Managing Supply By Enhancing Purpose
A common denominator across many successful initiatives, including those described below, is that employees are not just offered higher pay. Rather, the health care system tries to understand and address employees' frustrations and restore their dedication to helping others by offering training, mentoring, and career opportunities. In other words, they try to make work more purposeful. Recruits want to join organizations that have a passionate and engaged workforce. And existing employees are more likely to remain in such jobs.
Four primary factors influence the supply of available health care workers. Interestingly, many providers have discovered that improvement in one dimension often has positive spillover effects in other areas.
Retention. Amedisys, a health care system based in Louisiana, was able to lower voluntary turnover by 20% by combining traditional approaches to hiring and retention—such as onboarding interviews, quarterly pulse surveys, and exit interviews—with new, data-driven techniques. Detailed analysis of the resulting data uncovered 36 factors that could trigger voluntary departures. This type of predictive analysis has the potential to address such retention risks as early retirement and to sharpen the employee value proposition, which can help in recruiting.
Meanwhile, HCA Healthcare, which operates more than 180 hospitals in the US and UK, is addressing nurse burnout by providing real-time assistance from psychologists and social workers. It also offers a mobile app that allows nurses to connect with mentors and network with peers.
A common denominator across many successful initiatives is that employees are not just offered higher pay.
Talent Pipeline. Partnerships between institutions of higher education and employers can power the talent pipeline. West Michigan’s Grand Valley State University and Corewell Health (formerly Beaumont Health Spectrum Health) partnered to expand the number of Grand Valley nursing graduates from 1,000 to 1,500 a year through increased financial aid, curriculum enhancements, student support services, and clinical experiences. Corewell hopes the $19 million initiative will reduce its workforce gaps by improving access to local jobs and training in the medical field.
Mobility. Rather than rely on static or outdated views of staffing levels, organizations can allocate personnel to areas of greatest need. Baystate Health, which operates in western Massachusetts, created a team of professionals in anesthesia, radiology and imaging, emergency medicine, and other disciplines that it dispatches to one of four hospitals depending on need. A set of common protocols allows the practitioners to maintain the quality of care as they move from hospital to hospital.
Reskilling and Upskilling. Training and education allow an organization to develop talent within its own workforce rather than hiring from outside. LHC Group, a provider of home health services in the US, invested $20 million in the College of Nursing and Allied Health Professions at the University of Louisiana at Lafayette. The arrangement allows LHC to provide employees with discounted tuition and nurses with career progression opportunities as adjunct professors or through postgraduate training programs.
Reshaping Demand by Improving Productivity
Barring another pandemic or some other health care crisis, demand for health care is likely to remain fairly constant in the coming years. Providers can meet that demand with greater efficiency, innovation, and sophistication in the short to medium term, while working to improve the overall health of the population in the long term.
The first three initiatives described below have improved the productivity of the health care systems that undertook them, while the fourth is contributing to a healthier society. In all cases, greater productivity is reducing the need for medical care and services.
Efficient Care Delivery. The pandemic set in motion innovations in self-care, remote care, and delivery. Telemedicine and remote patient monitoring have both been around for a while but have not yet reached their full potential. BCG estimates that at least $1.6 trillion can be saved globally each year through virtual consultations and other digital services.
As part of a larger effort to eliminate defects in care, University Hospitals in Cleveland focused on discharging acutely ill patients to their homes rather than to skilled-nursing facilities. Before discharge, the hospitals schedule a follow-up visit with a primary-care or specialist physician within seven days. After one year, 61% of patients were receiving these visits, up from 25%. Readmission rates within 90 days of discharge fell from 32% to 27%.
Innovative Care Models. In the future, health care delivery is likely to be faster, cheaper, and closer to home. More than 40% of industry leaders anticipate an increase in procedures performed in outpatient ambulatory settings, and more than 60% expect to see more care delivered in nonclinical settings such as the home. We project that as much as one-third of all hospital volume could move into ambulatory, home, and virtual-visit settings over the next ten years. Solutions are already expanding to cover more points of care—including diagnostics, urgent care, primary care, specialty care, and postacute care. The merger of Teladoc and Livongo in 2020 is one example of the convergence of telemedicine and remote patient monitoring in a single company.
End-to-End Patient Journey. Every stage in the patient journey—from provider selection through posthospitalization—can be reshaped and improved through personalization. Personalized health care recognizes patients as unique individuals with unique health histories and circumstances. It aims to achieve better health outcomes by providing a tailored approach to care and a hassle-free experience.
Providers can meet the demand with greater efficiency, innovation, and sophistication, while working to improve the overall health of the population.
In just 6 to 12 months, some payers that have implemented personalization have seen the patient experience improve by 10%, administrative costs drop by 5% to 10%, and quality increase by 20% to 25%. Similarly, providers have seen significant improvements in consumer satisfaction, in the length of hospital stays, and in 30-day readmissions.
The UK's Royal Marsden, for example, coordinated cancer services through the London Cancer Hub during the pandemic. Despite an overall decrease in cancer referrals and the potential for increased cancer-related deaths, the Cancer Hub ensured continuity of care by sharing resources and staff across ten hospitals.
Population Health. Oak Street Health, a US health care provider focusing on the elderly in underserved neighborhoods, aims to keep patients out of acute-care settings through preventive and public-health measures. The organization places clinics in areas with high foot traffic, provides transportation to patients who cannot travel on their own, and urges primary-care doctors and nurses invest time in getting to know their patients. Oak Street identifies potential risks by segmenting patients into one of four tiers based on age, comorbidities, recent utilization patterns, and degree of social support. This helps target interventions and allocate resources to maintain patient health. Oak Street reports that the approach has helped to halve hospital and emergency room admissions and to lower readmission rates by almost as much.
The health care workforce crisis is real. Money is not the only answer. Many health care organizations are still able to recruit, but they struggle to retain employees. Health care organizations can heal rather than bandage their current operating model by letting productivity and purpose be their guides.
In undergoing this work, leaders should consider the following questions as prods to action:
- How will your organization harness purpose to address workforce challenges?
- What are the most effective levers with which your organization can address its workforce challenges?
- What are the partnerships your organization can establish to invigorate workforce supply?
- How big an operational and workforce benefit can your organization gain by pivoting from stopgaps, such as hiring traveling nurses, to long-term, systemic solutions?
- How can your organization ensure enduring workforce stability through targeted investments in training, retention, and efficiency?