Curbside Consult with Dr. Jayne 8/21/23

One of my favorite practice administrators has worked her way up through her health system and is now the head of human resources for the organization. We were catching up the other day and talked about some of the challenges she is facing in her new role.

Of course, recruiting is a major focus, especially in direct patient-facing roles such as nursing and social work. They’re also having challenges in recruiting respiratory therapists and child life specialists, the latter being more important as they’re trying to grow their presence in the pediatric hospital space.

However, retention is the largest issue she is facing, describing it as an arms race between competing care delivery organizations that serve the same markets. She’s finding more frontline healthcare workers who are willing to move from one health system to another over a few dollars in hourly pay than was common in years past, which is causing a lot of undesired turnover.

Hospitals and health systems shouldn’t be surprised by this. For some time, employees have been increasingly feeling like loyalty is a thing of the past. This sentiment was exacerbated by the things that happened during the height of the COVID pandemic, when caregivers were treated as expendable and were not supported with adequate personal protective equipment or adequate time to recover from the horror they were experiencing on a daily basis.

In my area, we saw hundreds of nurses leave a given hospital to become travel nurses at a hospital across town, making up to three times the pay. Now we’ve arrived at a new normal where salaries have adjusted and most of the travel nurses are gone, but healthcare workers are still voting with their feet. Hospitals may continue to argue that they’re working on slim margins and don’t have the money to keep up with their competitors, but I’m seeing them become increasingly creative with strategies to retain people.

My colleague’s organization is banking on the fact that AI might help augment staffing in more task-based departments such as the central billing office, credentials verification office, and even within her own human resources department. Not surprisingly, the story they’re telling is that as AI takes on tasks that require lower-level skills, they will be able to move those employees to other roles, including cross-training them to work in clinical spaces.

I think there is some level of wishful thinking in this regard. Not everyone has the temperament to work with patients who are often going through some of the worst things they can imagine. Some of the best workers I’ve encountered in clinical areas view their work more as a calling than as a job, and you can tell easily which employees are which when you encounter them as a patient.

She noted that one of her most pressing challenges will be changing attitudes about workers taking time off. She’s made it a point of engaging directly with workers to understand how they feel about the organization, and not just relying on surveys, which may not fully explain what’s going on with a workforce. She has found that some of the nurses feel guilty about taking time off, because it creates additional load for their co-workers.

Other workers, such as those in technology support and other departments, feel like they’re perceived as not being team players when they take all the time off to which they’re entitled. The organization buys back unused blocks of paid time off and has no minimum on how much employees have to take during the year. She’s been starting to socialize the idea that workers should have to take a minimum amount of time off in order to encourage them to recharge.

She’s also floating the idea of paid hours to be used for volunteering in the community, which is an idea that I really like. She’s trying to get approval for a relatively small number of hours to start, four hours every six months. In a large organization, however, that’s a substantial commitment, so it will be interesting to see how that effort plays out. I suspect that many of their employees are already supporting community organizations, so for them it would be additional compensation for things they are already doing, but for others it might be a way to encourage employees to engage in a way they haven’t done.

Given recent attention to student loans, she’s also considering expanding the organization’s loan repayment efforts. That might be attractive to younger workers, but won’t mean much to older workers. It will be interesting to see what she comes up with to balance that out across other employee segments.

I’m excited for her and enjoyed seeing her enthusiasm for her new role. Only time will tell how much support she’ll receive from her organization and whether other members of the leadership will see the proposed changes in the spirit in which they are intended. I’ve seen a fair amount of turnover in human resources roles in the last few years, so I hope she has success in this endeavor. I can imagine it might be easy to burn out if she doesn’t get the support she’s expecting, and a burned-out human resources leader isn’t going to be in the best position to help her co-workers.

With the Epic User Group Meeting this week, lots of informatics folks and health system executives have descended on Madison, Wisconsin. According to one of my friends who is a local but not affiliated with Epic, it’s “when we hunker down and don’t go anywhere, because the traffic is terrible and all the restaurants are packed.” Traffic in Madison is nothing to sneeze at normally, so I don’t blame folks for laying low when the big show is in town.

To increase my knowledge about the area, he sent me this article about the “great butter and cheese fire of 1991,” which is burned into the memories of many locals. The fire, which took more than a week to fully extinguish, was ultimately attributed to a malfunctioning forklift battery. The fire’s intensity was fueled by burning insulation and more than 12,000 tons of butter and cheese along with 5,000 tons of hams, hot dogs, cranberries, and baked goods. Firefighters on the scene described at “river of butter” that flowed when the building collapsed and described five-foot-deep pools of butter.

Firefighters were hampered by a “moat” of dairy products that kept fuel trucks from reaching the ladder trucks, leading to the need for people to hand-carry buckets of diesel fuel to keep the trucks running. Personnel from the Department of Natural Resources were on hand to protect local streams and lakes from the flood of butter. Retention ponds were used to contain butter that was flowing faster than it could be pumped into the sewer system. Several dams were built to control the torrents of butter. Ultimately firefighters had to discard most of their personal gear due to contamination and ongoing rancid smells. Here’s to hoping that we never see another event like this in our lifetimes, and that everyone headed to Madison has uneventful travel.

Are you attending the Epic User Group Meeting, and what are your favorite parts of the event? Leave a comment or email me.

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