Hospital and health system CEOs are in a position to influence their workforces, as well as healthcare altogether. As they connect with their teams, they have unique opportunities to support clinicians and their well-being.
These efforts are more crucial than ever amid staffing shortages, burnout and workplace violence.
With this in mind, Becker's asked some of our recently honored CEO influencers: How can hospital leaders decrease attrition and bring joy back to clinicians? Below are their responses, in alphabetical order.
Note: Responses have been lightly edited for concision and clarity.
Barry Arbuckle, PhD. President and CEO, MemorialCare (Fountain Valley, Calif.): The well-being and retention of our clinical staff is of the utmost importance to us. Over the past year, as we're recovering from the effects of the pandemic on our health care workforce, we have been listening closely to our clinicians across MemorialCare. We recognize the impact we can make in a clinician’s day by focusing on their well-being and giving them the opportunity to focus on why they chose health care — patient care, not the administrative tasks that get in the way of doing what they do best. MemorialCare is investing in technologies that focus on automation across our health system. We specifically are partnering with Epic to deploy the latest enhancements and AI tools that focus on administrative tasks such as in-basket messages and general document and summary reviews, to reduce our clinicians time behind a computer and allow for more time with their patients. We are also exploring ambient listening technologies that target the reduction of manual documentation and enhanced patient engagement opportunities. Each of these tools specifically target reducing physician and nursing burnout, while giving them the opportunity to reconnect with their patients, as well as their mission and purpose.
Carl Armato. President and CEO of Novant Health (Winston-Salem, N.C.): One of my favorite parts of my job as CEO is getting to round at our facilities and connect directly with our care teams about what's working, and more importantly, what's not. We have a solutions-oriented approach to every challenge our clinicians identify, and we're making fundamental changes to the way we work to reduce provider burden and recapture the joy of medicine. I've shared before that our Getting Rid of Stupid Stuff initiative has significantly reduced the workload for our clinicians, but that's just one example of how we're prioritizing the expertise and feedback of our care teams. We have clinicians serving in every area of leadership across the organization, directly shaping the care we deliver and helping adapt our operations to meet the needs of our patients and care teams.
Joseph Cacchione, MD. CEO of Jefferson Health (Philadelphia): Hospital and health system leaders must prioritize clinician well-being. Not only can it decrease attrition and bring joy back to medicine, but it can also improve the quality of care patients receive. Jefferson Health surveys clinicians annually to better understand the challenges facing our providers. Some strategies we’re working toward based on this survey feedback include:
- Building an organizational culture that values and prioritizes work-life integration;
- Reducing EHR inefficiencies and removing duplicative administrative tasks wherever possible (e.g. referrals, insurance paperwork, EHR entries, etc.);
- Having all unit/team members practice at the top of their license;
- Fostering and investing in safe working environments;
- Improving workflows and ensuring teams have the resources needed to do their jobs effectively;
- Increasing opportunities for bi-directional communication between frontline clinicians and leadership;
- Prioritizing administrative rounding to stay well-informed of challenges and opportunities facing our frontline workers;
- Educating clinicians about the importance of prioritizing their own mental health and wellbeing, and providing the necessary resources and tools to support it.
Elizabeth Concordia. President and CEO of UCHealth (Aurora, Colo.): Healthcare clinicians, including physicians, nurses, advanced practice providers and other staff members, are facing unprecedented challenges in hospitals and clinics across the U.S. Many experience workplace violence on a regular basis, and as large numbers of nurses leave the workforce or retire, hospitals and clinics are facing a shortage of healthcare workers.
To help address burnout and support clinicians, hospital leaders must listen to staff members and providers, recognize the challenges they face, and take meaningful actions to help clinicians feel safe and recognize the essential roles they have in improving patients' lives.
At UCHealth, we recently launched a new training program, SAFE, that reminds healthcare workers to assess the situation and protect themselves before they step into a patient's room. We have strengthened our responses to security and behavioral health incidents, expanded our employees' behavioral health resources, and launched clinical peer support teams. We are also communicating clearly with our patients and visitors that aggressive, abusive or disrespectful actions toward our team members will not be tolerated.
Enabling clinicians to work at the top of their scope also helps improve satisfaction. We are now expanding pilots of new, innovative roles including patient technology technicians, virtual sitters, wound care technicians and others. These new roles allow our RNs to focus more on patient care instead of managing technology, for example, which is now the focus of one of our new positions.
UCHealth also takes every opportunity to demonstrate gratitude to our clinicians and to show the impact they have on our patients. With patients' permission, we produce written or video stories about their care and outcomes, sharing these stories with our staff and providers to help kindle their passion for patient care.
Certainly, more work needs to be done, and we count on the direct involvement of our clinicians to identify opportunities and develop plans to provide even more support.
Joanne Conroy, MD. CEO of Dartmouth Health (Lebanon, N.H.): Across Dartmouth Health, we are seeing the emergence of a very different workforce than what we have been used to. Many of us had employees who spent their entire careers with us, and that's probably not going to be true in the future.
One solution we see is to have nurses operate at the top of their licenses so that they can supervise other trained staff, such as certified nursing assistants. That could result in a possible reduction in the need for nurses by 30%. A trained group of medical assistants in an operating room could perform the circulating component under the supervision of a registered nurse, who would manage a number of operating rooms.
Of course, measures like this should always be carried out directly in conjunction with the staff who will be impacted. We've heard some nurses say, "I went into healthcare because I love my patients and want to work directly with them." It's important to make these changes with nurses and not to them.
I also urge healthcare executives to engage employees to be part of their workforce rather than forcing them to fit into an inflexible model of work. For years, we offered 12-hour shifts for nurses, and many of them did not want anything different. But times have changed, and there are nurses who may not want to work 12 hours. If we can't get someone for 12 hours but can for six, we need to figure out how to make that happen. We should think with a gig-economy mentality so that once these employees come to work for our organization, we retain them.
Russell Cox. President and CEO of Norton Healthcare (Louisville, Ky.): Working directly with clinicians to acknowledge and support their sense of purpose is key to retention. Clinicians who know their "why" and feel supported by leadership are more likely to find joy in their work. It is imperative that clinicians have a voice at the table and feel safe to ask for what they need. We have asked for feedback and have actively listened via open forums, rounding, virtual meetings and surveys to understand what obstacles our teams are currently facing and what concerns and suggestions they have. Finding new models of care that help alleviate unnecessary administrative burdens and continuing to develop opportunities for personal and career growth and development also are imperative to supporting our clinicians. Collaboration and communication are key. By demonstrating our commitment to employee well-being during some of the most challenging times in healthcare, we have been able to show those across our system that we are here for them.
Airica Steed, EdD, RN. President and CEO of MetroHealth (Cleveland): I firmly believe healthcare institutions can not properly care for their patients unless they are first caring for their caregivers. This is particularly true in a post-COVID landscape which frankly pushed all of us to our breaking point. In response, CEOs need to focus on developing a people-first culture that is built on transparency, trust, intentional listening and empowerment. Employees need to feel heard and valued while also being allowed to balance work responsibilities with their personal lives. Giving caregivers more control over their work and more opportunity for work-life balance makes for happier caregivers — and happier patients.
At MetroHealth, I have created a healthy conversations series which is designed to collect feedback from all 8,700 of our employees. I want to know what is working, what isn't and what front-line staff feel can be done to improve services to our patients and communities. I am backing this up by conducting leader listening rounds at our 40-plus facilities across the region to get a firsthand look at what our caregivers experience and how I can help support the great work they undertake every day. In addition, we have created an Ask the CEO email inbox, which allows our caregivers to reach out directly to me with their concerns, suggestions, and notes of gratitude for their fellow caregivers. The feedback I have received through these efforts has helped me better meet the needs of our employees and our patients, while also advancing our mission to provide the highest quality of care to everyone regardless of their ability to pay.
Finally, I do want to point out that we need to make sure our employees can have a little fun! Given all that we have been through over the last three years, we all need an opportunity to laugh, to celebrate and to connect with others. MetroHealth has a very strong network of employee resource groups that allow individuals with similar interests to gather, participate in social activities, and give back to their communities. We also host quarterly breakfasts for caregivers celebrating milestone anniversaries and an annual food truck "palooza" at our various campuses, both of which allow folks to taste the local cuisine and interact with other members of the MetroHealth community.
These are just some of the ways we make sure our caregivers are cared for.
Warner Thomas. President and CEO of Sutter Health (Sacramento, Calif.): Although working in the healthcare industry can be challenging, especially when you consider all that's happened over the last few years, it provides those of us who've chosen this career path great purpose with the opportunity to take care of people. At Sutter Health, another high priority for us is taking care of our people, and an important part of that is helping them align their personal purpose with our organization's mission. We want our physicians, clinicians, care teams and all our staff to feel valued, respected and inspired, but also feel a deeper connection to a greater purpose.
Our goal is to make Sutter the best place to work and practice medicine, and to get there, we're increasing our investments in programs that help us build an even stronger workplace culture and are enhancing workplace safety too. This includes offering competitive pay and benefits as well as enhancing and expanding learning and growth opportunities at every level of the organization. We also work to help our physicians and other healthcare professionals think deeply about their purpose and the impact they make by changing lives every day.
We're elevating the voices of physicians so they're more deeply embedded in our operations and decision making and reducing inbox burden so they can focus more on practicing medicine. We're infusing diversity, equity and inclusion in everything we do. By aligning our teams around unified strategy that increases transparency, trust and clarity, we enhance our organizational effectiveness and also nurture a deeper connection to our collective mission and serving patients.
As a result of our efforts, staff turnover has dropped to 14%, down nearly 28% since last year at this time and far below the national average. Our journey toward supporting our teams continues, and the driving force behind all our efforts is simple: we deeply care about our people and supporting them is not just a commitment but the essence of our purpose.