The Trek of Unknown Territory: 5 Strategic Workforce Interventions for Healthcare Organizations to achieve Cultural Harmony in the COVID-19 pandemic.

There is no secret that the landscape of healthcare has changed in the last two years because of the COVID-19 pandemic. Organizational cultures are operating in the fog to define what the future state will look like, recruitment of qualified nursing staff is particularly a challenge, while other allied health professions are evolving. “Additionally, COVID fatigue is taking an enormous toll on healthcare workers, and as the pandemic has progressed, clinicians and healthcare professionals have had to navigate numerous policy changes, diagnostic discrepancies and treatment developments, which have been hard to manage” (Junqueira, 2020). Executives and Operational leaders must be nimble to respond to rapid change, while letting go of the ideology that things will return to practices of old, and furthermore use leadership innovation to foster cultural harmony in a new reality. ???

Here are five key strategic workforce interventions healthcare organizations should be using to traverse in the trek of unknown territory: ?

1.?Don’t forget to Butter your Bread- The pandemic has gleaned light on specialties that largely influence the bottom line for many hospitals: Perioperative, critical care, cardiovascular, neuroscience, emergency/trauma, and other complex service disciplines are struggling to attract/retain talent. Nursing/allied health professionals recognize the financial benefits of working for staffing agencies and how a willingness to travel can prove advantageous to build their own individual wealth. Many integrated health networks recognize that to be competitive, they must offer specialty incentives to keep their clinical business units operating, payout sign-on bonuses to onboarding team members, develop retention rewards for existing staff, increase discretionary benefits, pay close attention to salary structures, and create attractive total compensation packages.

2.??Unskew your View- Healthcare organizations must change traditional hierarchal viewpoints, to view organizational structures that are more representative of the continuum of services and see human capital on a circular spectrum. When clear lines of authority in leadership are drawn, combined with a role ranking of importance for the care delivery process, it is easy to forget about your low wage workers and support staff. As many organizations are dealing with the day-to day challenges of managing throughput and capacity, there is a heavy reliance on support functions in the gamut of provision of care, and the precedence to address the nursing and physician shortage is necessary.?In parallel, talent acquisition professionals and executive leaders require a multidisciplinary perspective to evaluate the many roles that continue to advance because of the pandemic. The increasing number of vented patients in critical care units has placed a new spotlight on the role of respiratory therapists, also environmental services associates have an even greater responsibility to work with Infection preventionists to control spread of the virus, while pharmacists are behind the scenes organizing vaccine storage protocols and monitoring inventory levels of remdesivir. Transporters are instrumental at getting patients from one point of care to another, CT techs are essential for lung scans/biopsies in imaging departments, and pulmonary rehab specialists offer therapeutic management interventions in the outpatient setting. These are just a few examples of pathways along the care continuum that have great impact if organizations lose sight of their importance as it relates to the pandemic. ???

3.?Know the mental pathology- Front-line healthcare leaders are creating better work-life balance for their team members to allow flexible scheduling, remote work from home opportunities, while others support psycho-social wellness to offset the general impact the pandemic has had on healthcare workers compared to other professions. Healthcare organizations need to have a general awareness of the symptomatology/psychopathology the pandemic has caused its employees and take a more proactive approach to foster an environment of care. The adverse impact of social distancing, daily changes in the workplace, loss of loved ones/family members, a newly introduced vaccine, current state of world-wide chaos, and overall disruption to life as we know it is multi-dimensional. An Italian study conducted April 2020, three weeks after the governmental lockdowns/restrictions, revealed that more than 30% of participants displayed elevated symptoms of depression/anxiety/and obsessive compulsiveness (Mariani, Monaco, and Di Trani, 2021).?The study asserted the alarming conditions caused by the pandemic for both clinical and non-clinical populations, were markers to establish varying degrees/traits between demographics, and association to severity and linguistic patterns. Thus, it is not unreasonable to think that clinical interventions are necessary to combat the psychological effects of COVID-19, and some health systems have used individual/group therapy as a coping mechanism to help care/service providers with emotional processing. ???

4.?Consider an HR consortium- Competing health systems should explore collaborative associations for tactical hiring strategies in their marketplaces. The pandemic has created bidding wars for talent, turnover rates are increasing at alarming rates, seasoned/skilled workers are retiring or choosing second careers and leaving an overall knowledge deficit in the healthcare workforce. Responsive organizations stay current to avoid pay compression or make market equity adjustments as necessary to be competitive, but the cannibalization that is occurring in the current climate is evidence that a more strategic solution is necessary. Perhaps, a shared governance for clinical resource management is ideal, or consolidated partnership agreements to determine salary ranges/position classifications for key/hard to fill positions, or early pipeline development through academic partnerships, and or multi-entity float pools for dispersion of talent across more than one organization based on resource need could provide some reprieve. ???

5.??Social Determinants of Health, Accessibility, Affordability, and DEI- Now more than ever, leading integrated health networks are more connected to the disparities in healthcare that plague the patient communities for which they serve. As population health data becomes more available, the inequities for healthcare access and affordability are more glaring in underserved communities and addressing the social determinants of health during this pandemic has been even more challenging. Beyond traditional comorbidities such as diabetes, cardiovascular disease, hypertension, mental health disorders, drug abuse, stroke, and other common illnesses: Healthcare organizations have had to build trust in minority communities often plagued by these diseases, to see the benefits of vaccination for the Coronavirus, and many health systems have made the vaccine mandatory for their workforces. Community health strategies must be laser focused, specific to target at-risk populations, leverage technology (telehealth), and offer a window seat to equitable/impartial/unbiased methodologies. Revenue Cycle Operations and Comprehensive Patient Access Centers are hard pressed to develop financial counseling processes in their pre-service/scheduling routines, making patients aware of their liabilities, and getting charitable/medical assistance when necessary. ?Diversity/Equity/Inclusion (DEI) taskforces are being assembled to offer special attention to healthcare organizational culture and requires a higher degree of attention and skill. Healthcare Executives must evaluate their C-suites and hospital boards of directors (BOD’s), to improve gender and ethnic representation specifically to match the communities for which their healthcare organizations serve and take a diagnostic analytical position on developing metrics to measure DEI performance factors. ?Few organizations are intentional to imbed these indicators into their executive bonus structures, creating a direct correlation to organizational culture objectives, and developing expectations or behavioral standards. ?Deliberate pipeline management and culpability can be achieved: Using data to evaluate size, structure, demographic make up of the C-suites, BOD’s, direct reports to the CEO, combined with selective screening of new board members, and publishing these efforts to document progress are functional methods (Larcker and Tayan, 2020). Composition is critical, no longer is it enough to check the box, DEI must be imbedded in to the organizational mission/vision/values, and rules of governance must be consequential. ???

Works Cited

Junqueira, L. (2020, July 15). The new system: How will healthcare organizations navigate COVID-19 and beyond? Retrieved from www.elsevier.com: https://www.elsevier.com/connect/the-new-system-how-will-healthcare-organizations-navigate-covid-19-and-beyond

Larcker, D. T. (2020). Diversity in the c-suite: The dismal state of diversity among fortune 100 senior executives. Stanford Closer Look Series, 1-23. Retrieved September 8, 2021, from https://www.gsb.stanford.edu/sites/default/files/publication-pdf/cgri-closer-look-82-diversity-among-f100.pdf

Mariani, R. M. (2021, August 25). Putting into words the COVID-19 lockdown experience: Psychological symptoms and referential process. (A. Taylor, Ed.) MDPI, 1-10. doi:10.3390/healthcare9091100?