Sentara recently said it would raise the salaries of most of its employees. It will also offer reimbursement for adoptions and infertility care as well as increased vacation pay, parental leave and other benefits. How does this play into your recruitment and retention strategy?
We will be short of between 300,000 and 500,000 nurses nationwide through 2028. Add to that a shortage of about 500,000 other allied health professionals, and it’s a really scary thing in terms of staffing of 12 hospitals and associated clinics. We tried to be one step ahead in terms of salaries, compensation and benefits design. To some extent, this has allowed us to stabilize our workforce. Looking at how we create better workforce flexibility for our team members will become more important to us in terms of how we think about change and how we think about matching skill sets to areas of preferred work of nurses. Then there’s the notion of getting people to practice at the top of the license. It’s about thinking about new ways to deliver care – how we leverage other team members to help in the caregiving process and free up those members to focus on their peak of Licence. We can also leverage technology to create smoother, simpler and more efficient workplaces.
We also need to do a better job of creating the desire in people to pursue healthcare careers. This is going to require us to start engaging at the high school level and educating children about the benefits of a healthcare career. We need to create the career path within our organization, and in partnership with others, to help people grow their careers.
How do you facilitate the practice at the top of license?
There are several opportunities. One: How do we cultivate and continue to evolve legislative and regulatory bodies to enable more consistency and bring us to the top of licensing across all of the different geographies we serve? Second, it’s about leveraging technology. Our doctors, unfortunately, would tell you that they spend an average of two hours documenting patient care and everything they did during their day. It’s a lot of time. The promise of electronic health records still holds. But the way we’ve built it today sucks a lot of administrative time out of those caregivers rather than having them spend their cognitive time caring for patients.
How do you meet the mental health needs of caregivers and patients?
Internally, we have created safe spaces for nurses to visit behavioral health team members in our facilities. It’s a good first step. The statistics are ugly: 100,000 nurses under the age of 35 nationwide have left the field in the last two and a half years because of stress. There is more work to do there.
Externally, the COVID-19 crisis has exposed long-simmering issues with the access, under-diagnosis, and under-treatment of behavioral health issues. You see patients in crisis presenting to our emergency departments, and there is no good opportunity to place these patients in appropriate settings. This creates bottlenecks in our emergency departments, which are not ideal for treating behavioral health patients. We have remodeled some of our emergency departments to create a dedicated behavioral health space that allows us to free up staff. We’ve also started moving towards outreach – think virtual care and try to reach people before they’re in crisis.
In the longer term, we will have to move towards public-private partnerships. These are going to look at how we are increasing the number of behavioral health professionals in the market. Virtual care holds great promise for creating better access.
We also ask the question: do we need to think differently about the behavioral health continuum of care, and how can we integrate it more into our primary care practices? Behavioral health issues usually go hand in hand with chronic care issues for many people and if one is left untreated, the other will suffer. We consider it our responsibility to determine how we can do a better job there.
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