is different and may not have the same draw without the integrated care delivery model.
Mr. Gronewald recommended focusing on leveraging current partnerships with EHR companies to solve workforce issues.