Sentara recently said that it would boost pay for most of its employees. It will also offer reimbursement for adoptions and infertility care as well as increasing paid time off, parental leave and other benefits. How does this play into your recruitment and retention strategy?
We’re going to be short between 300,000 and 500,000 nurses nationally through 2028. Stack that onto a shortage of another roughly 500,000 other associated allied health professionals, and it’s a really scary thing in terms of staffing 12 hospitals and associated clinics. We’ve tried to get ahead of the curve in terms of wages, compensation and benefit design. To a degree, that’s been very successful for us in terms of stabilizing our workforce. Looking at how we create better workforce flexibility for our team members is going to become more important for us in terms of how we think about shifting and how we think about matching skill sets to nurses’ preferred areas of work. Then there’s the notion of getting people to practice at the top of license. It’s thinking of new ways to deliver care—how we leverage other team members to help in the care delivery process and free up those members to focus at their top of license. We can also leverage technology to create smoother, easier, more efficient workplaces.
We also have to do a better job of creating desire for people to jump into healthcare careers. That is going to force us to start engaging at the high school level and educating kids on the benefits of a healthcare career. We need to create the career pathing within our organization, and in partnership with others, to help people evolve their careers.
How do you facilitate practicing at the top of license?
There are several opportunities. One: How do we cultivate and continue to evolve the legislative and regulatory bodies to allow for more consistency to get us to top of license across all the different geographies that we serve? Secondly, it’s about leveraging technology. Our physicians, unfortunately, would tell you they spend two hours on average documenting the patient care and everything that they have done during their day. That’s a lot of time. The promise of the electronic health records still holds. But the way we have constructed it today is sucking a lot of administrative time out of those caregivers rather than having them put their cognitive time into taking care of patients.
How are you addressing mental health needs both among caregivers and patients?
Internally, we created safe spaces for nurses to be able to go visit behavioral health team members in our facilities. That’s a good first step. The stats are ugly: 100,000 nurses nationally under the age of 35 have left the field over the last two-and-a-half years because of the stress. There’s more work to be done there.
Externally, the COVID-19 crisis exposed long-simmering issues with access, under-diagnosis and under-treatment of behavioral health issues. You see patients in crisis showing up in our emergency departments, and there’s not a good opportunity to put those patients in appropriate settings. It creates logjams in our EDs, which are not ideal for treating behavioral health patients. We’ve remodeled some of our EDs to create designated behavioral health space that allows us to free up some staff. We’ve also started to pivot toward outreach—think virtual care and trying to get to people before they are in crisis.
In the longer term, we’re going to have to evolve to public-private partnerships. Those are going to look at how we beef up the number of behavioral health professionals in the marketplace. Virtual care has a ton of promise to create better access.
We’re also asking the question: Do we have to think differently about the care continuum regarding behavioral health, and how do we embed it more in our primary care practices? Behavioral health issues typically go hand-in-hand with chronic care issues for a lot of folks and if one goes untreated, the other is going to suffer. We see it as a responsibility of ours to figure out how we could do a better job there.