Improving patient experience and health outcomes through a diverse workforce

Providing the highest-quality healthcare means getting nearly everything right, and perhaps the best way of gauging that is through patient experience.?

It is patients who ultimately decide how well we are achieving this, and as they do, they naturally think about the quality and effectiveness of treatment, but also the compassion with which they were treated. They tell us this in reviews, feedback and the scores they provide. In fact, being treated with kindness and compassion often outweighs even their treatment outcomes.

We know that a key quality in creating an optimal patient experience is having caregivers who look like the patients and communities we serve.

Not just because that seems like a good strategy, but because research?shows that patients do better when their caregivers look like them.?

This is also a crucial step in improving health inequities, meaning the systemic differences in the health status of different population groups, whether they are grouped by race, ethnicity, or economic status, among other factors.

But it is also necessary?for us, because one of the greatest challenges affecting healthcare organizations is the ability to hire enough caregivers. In fact, The Advisory Board in February reported “workforce challenges” as the?top concern of healthcare CEOs in 2023.?

How could it not be? You can’t operate as a healthcare organization if you don’t have enough staff to treat patients. A shortage of?technicians was identified as the biggest concern,?followed by a shortage of RNs, but we also know there are nationwide physician shortages.

Our industry shines a light on both patient experience and minority health during April, and while we must focus on these all year round, it’s an ideal time to discuss what University Hospitals is doing to retain and recruit caregivers who can provide an excellent patient experience.?

The first step, of course, is retaining and developing the staff you have. We work on this in many ways by investing in ongoing learning opportunities and support, including tuition reimbursement and training that allows caregivers to expand their scope of expertise or advance their careers. It is our UH ?“Outside In & Inside Up” philosophy, whether it is a nurse obtaining the additional credentials to become a certified nurse practitioner; or helping licensed practical nurses (LPNs) upskill to become registered nurses;?or providing the pathways for?non-degreed and non-credentialed?employees to obtain credentials and degrees so they can increase their earning potential. The latter program offers coaching, career management workshops, job shadowing, job training and education, to help them move upward.?

For recruiting, we have a number of direct hire programs. Among them are Earn & Learn Apprenticeship programs for in-demand positions such as medical assistants, pharmacy technicians and LPNs;? community programs, including the “Step Up to UH” program, which recruits chronically underemployed or unemployed people from seven Greater University Circle neighborhoods for workforce-readiness coaching, job-specific training and, ultimately, jobs at UH; the “Partner Up" program, which involves hiring high school students; and community partnerships to train phlebotomists and sterile processing techs.?

We also utilize pipeline-building programs that educate the next generation of caregivers, with particular focus on students who are?underrepresented in medicine.

The?racial composition of medical schools shows that the percentage of underrepresented minorities is far less than the proportion of underrepresented minorities who we treat as patients. So there is an opportunity to help recruit, promote and mentor underrepresented minorities to help them get into medical school and other aspects of the medical profession. For these reasons, we've invested in promoting the David Satcher Clerkship for medical students and the Second Look program for underrepresented residency applicants with the goal of increasing their representation. ?

We also are part of a Workforce Sector Partnership -- a collaboration with Cleveland Clinic , The MetroHealth System (Cleveland, OH) and Southwest General Health Center -- connecting Cuyahoga County residents to career opportunities. And we are members of the Healthcare Anchor Network where we made the commitment to align our hiring practices, so we?provide opportunities for individuals who may have faced barriers to employment due to factors such as low income, lack of access to education and training or other socio-economic challenges. ?

In 2023, 25% of UH total hires in Cuyahoga County (an area where a high percentage of economically disadvantaged people reside) came from this effort, with 88% of them being minorities. This also represented an 18% increase over 2022.

Today, workforce development is not an option, but a necessity.

However, we don’t stop there. Once hired, we want to ensure that our employees appropriately care for the communities we serve. To accomplish this, we have significantly enhanced our diversity, equity, and inclusion training and education programs. This expansion includes the introduction of more than 35 asynchronous resources that cover topics such as "Fostering Inclusive Workplaces: Activating a Growth Mindset," online bias training, bias case studies, and personalized departmental-specific training sessions.

Cultural sensitivity is also drawing job candidates, as 86% of them say the Diversity, Equity and Inclusion programs are important. We have also launched a diverse portfolio of Employee Resource Groups. ?

Ultimately, there is a significant economic burden that results from the racial, ethnic and educational health disparities in this country – estimated at $451 billion, according to a 2024 report by the American Hospital Association.?

By recruiting and retaining the best and most diverse caregivers who will assist in mitigating healthcare disparities, we will not only provide our patients with the most exceptional patient experience possible, but we will ensure University Hospitals’ legacy of healing, teaching and discovering for decades to come.