By A. Kevin Troutman, Partner, Fisher Phillips
At the dawn of a new year, experts agree that human resources professionals in the health care industry face daunting challenges. In fact, even the single most long-standing challenge now comes with new twists.
Including huge hospital systems, neighborhood physician and dental practices, clinics, diagnostic centers and home health agencies, to name a few, the health care industry comprises a vast slice of the country’s economy – as much as one-sixth, many studies suggest. More fundamentally, everyone has a personal stake in the well-being of a system that cares for the injured, sick, and infirm. In short, health care leaders must find ways to meet looming HR hurdles.
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Even after taking new twists into account, the core challenge for health care HR is all-too-familiar. Almost all other major twists and challenges intersect with this one.
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Specifically, nearly all studies and literature agree that HR leaders face growing pressure to recruit and retain talented, engaged staff to meet the industry’s growing workload. Several factors complicate this challenge, including the aging workforce, coupled with the increasing demand for health care services; burnout and disillusionment by many qualified professionals, including nurses; new and rapidly changing technology; generational differences within the workforce; workplace health risks; regulatory requirements; and training/development demands.
Staffing needs are not limited to a demand for nurses and doctors. They include other specialized clinical professions; workers who manage and develop technology; those who take care of the plant and equipment, including maintenance and custodial workers; admitting and billing staff; and those who prepare and serve the food, to name just a few other job classifications. Recruiting, screening and orienting new employees are, of course, costly and time-consuming.
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Just a few facts illustrate HR’s dilemma. Studies generally agree that nearly one of every five hospital employees leave their jobs each year. Stated another way, about 85 percent of jobs turn over during a five-year period. Nurses, who comprise the largest single group of hospital employees, turn over at only a slight lower pace.
If health care employers could hang on to more employees, it obviously would ease the need to recruit more new hires. This is obstacle is becoming increasingly difficult to overcome, however, because millions of baby-boom workers are retiring each year. Nursing schools and other educational institutions seem unable to keep pace with the growing demand. Further, most new grads face a steep learning curve when they first face the realities of clinical practice on the front lines. The shock of that initial transition even causes some to question their career choice and possibly change jobs.
Retaining great employees is difficult for several other reasons. Many clinical professionals, especially registered nurses, cite burnout as a reason that would lead them to consider changing jobs. Burnout often results from perceptions of short staffing, a situation that can create a self-fulfilling prophecy. Other oft-cited reasons for burnout are perceived lack of respect or advancement opportunities. If nurses do not believe they are treated well or do not feel sufficiently connected to nursing leadership, they are unlikely to stay longer with their employer.
According to the Occupational Safety and Health Administration (OSHA), health care workers also are at high risk for workplace violence incidents. This makes sense, considering the settings, such as emergency rooms, home care visits, and interactions with patients who are combative, perhaps due to drug use. Hospital employees also are exposed to infectious diseases. A very dramatic example was the Ebola scare that emerged just a few years ago. Inadvertent needle sticks or other sharps injuries pose another risk.
If that is not enough, the rapid digitization of health care poses unique challenges from both security and training standpoints. This may be particularly true for employees who grew up documenting everything on paper. Digitization (or computerization) creates new security risks, including those as basic as avoiding clicking on suspicious emails or unverified links, as well as proper use of passwords, keeping display screens from being visible to unauthorized personnel, and not leaving a digital workstation unattended. And, of course, each improvement in technology also requires teaching users how to navigate the new system.
This point highlights yet another developing issue. Workers from different generations tend to view the workplace – and their entire approach to their jobs – differently. For example, while baby boomers and Gen Xers may have focused on competitive compensation, millennials are far more interested in flexibility, fringe benefits, and advancement opportunities. Generational differences may also lead to more workplace rivalries or conflict, which leaders must attempt to manage. All of this occurs in a very competitive, cost-conscious, and highly regulated environment.
Meeting the Challenge
With these considerations in play, what can HR leaders do to meet the challenge? Solutions probably begin with development of an overall strategic and cultural plan that fits the organization’s resources and values.
Planning should encompass various types of communications. This includes communications with the staff to convey the employer’s awareness of and plans to deal with their concerns and to solicit (and respond to) staff comments and complaints; communications with supervisors and leaders to emphasize the importance of being visible, respectful and responsive to all employees; and announcements about what management is doing to address employee concerns, such as improving workplace safety. Regularly share management’s vision of the organization’s future and the employees’ role in it.
Support these communications with supervisory and leadership training. Teach employees more about how staffing patterns work, and consider innovative ideas for hiring more nurse-extenders, for example. Then train the nurses to better equip them to supervise such employees. Train supervisors about their new role, drawing clearer distinctions between direct care-giving and managing the work of others. Supervisors must recognize the importance of not letting problems fester. And always keep in mind that, to front-line employees, supervisors, and leaders are the face of the organization.
Also, provide plenty of training to enable employees to use technology effectively and securely. This includes training to safeguard the privacy and security of patient and organizational information. Keep in mind that, even though health care providers are inviting targets for malicious hackers and malware, the greatest security risks lie with the internal users of an organization’s cyber-systems.
When planning training offerings, do not overlook the desires of millennials (and others) to learn new things and advance in their careers. Consider tuition reimbursement programs if these are not already in place. Develop relationships with schools that train future nurses, laboratory and imaging techs and information technology professionals, among other things. These provide great ways to screen and recruit qualified applicants.
Evaluate the needs and priorities of senior employees who are considering retirement, but who might be interested in scaling back to reduced schedules. To the extent possible, keep flexibility in mind. Provide innovative staffing apps, where feasible, to permit employees to volunteer for additional shifts or to find schedules that work best for them. Also, since it remains true that about 90 percent of RNs are female, those who are having and raising children will be attracted to employers who offer family-friendly policies, programs, and scheduling practices.
In sum, 2020 promises to be another challenging, but exciting year, with opportunities to innovate and shape a brighter future. While the stakes have never been higher, the potential rewards have never been greater.