AHA: ‘A Strong and Resilient Workforce is the Backbone of Our Hospitals and Health Systems’

By Christopher Cheney

A new report published by the American Hospitals Association (AHA) calls on health systems and hospitals to focus on three core challenges to address the strained healthcare workforce.

Health systems and hospitals are facing widespread workforce shortages, particularly in nursing. Top healthcare executives say staffing shortages are their most pressing clinical care problem now that the crisis phase of the coronavirus pandemic has passed. Burnout has spiked during the pandemic.

The new AHA report says the healthcare workforce needs to be a top priority for health systems and hospitals. “A strong and resilient workforce is the backbone of our hospitals and health systems. There is no higher priority than ensuring that we care for the caregiver, that we make our working environment safe, and that we foster the ability for individuals to have joy in their work. While healthcare workforce challenges are not new, the pandemic has greatly exacerbated them. This national emergency demands bold, immediate action from public and private sector leaders.”

Core workforce challenge 1: Reconnecting clinicians to professional purpose

Promoting a sense of professional purpose is essential to sustain the healthcare workforce, the report says. “As part of efforts to successfully recruit and retain a qualified, dedicated and diverse workforce, hospitals and health systems must create environments that consistently support meaningful work and nurture relationship-building with colleagues, patients, and families. Maximizing patient care time while minimizing administrative tasks is essential to reinspiring workers to find the joy, satisfaction, and meaning they value so highly.”

There are five primary approaches to reconnect clinicians with professional purpose, the report says:

  • Culture: Health systems and hospitals should foster organizational cultures that are aligned with mission-driven values such as empowerment, responsiveness, and collaboration.
  • Determine what matters to employees: Health systems and hospitals should use employee engagement tools such as onboarding, surveys, town halls, and rounding to recognize the needs of workers and establish a work environment that they value.
  • Strengthen employee satisfaction: To decrease burnout and increase retention, health systems and hospitals should focus on employee satisfaction through efforts such as safe work environments, competitive compensation, adequate staffing levels, flexible scheduling, and shared decision-making.
  • Support self-care: To provide high-quality care to patients, clinicians need to take care of themselves. Health system and hospital leaders should encourage clinicians to seek care for their physical and mental health. Organizations should offer educational programs as well as self-care resources that meet a range of needs.
  • Embrace patient-centered care: Patient outcomes and wellness should be pivotal elements for models of care. Technology should support better care and boost direct patient interaction.

Core workforce challenge 2: Provide support, training, and technology clinicians need to excel in multiple care settings

The shift in care delivery from the hospital setting has accelerated during the pandemic, the AHA report says. “The pandemic has accelerated changes in the ways care is delivered, with a wider acceptance of virtual in addition to in-person options. The settings where care is delivered also continue to expand, whether it’s where patients live, in outpatient clinics, in community facilities or in hospitals. The ability to succeed in, and transition seamlessly between, a wide variety of care environments requires new skills and technologies, new flexibility in the workforce, and innovative strategies for workforce management.”

There are six primary approaches to support this shift in care delivery, the report says:

  • Go virtual: The report calls on health systems and hospitals to seize virtual care opportunities. For example, Des Moines, Iowa-based MercyOne has launched a virtual nursing model that has a virtual nurse assist bedside nurses in monitoring patients, communicating with patients, and discharge planning. The virtual nurse program has improved patient safety and quality, enhanced communication between patients, family members, and care teams, and boosted clinician satisfaction and productivity.
  • Embrace technology: To automate repetitive tasks and improve clinical productivity, health systems and hospitals should launch a range of technological solutions, including natural language processing to ease documentation burdens and artificial intelligence to mine big data.
  • Care delivery model innovation: High-tech and high-touch approaches to care delivery models have the potential to improve quality of care and achieve staffing efficiency. For example, Partners for Nursing Staffing promotes a care delivery model with three elements: on-site care, patient monitoring equipment, and ambulatory access as well as virtual and remote care delivery.
  • Professional development: Foster expertise and leadership skills by offering interdisciplinary training across organizations, departments, and sites of care.
  • Focus on young workers: Health systems and health systems should build nursing and healthcare competencies in high schools as well as offer undergraduate scholarships.
  • Clinical professional training programs: Clinician and nurse education programs should promote the use of new technology, cultivate multidisciplinary care teams, and promote soft skills such as listening and empathy. These programs should also include exposure to home health services and incorporating family views in care.

Core workforce challenge 3: Recruitment, retention, and pipeline

Workforce development is crucial, the report says. “To ensure high-quality patient care now and in the future, healthcare workforce recruitment and retention must be top priorities in the short term. At the same time, developing a robust pipeline is critical to creating a sustainable long-term solution.”

There are 11 primary approaches to recruitment, retention, and a robust employee pipeline, the report says:

  • Training options: Health systems and hospitals should work with schools, community organizations, and other healthcare organizations to offer apprenticeships and other on-the-job training opportunities.
  • International recruitment: Health systems such as Sioux Falls, South Dakota-based Sanford Health are recruiting nurses from overseas. These hiring programs can include housing during the transition period as well as working with international nurses to help them fit into their new communities.
  • Nurse training programs: In 2022, about 60 schools and hospitals have either launched or expanded nursing programs.
  • Promote flexibility: Offer flexibility in areas such as scheduling and remote work.
  • Boost upskilling: More than half of healthcare workers say they want upskilling, which can reduce financial barriers to advancing professionally.
  • Invest in onboarding: An effective onboarding program supports retention by establishing engagement at the time of hiring and building employee loyalty.
  • Inclusive workforce: Health systems and hospitals should support the efforts of medical, nursing, and allied health schools to promote diversity in their students. Health system and hospital leadership should embrace diversity, equity, and inclusion.
  • Offer nontraditional support: As part of recruitment and retention efforts, health systems and hospitals can offer housing grants or build affordable housing for employees. Health systems and hospitals can work with community organizations such as the chamber of commerce to find job opportunities for the spouses or partners of recruits. They can find community partners for childcare or offer on-site childcare.
  • Consider culture in recruitment: Health systems and hospitals should discuss the pros and cons of their community with recruits to make sure it matches their lifestyle and professional expectations.
  • Offer competitive financial benefits: In addition to competitive salaries, health systems and hospitals should offer financial benefits such as pay for mentoring, relocation expense assistance, and student loan assistance.
  • Launch in-house staffing agencies: Health systems and hospitals can have their own staffing agencies for nurses and clinicians that offer the premium pay and flexibility of travel agencies but have the stability of working for a single employer.

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.