Solving the workforce shortage

Health Progress, Mar/Apr 2003 by Burnside, Gordon

A New Book from the American Hospital Association Addresses the Growing Crisis

No health care leader needs to be told that the contemporary United States is facing a workforce crisis. In 2001, 84 percent of U.S. hospitals reported a shortage of registered nurses (RNs); 71 percent reported a shortage of radiology/nuclear imaging technicians; and 46 percent reported a shortage of pharmacists.* Although the deficits were less dramatic for other categories of health care workers, they continued across the board.

Nor is the situation likely to soon get better. Hospitals are increasingly having a difficult time hiring new workers-and at the very moment when those workers are needed most. Not only is the U.S. population as a whole aging; the vast "baby boom" generation will soon begin entering its 60s. To provide high-quality care for its citizens, the United States must first find a way to staff its health care organizations. The nation, which had 10.9 million health care workers in 2000, will need more than 14 million of them by 2010!

Unfortunately, this workforce crisis comes at a time when people are finding careers in health care less attractive than formerly. Women, for example, used to take hospital jobs because they had few other options. Today women are free to work in any field they choose. The same is true for ethnic and other minorities.

To help hospitals meet the workforce crisis, the American Hospital Association (AHA) formed the AHA Commission on Workforce for Hospitals and Health Systems. Last year, that group published In Our Hands: How Hospital Leaders Can Build a Thriving Workforce. The book is organized in five chapters, each of which offers a key to the recruitment and retention of workers. Each of the five keys is illustrated by a description of recruitment/retention efforts at AHA member hospitals.

Readers will note that CHA-member organizations are mentioned in a number of the book's recruitment/retention efforts. Many AHA-memher hospitals also belong to CHA.

FOSTER MEANINGFUL WORK

"Today," the authors write, "many workers see hospitals as traditional, bureaucratic, and driven by rules and regulations rather than caring." To change this perception, health care leaders must work with employees to redesign jobs and make them more meaningful.

Via Christi Regional Medical Center, Wichita, KS, has created what it calls an "Attending RN" care model for its nurses. Attending RNs staff nursing clinical practice groups that, like similar physician groups, accept responsibility for evening and weekend coverage. Each group has a rotating chairperson who facilitates group decisions regarding practice issues. Attending RNs take rounds with attending physicians and manage patients' clinical needs through coordination of an outcomes-driven team effort.

Teams are also at the heart of a new care model adopted by the Veterans Health Administration (VA). At VA hospitals, multidisciplinary teamsincluding physicians, advanced practice nurses, physician assistants, pharmacists, and other health professionals-provide a coordinated continuum of care to a defined population. In essence, the teams are group practices.

IMPROVE THE WORKPLACE PARTNERSHIP

"The overall situation will not improve if employees leave organizations as fast as new workers are hired," the authors say. "Retention is just as important as recruitment."

In efforts to make their workplaces more employee-friendly, both St. Marys Hospital Medical Center, Madison, WI, and Baptist Hospital, Pensacola, FL, are promoting a "no secrets" culture.

St. Marys leaders share as much informationfrom data on financial trends to strategic and legislative initiatives-as possible with staff members. Nurses have a voice in the hospital's strategic planning. At Baptist Hospital, quarterly meetings provide employees with information concerning finances, patient satisfaction, quality measurement, and other matters.

Mission St. Joseph's Health, Asheville, NC, teamed up with the federal government's Fannie Mae and a local housing coalition to make home ownership part of the hospital's benefits package. The program offers home-buyer education and assistance in securing loans.

BROADEN THE BASE

"The health care workforce does not mirror the diversity of the general U.S. population," the authors write. "Ethnic and racial minorities are severely underrepresented."

In an effort to increase minority representation, SSM Health Care, a St. Louis-based system, has launched an initiative that requires diversity training for all employees; offers a diversity mentoring program; sponsors internships and summer development programs for minority students; and presents a Diversity Forum that brings together people of color, different ethnicities, and disabilities to network and enhance their leadership skills.

The Arizona Hospital and Healthcare Association's Salsbury Scholarship Program awards scholarships to Hispanic, AfricanAmerican, and Native American students seeking careers in health care. Clarian Health Partners, Indianapolis, has joined the Indiana Minority Health Coalition in promoting activities and events that encourage minority youth to pursue careers in health care.