The future of health care lies in the quality of its people. This fact creates a significant challenge — and opportunity — for industry leaders. It's clear that the talent supply of the past will not meet the demands of tomorrow. With payments tied to patient satisfaction and quality, a lack of clinicians to care for an aging population, and shrinking reimbursement rates, health care organizations need talent that can successfully, and quickly, adapt.
Health care organizations should hire employees with more than just the usual competencies, degrees and certifications. Today, health care leaders must identify, develop and acquire employees with new skills — skills that aren't learned in medical school and weren't required to succeed in the traditional, volume-based system. This new requirement lets health care leaders create a strategic advantage by effectively building and harnessing the power of their people.
First, organizations must create a culture of engagement. Even the most highly motivated employees can derail an organization's success if they are not engaged by their leader and empowered to make decisions and drive innovation. Unhappy and dissatisfied employees not only decrease the productivity of those around them; they also can cost an organization millions of dollars when they decide to jump ship. In fact, a recent study by the American Society for Healthcare Human Resources Administration estimated that reducing turnover by just 1 percent could save an organization as much as $1 million per year.
Most critically, with an increase in hospital consolidation and the acquisition of physician practices, hospital leaders must:
- engage newly employed physicians from the onset of hire to ensure they feel valued and connected to the hospital and its culture;
- help the new physicians adapt to the organization;
- build support systems for these physicians.
Employee engagement can lead to improved patient satisfaction, better health outcomes and lower costs.
While employee engagement is critical, it's not enough on its own to succeed in today's health care environment. Organizations also need employees who can extend themselves beyond the traditional silos and collaborate across functions, departments and even venues to facilitate patient care. Finding people who can work effectively in a collaborative environment can be challenging in an industry that often has been driven by individual achievement.
Victoria Rich, R.N., chief nursing officer of Penn Medicine, an academic medical center at the University of Pennsylvania, and Patrick J. Brennan, M.D., chief medical officer and senior vice president at Penn Medicine, understood the problem when they brought together the chief medical officers, chief nursing officers and hospital leaders at Penn to acknowledge the organizational silos and lack of collaboration between parties.
"We weren't getting to where we needed to be in terms of elevating care," says Rich. "The first step was to get everyone in one room and set a simple goal around accountability. Regardless of our roles, we each had to agree to break tradition and create a culture of collaborative care."
Rich and Brennan then interviewed 24 key stakeholders and leaders from the hospital on what was most important to them. They later asked the same question of 100 clinicians, physicians, pharmacists, nurses and therapists throughout the hospital. The results were compiled into a new blueprint for collaborative care with the ambitious goal of eliminating preventable deaths and 30-day readmissions by July 1, 2014.
To reach this goal, Penn established a unit-based clinical leadership model that brought together collaborative teams of physicians, nurse managers and quality coordinators in patient units at each of Penn Medicine's hospitals. Working together, UBCL teams are responsible for innovative quality improvements that help ensure the highest level of care.
Specifically, the UCBL model was designed to increase emphasis on four main components and on working together to meet the goals set for each component.
Risk stratification. Goal: To identify patients at greatest risk for readmission and take actions to reduce or eliminate those risks. Steps: Use new-age technologies to track patients and reduce readmission rates. These include (1) the "risk flag" tool, which is installed in a patient's electronic health record and allows caregivers to calculate a patient's likelihood for readmission based on an extensive set of personal health variables, and (2) the "daily readmissions report," which provides comprehensive information to help Penn better understand trends and patterns for newly readmitted patients.
Planning for post-discharge needs. Goal: To listen to and learn from patients and create discharge goals and plans that reflect their unique needs and circumstances. Steps: Increase emphasis on planning for post-discharge needs by including nurses, physicians, nurse practitioners, social workers, pharmacists and others as identified by each UBCL team in daily interdisciplinary rounds.
Patient and family education. Goal: To make sure that patients and their families have the information they need after discharge to stay well. Steps: Increase emphasis on medication management by adding a unit-based clinical pharmacist to each unit. Develop a patient and family advisory committee. (Penn also films classes and has them available on in-house iPads for patients who are discharged between the regularly scheduled classes.)
Strong discharge communications. Goal: To make strong discharge communications a top priority. Steps: Use electronic discharge summaries that enable the electronic exchange of comprehensive patient reports between Penn's hospitals and other facilities, patients' physicians, and the patients themselves. Penn also established patient care connectors — registered nurses who follow patients for seven days after discharge to help with family support, ensure that patients make necessary follow-up appointments and take medications properly.
"It was important to get everyone on the same page and focus on enhancing the quality of patient care," Rich said. "With the new blueprint in place, we predict accomplishing our goal and higher patient satisfaction scores in 2014."
As the pace of change in the health care industry accelerates, helath care organizations also need emplopyees who can think critically andn solve problems. Healtha care professionals must be able to think on their feet, respond quickly to their patients' needs, and adapt in new situations to serve the patient and seek out greater efficiencies.
Being able to think critically while following best-practice guidelines and standards not only helps to improve the quality of care, but also inspires efficiency and cost-effective improvements. In addition, intentionally hiring for and filling departments with a combination of styles and approaches drives innovation and diverse thinking, which results in better patient outcomes.
Employees who are willing to embrace technological changes are critical to the future of health care. With EHRs and technological advances constantly changing health care delivery, organizations will need technologically savvy, eager learners who can embrace these changes quickly and successfully.
High Potential Talent
To effect change, health care executives and human resources officers must agree on the competencies critical to their organization's success. Then, these competencies must be incorporated into the organization's broad human capital strategies:
Design training and development programs to groom talent. HR leaders should create training programs designed to develop critical skills among employees. Creating enterprise-level training programs, for example, can help employees gain a broader perspective of their organization's vision and purpose, and promote collaborative behavior.
Develop recruitment processes that test for required skills. HR leaders should evaluate candidates for desired characteristics during the interview process by developing screening tools that identify candidates who are more likely to, for example, think critically or collaborate. These traits also can be revealed in behavior-based interviewing and reference checks.
Promote and reward desired behaviors. HR leaders should encourage, measure and incentivize employees who exhibit the behaviors needed for the organization to succeed. This can be done through performance evaluations, reward plans or recognition programs that send a powerful signal about the importance the organization places on these core competencies.
Maintaining a Patient Focus
Ultimately, the most important factor in the success of a health care organization is its employees' focus on and passion for coordinated, patient-centric care. Without a strong desire to improve patient outcomes, hospitals and health systems cannot excel. Hospital leaders have the unique opportunity to set an example, develop their current employees and make sure their new hires fit within a patient-centric culture.
Tim Rice, CEO at Cone Health in Greensboro, N.C., set an example when redesigning the pediatric health services unit. He brought together the doctors and nurses from the unit and asked both parties to collaborate, leaving behind their individual goals and priorities.
To ensure the patient came first, Rice placed a baby doll on the table as the centerpiece to every departmental meeting. "We wanted to set the stage and make sure everyone was focused on the bigger picture," said Rice. "Often times, we get too caught up in what's best for us. We should always be asking ourselves what's best for the patient."
Succeeding in the Future of Health Care
High-performing talent is the solution to the rising costs and challenges facing the health care industry. Organizations that take a disciplined approach and develop, attract and retain talent with these new competencies will improve patient outcomes, drive revenues and succeed.
Jill Schwieters is president of Pinstripe Healthcare, a firm that offers recruitment process outsourcing solutions for the health care industry. The firm is based in Brookfield, Wis.